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Pathology


High quality Pathology & diagnostics are an imperative for better treatment and patient care. Health issues are steadily rising in both, rural and urban population, due to various factors. Detecting a health problem at an early stage is vital. One of the best approaches to keep track of your health is to visit our centre and undergo screening tests. At Madicate, We committed to provide consistently superior quality health care services to address the day-to-day health care needs of the family.

Today, laboratory testing is performed in many different settings, from the large, highly automated central laboratory that performs thousands of tests a day to your own home, where you might do a pregnancy test or monitor your blood glucose levels. Samples can be blood, urine, a throat or nose swab or a piece of tissue - even a biopsy taken while you are under anaesthetic on the operating table.

pathology
pathology
pathology

Pathology Facilities


  • Hematology
  • Serology
  • Biochemistry
  • Electrolyte
  • Immunology
  • Microbiology
  • Histopathology
  • Cytology

Hematology -1

Hematology

Hematology ('hema-' is from the Greek word for 'blood') is the study of blood in regards to a person's health or disease. It includes blood, blood-forming organs, and the proteins involved in bleeding and clotting.

Hematological tests can evaluate numerous conditions involving blood and its components. They can also be used to diagnose inflammation, anemia, infection, hemophilia, blood-clotting disorders, leukemia, and response to chemotherapy, among many other things. Let's take a look at some of these tests.

Complete Blood Count Test and Components:

A complete blood count (CBC) measures several components and features of your blood. A CBC and its individual components are tested on whole blood. It can include measurements of the following:

White blood cells

White blood cells (WBC) make up the body's primary defense system and knowing their number is an important tool in diagnosing and monitoring infection and leukemic disorders. A normal WBC level is 4,500 - 11,000 per mm³ of blood.

Increased WBC levels are most notably found in those with any type of infection, but are also found in anemia, collagen disorders, and those with physiologic stress, such as pregnancy. Low WBC levels are seen in malnutrition, rheumatic disorders (lupus, arthritis), some viral infections, and those undergoing chemotherapy or other forms of bone marrow suppression.

Red Blood Cells

Red blood cells (RBC) are responsible for the transport and exchange of oxygen. Measurement of RBCs is important in monitoring the effects of blood loss and the progression of chronic disease. Normal counts of RBCs are 3,900,000 - 5,800,000 per mm³ of blood.

RBC values are increased in those with anxiety or stress, bone marrow failure, and dehydration. A decreased RBC value will be found in those with chronic inflammatory diseases, chemotherapy patients, anemia, blood loss, and many cancers.

In addition to a count of WBCs and RBCs, a complete blood count can include further tests to evaluate the size, weight, and shape, of those cells. These more detailed tests are helpful in diagnosing and monitoring therapy for cancer and anemic patients.

Hemoglobin

Hemoglobin (HgB) is the oxygen-carrying protein in red blood cells. Hemoglobin levels are a direct reflection of the amount of oxygen in the blood. A normal hemoglobin concentration is 11-15 grams per deciliter (g/dL) of blood.

Increased HgB is seen in those with dehydration, chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF), and those at high altitude. A decreased HgB value is seen in anemia, blood loss, liver disease, as well as leukemia and lymphomas.

Hematocrit and Platelets

Hematocrit (HCT) is the proportion of red blood cells to plasma, the fluid component of your blood. HCT helps to evaluate anemia and hydration. A normal percentage of hematocrit is 33 to 49%. The increase and decrease levels of HCT mirror those of hemoglobin.

RBC, HgB and HCT tests parallel each other and are frequently used together to evaluate anemia.

Platelets (PLT) have an essential function in blood clotting. A normal value is 150,000 - 450,000 platelets per mm³ of blood.

An increased platelet value is seen in conditions that involve inflammation such as acute infection, trauma, and some malignant cancers. A decreased platelet count is found in alcohol toxicity, anemia, blood loss, infection, many congenial conditions, and coagulation disorders.

Serology -2

Serology

Serologic tests are blood tests that look for antibodies in your blood. They can involve a number of laboratory techniques. Different types of serologic tests can diagnose various disease conditions. Serologic tests have one thing in common. They all focus on proteins made by your immune system. This vital body system helps keep you healthy by destroying foreign invaders that can make you ill. The process for having the test is the same regardless of which technique the laboratory uses during serologic testing.

Why Do I Need a Serologic Test?

To understand serologic tests and why they're useful, it's helpful to know a little about the immune system and why we get sick.

Antigens are substances that provoke a response from the immune system. They are most often too small to see with the naked eye. They can enter the human body through the mouth, through broken skin, or through the nasal passages. Antigens that commonly affect people include the following:

  • bacteria
  • fungi
  • viruses
  • parasites

The immune system defends against antigens by producing antibodies. These antibodies are particles that attach to the antigens and deactivate them. When tests your blood, they can identify the type of antibodies and antigens that are in your blood sample and identify the type of infection you have.

Sometimes the body mistakes its own healthy tissue for outside invaders and produces unnecessary antibodies. This is known as an autoimmune disorder. Serologic testing can detect these antibodies to help your doctor diagnose an autoimmune disorder.

What Happens During a Serologic Test?

A blood sample is all that the laboratory needs to conduct serologic testing.

The test will occur in your doctor's office. Your doctor will insert a needle into your vein and collect blood for a sample. The doctor may simply pierce the skin with a lancet if conducting serologic testing on a young child.

The testing procedure is very quick. The pain level for most people isn't severe. Excessive bleeding and infection may occur, but the risk of either of these is very low.

What Are the Types of Serologic Tests?

Because antibodies are so diverse, various tests are useful for detecting the presence of different types:
  • An agglutination assay shows whether antibodies exposed to certain antigens will cause particle clumping.
  • A precipitation test shows whether the antigens are similar by measuring for the presence of antibody in body fluids.
  • The Western blot test identifies the presence of antimicrobial antibodies in your blood by their reaction with target antigens.

The testing may also diagnose an autoimmune disorder. In that case, antibodies to normal or non-foreign proteins or antigens would be present in the blood.

The presence of certain types of antibodies can also mean that you're immune to one or more antigen. This means that future exposure to the antigen or antigens won't result in illness.

Serologic testing can diagnose multiple illnesses, including:

  • brucellosis, which is caused by bacteria
  • amebiasis, which is caused by a parasite
  • measles, which is caused by a virus
  • rubella, which is caused by a virus
  • HIV
  • syphilis
  • fungal infections

What Happens After Serologic Testing?

The care and treatment provided after serologic testing can vary. It often depends on whether antibodies were found. It may also depend on the nature of your immune response and its severity.

An antibiotic or another type of medication may help your body fight the infection. Even if your results were normal, your doctor might order an additional test if they still think you might have a specific type of infection.

The bacteria, virus, parasite, or fungus in your body will multiply over time. In response, your immune system will produce more antibodies. This makes them easier to detect as time goes on and the infection gets worse.

The tests results may also show the presence of antibodies related to chronic conditions, such autoimmune disorders.

Biochemistry -3

Biochemistry

BLOOD COLLECTION AND BLOOD TEST

Blood tests are recommended to be conducted for preventive purposes once a year until one is 50, after that, every six months. Different metabolic and other disorders that occur in the body may be detected in blood tests. Everybody has its own specific enzymes, proteins or other organic molecules. As the blood system passes through all the organs, provides food to the cells and eliminates unnecessary and harmful products of the metabolism, any change in an organ(s) will be reflected in the blood circulation with the change in the concentration of enzymes, proteins, electrolytes, etc.

BIOCHEMICAL ANALYSIS AND BLOOD EXAMINATION

After collecting blood in different tubes with or without anticoagulant (e.g. the blood count requires EDTA anticoagulant, whereas most biochemical analysis need blood coagulation to obtain serum on which most analyses are conducted), blood/serum is analysed in different machines depending on the group of analyses. The main metabolic parameters (glucose, fats, proteins, enzymes) are determined with biochemistry analyzers which operate on the principle of photometry/spectrophotometry, while hormones and tumor markers are determined with immunochemistry analyzers. Their determination is mostly based on At-Ag reactions. The blood count with a differential leukocyte formula is determined with hematology analyzers, whose operation is based on different principles (ranging from potentiometry to flow cytometry, etc.) Most biochemistry analyses in Beo-lab are conducted with the most advanced integrated biochemistry autoanalyzer by ABBOTT company.

BLOOD COUNT ANALYSIS

A complete blood count analysis most often implies the blood count performed on the hematology analyzer. Today there are different hematology analyzers with at least 8 parameters to more than 20 parameters in the blood count analysis. To gain a general overview and control of the blood count, it is sufficient to conduct an analysis on the hematology analyzer with 8 parameters. Anemia or other hematological diseases require a hematological analyzer with more than 8 parameters.

INTERPRETATION OF LABORATORY AND BIOCHEMICAL BLOOD FINDINGS (RESULTS)

Interpretation of biochemical findings at a personal request will be provided by a Beo-lab specialist. Interpretation of biochemical results is a responsible and complex obligation of a specialist, and it requires a detailed analysis of every pathological finding.

BLOOD COUNT INTERPRETATION

Blood count interpretation, also at a personal request of the patient, will be provided by Beo-lab specialists. Blood count results reflect the number of blood cells in the bone marrow, and their ratio in blood circulation. The number of blood cells (leukocytes, erythrocytes and platelets) as well as the concentration of hemoglobin, hematocrit and other blood count parameters affect interpretation of the blood count.

REFERENCE VALUES OF BLOOD, BLOOD COUNT AND OTHER BIOCHEMICAL PARAMETERS

Reference values (an earlier term "normal values") of the blood count and biochemical analyses are predetermined ranges of concentrations of every parameter separately, depending on the gender and age of the patient as well as on reagents and devices used in the analysis. Every laboratory is required to indicate reference values depending on reagents and devices used.

LABORATORY URINE FINDINGS

A laboratory urine finding may have several meanings depending on the present urine parameters. The finding may be normal, which means that the analysed urine parameters are within the normal range. Also, the finding could be pathological according to a parameter (e.g. more than 5 leukocytes or erythrocytes are present, or positive glucose or hemoglobin in urine is found, etc.).

Electrolyte -4

Electrolyte

An electrolyte disorder occurs when the levels of electrolytes in your body are either too high or too low. Electrolytes are naturally occurring elements and compounds in the body. They control important physiologic functions.

Examples of electrolytes include:

  • calcium
  • chloride
  • magnesium
  • phosphate
  • potassium
  • sodium

These substances are present in your blood, bodily fluids, and urine. They're also ingested with food, drinks, and supplements.

Electrolytes need to be maintained in an even balance for your body to function properly. Otherwise, vital body systems can be affected. Severe electrolyte imbalances can cause serious problems like coma, seizures, and cardiac arrest.

Symptoms of electrolyte disorders

Mild forms of electrolyte disorders may not cause any symptoms. Such disorders can go undetected until they are discovered during a routine blood test. Symptoms usually start to appear once a particular disorder becomes more severe.

Not all electrolyte imbalances cause the same symptoms, but many share similar symptoms.

Common symptoms of an electrolyte disorder include:

  • irregular heartbeat
  • fast heart rate
  • fatigue
  • lethargy
  • convulsions or seizures
  • nausea
  • vomiting
  • diarrhea or constipation
  • abdominal cramping
  • muscle weakness
  • muscle cramping
  • irritability
  • confusion
  • headaches
  • numbness and tingling

Causes of electrolyte disorders

Electrolyte disorders are most often caused by a loss of bodily fluids through prolonged vomiting, diarrhea, or sweating. They may also develop due to fluid loss related to burns. Certain medications can cause electrolyte disorders as well. In some cases, underlying diseases are to blame.

The exact cause may vary depending on the specific type of electrolyte disorder.

Conditions caused by electrolyte level imbalances include:

  • calcium: hypercalcemia and hypocalcemia
  • chloride: hyperchloremia and hypochloremia
  • magnesium: hypermagnesemia and hypomagnesemia
  • phosphate: hyperphosphatemia or hypophosphatemia
  • potassium: hyperkalemia and hypokalemia
  • sodium: hypernatremia and hyponatremia
  • Calcium : Calcium is a vital mineral that your body uses to stabilize blood pressure and control skeletal muscle contraction. It's also used to build strong bones and teeth.

Risk factors for electrolyte disorders

Anyone can develop an electrolyte disorder. Certain people are more at risk because of their medical history. Conditions that increase risk for an electrolyte disorder include:

  • alcohol use disorder
  • cirrhosis
  • congestive heart failure
  • kidney disease
  • eating disorders, such as anorexia and bulimia
  • trauma, such as severe burns or broken bones
  • thyroid and parathyroid disorders
  • adrenal gland disorders
  • Preventing electrolyte disorders

Immunology -5

Immunology

Immunology deals with physiological functioning of the immune system in states of both health and disease as well as malfunctions of the immune system in immunological disorders like allergies, hypersensitivities, immune deficiency, transplant rejection and autoimmune disorders.

Immunology deals with physical, chemical and physiological characteristics of the components of the immune system in vitro, in situ, and in vivo. Immunology has a vast array of uses in several disciplines of science and medical science.

We offer a wide range of immunologic tests. These include the following:

1 . Tests for evaluation of hyperproteinemias and immune deficiencies: This includes serum, body fluid and urine electrophoresis and individual quantification of immunoglobulins.

2. Tests for immune-mediated disease: This includes antinuclear antibodies (ANA) testing, rheumatoid factor (RF) testing, Coombs testing and crossmatch (for transfusion and diagnostic purposes, i.e. mare-foal or mare-stallion incompatibility).

Microbiology -6

Microbiology

Microbiology is the study of microscopic organisms, such as bacteria, viruses, archaea, fungi and protozoa. This discipline includes fundamental research on the biochemistry, physiology, cell biology, ecology, evolution and clinical aspects of microorganisms, including the host response to these agents.

Pathogens

  • Salmonella
  • Listeria
  • E.coli 0157
  • Campylobacter
  • Shigella
  • Vibrio

Typical enumerations

  • Cl. perfringens
  • Coliforms
  • E.coli
  • Enterobacteriaceae
  • Pseudomonas aeruginosa
  • Staphylococcus aureus
  • Total Viable Count (TVC)
  • Yeast and Moulds

Histopathology -7

Histopathology

Histopathology is the microscopic examination of biological tissues to observe the appearance of diseased cells and tissues in very fine detail.

Histopathology test procedure involves examination of sampled tissues under a microscope using three types of specimens:

* Larger specimens The larger specimens include organs or parts of organs that are removed during surgical operations. For instance, large bowel after a colectomy, tonsils after a tonsillectomy, etc.

* Pieces of Tissues The test also involves pieces of tissues that are taken for performing the test.

* Fluid and tiny pieces of tissues Fluid and very small pieces of tissues (individual cells or group of cells or fluids taken from around the lungs, etc.) can be obtained via a fine needle aspiration (FNA).

Uses of Histopathology

The samples of the tests performed by the histopathology laboratory are primarily used in clinical medicine which typically involves a biopsy process, i.e. a surgically removed sample from a patient for detecting the presence of cancerous cells in the body. Histopathology test is done by a specialist physician known as Histopathologist.

The specimens taken out during the test are processed using special histological techniques at a specialised histopathology laboratory. The disease cells and biological tissues are also studied for several other reasons, such as?—?to investigate crimes including to look for causes of injury or death, to examine historical artefacts containing biological tissues, to study regarding ancient diseases also known as paeleopathy by using histological techniques.

As mentioned in the histopathology test list, some of the specimens that are required to be taken out from the body parts need initial tissue preparation. These are then analysed using appropriate techniques.

Cytology -8

Cytology

Cytology is most often used as a screening tool to look for disease and to decide whether or not more tests need to be performed. An example of screening would be the investigation of a breast lump. In combination with examination by the clinician and imaging tests, a needle aspirate of the lump submitted for cytology will show whether the breast cells are suspicious for cancer or look bland/ benign. If they look suspicious, a core biopsy with a larger needle may be performed which takes more tissue, allowing for a definitive diagnosis to be made before deciding what type of surgery is required (local removal of the lump or removal of the whole breast).

Exfoliative cytology

This is the analysis of cells that are shed from body surfaces. Examples include the lining cells of the uterine cervix (mouth of the womb) and of the bladder. The analysis of cells from the cervix is a minimally invasive procedure called a cervical or Papanicolaou smear (Pap smear). This involves the insertion of a speculum into the vagina to allow the clinician to directly view the cervix. The cervix is then gently scraped to retrieve cervical cells which are smeared directly onto glass slides at the bedside and submitted to a laboratory for examination. The material from the cervical scrape can also be directly tested for wart virus (Human Papilloma Virus), the major risk factor for the development of cervical cancer.

Aspiration cytology

This is the analysis of cells from within a mass or organ. This involves a more invasive sampling procedure called Fine Needle Aspiration (FNA). A needle is inserted into the area of the body being examined, sometimes with the use of imaging (e.g. ultrasound or CT scan) to ensure that the suspicious area is being sampled. This procedure may be performed after injection of local anaesthetic to numb the skin, or even under light sedation if involving a deep organ or tissue. The cells retrieved are expressed onto a slide and prepared in a similar way to the cervical smear. If fluid is aspirated (e.g. within from a thyroid cyst), it may first be spun by a centrifuge so that the cell-containing sediment collects at the bottom of the test tube, allowing the best material to be sampled for examination.