Manual of Medical Laboratory Techniques
Editors
S Ramakrishnan MA PhD FAMS
Professor Emeritus Department of Biochemistry & Cell Biology Vision Research Foundation Sankara Nethralaya,
Chennai, India
KN Sulochana PhD
Director Department of Biochemistry & Cell Biology Vision Research Foundation Sankara Nethralaya,
Chennai, India
Foreword
SS Badrinath
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This book has been published in good faith that the contents provided by the contributors contained herein are original, and is intended for educational purposes only. While every effort is made to ensure accuracy of information, the publisher and the editors specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the editors. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
Manual of Medical Laboratory Techniques
First Edition: 2012
9789350256343
Printed at
To
His Holiness Kanchi Maha Perriyaval with Our Sincere Pranams
7CONTRIBUTORS
- Angayarkanni N msc mphil phd
- Reader & Head
- Department of Biochemistry and Cell Biology
- Vision Research Foundation
- Sankara Nethralaya
- Chennai, India
- Doreen Gracias mbbs dcp phd
- Consultant
- Lecturer
- Hematology and Clinical Pathology
- Medical Research Foundation
- Sankara Nethralaya
- Chennai, India
- Jyotirmay Biswas ms fnams fic (path)
- Director of Uveitis & Ocular
- Pathology Department
- Sankara Nethralaya
- Chennai, India
- Krishnakumar S md
- Deputy Director of Research
- Director
- Nanobiotechnology Department
- Head
- L & T Department of Ocular
- Pathology
- Vision Research Foundation
- Sankara Nethralaya
- Chennai, India
- Kumaramanickavel G md
- Former Professor
- SN ONGC Department of Genetics and Molecular Biology
- Vision Research Foundation
- Sankara Nethralaya
- Chennai, India
- Lily Therese K phd
- Professor & Head
- L & T Microbiology Research Centre
- Vision Research Foundation
- Chennai, India
- Madhavan HN md phd fams fic (path)
- President
- Vision Research Foundation
- Director & Professor of Microbiology
- Director
- Vidyasagar Institute of Biomedical Technology & Science
- Sankara Nethralaya
- L & T Microbiology Research Centre
- Chennai, India
- Madhavan Jagadeesan mbbs do phd
- Former Head of the Department
- SN ONGC Department of Genetics and Molecular Biology
- Vision Research Foundation
- Sankara Nethralaya
- Chennai, India
- Mahalakshmi B phd
- Lecturer
- L&T Microbiology Research Centre
- Medical Research Foundation
- Sankara Nethralaya
- Chennai, India
- Malathi J phd
- Reader
- L & T Microbiology Research Centre
- Vision Research Foundation
- Chennai, India
- Punitham R bsc dmlt
- Lab Manager
- Department of Biochemistry and Cell Biology
- Medical Research Foundation
- Sankara Nethralaya
- Chennai, India
- Ramakrishnan S ma phd fams
- Professor Emeritus
- Department of Biochemistry & Cell
- Biology
- Vision Research Foundation
- Sankara Nethralaya
- Chennai, India
- Ramprasad VL phd
- Former Lecturer
- SN ONGC Department of Genetics and Molecular Biology
- Vision Research Foundation
- Sankara Nethralaya
- Chennai, India
- Soumittra N phd
- Lecturer
- SN ONGC Department of Genetics and Molecular Biology
- Vision Research Foundation
- Sankara Nethralaya
- Chennai, India
- Sripriya S phd
- Lecturer
- SN ONGC Department of Genetics and Molecular Biology
- Vision Research Foundation
- Sankara Nethralaya
- Chennai, India
- Vasanthi SB mbbs diplomate of american board of pediatrics
- Director
- Sri Nathella Sampathu
- Chetty Clinical Laboratory Services
- Medical Research Foundation
- Sankara Nethralaya
- Chennai, India
- Vinita Kumari ms mlt
- Junior Scientist
- SN ONGC Department of Genetics and Molecular Biology
- Vision Research Foundation
- Sankara Nethralaya
- Chennai, India
I do not indulge in any language of exaggeration when I say that the book entitled Manual of Medical Laboratory Techniques released by the Medical and Vision Research Foundation and Vidyasagar Institute of Biomedical Technology and Science, Sankara Nethralaya is “All-in-one” in two respects—it covers all the relevant subjects, namely Clinical Biochemistry, Medical Microbiology, Hematology, Genetics and Molecular Biology and all the necessary diagnostic tests in each specialty. The analytical procedures form a large spectrum—from the common tests like blood glucose estimation and simple microscopy to highly-sophisticated techniques like High Performance Liquid Chromatography.
There are no two opinions in the fact that application of medical laboratory techniques goes a long way in the diagnosis and differential diagnosis of diseases. It is common knowledge that correct diagnosis is a ‘MUST’ to institute proper therapy and thereby alleviation of human suffering. As such, this book will help the medical fraternity to achieve the goal of ‘EFFECTIVE PATIENT CARE’. I have no doubt that the technical staffs involved in analytical work, scientists, doctors and researchers would find the information given in the book very useful. In addition, votaries of microbiology and biochemistry in science colleges would also be benefited, as such books are few and far between. It is worth having the book as a priced, lifetime possession of the concerned staffs and the students, and in the libraries of medical institutions, hospitals and science colleges.
The untiring efforts of Dr S Ramakrishnan in education and training to younger generation imparted in our institution, are most laudable.
The book is jointly authored by highly qualified and experienced teachers who are also researchers and technologists of Medical and Vision Research Foundation and Vidyasagar Institute of Biomedical Technology and are experts in the field. Hence the “last word” has been given by them in the performance of each test efficiently and with precision. I could imagine the hard work they would have put in preparing the text, in spite of their heavy academic and professional schedule. I hasten to congratulate them for their valuable contributions to the discipline of medical technology and thereby service to the patients.
I thank Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, for having readily agreed to publish the book. I know they are second to themselves in the publication of a series of Medical books of value.10
As Chairman-Emeritus, I am happy to record that the ushering-in of the Manual of Medical Laboratory Techniques has got one more feather to adorn the crown of Sankara Nethralaya, the mother-organization of Medical Research Foundation and Vision Research Foundation and Vidyasagar Institute of Biomedical Technology and Science.
SS Badrinath
frcs(c) frcs (edin) dsc fams
Chairman-Emeritus, Sankara Nethralaya
Chennai, India
11PREFACE
“There is no wealth above the wealth of health.”
(Proverbs and wise sayings, Paul Vithayathil, 7th Edn, Vithayathil Publications, Cochin, India).
One can afford to lose wealth but not health which is a ‘must’ for happiness in life. No wonder ‘health for all’ is our goal. Strictly speaking, it should be the international goal too. For achieving this, diseases have to be erased from the Globe. It is impossible, as the cheapest commodity available at present appears to be only diseases! Hence, all attempts should be made to control and cure the diseases, to make the people happy—thanks to the medical and the technological professionals who strive and serve, day-in and day-out, devoting themselves to the care of the patients and alleviation of their sufferings.
Therapy and cure of a disease will be a success only if the diagnosis is correctly made. Application of Medical Laboratory Techniques is the sheet anchor for proper and precise diagnosis. Medical laboratory technologists belong to various specialties like Medical Microbiology, Hematology, Histopathology, Clinical Biochemistry, Human Genetics and Molecular Biology. Though the disciplines are different, there is unity in diversity, as the one and only mission of their votaries is to use, and, if possible, improve and innovate unfailing and sophisticated techniques in their respective fields in diagnosis, differential diagnosis, monitoring and if possible, cure of diseases of bewildering complexity—be they infectious or immunological, hematological or pathological, metabolic or genetic or just common.
The book Manual of Medical Laboratory Techniques is the essence of the subject jointly authored by highly qualified and experienced teachers, researchers and technologists of Medical and Vision Research Foundations, Vidyasagar Institute of Biomedical Technology and Science, Sankara Nethralaya, India, and is a presentation of diagnostic tests in their own specialties. Principles, methodologies, results, norms, interpretations, diseases concerned and bibliography have been given for the tests. Attractive illustrative diagrams are also given. Equal coverage has also been made for instrumentation. In short, it is all-in-one in medical laboratory techniques. A fact which deserves special mention is that a laboratory scientist can perform these tests without external guidance. The authors are confident that medical and technical institutions, hospitals, clinical laboratories, teachers, clinicians, technicians and students will find the book very useful and worthy of life-time preservation.12
The authors do not find suitable words to express their sincere thanks to Dr SS Badrinath, Chairman Emeritus, and Dr Bhaskaran, Chairman of Medical Research Foundation for their constant encouragement and Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, for publishing the book. Thanks are also due to many colleagues who have helped in the manuscript preparation of the book, correction of proof and secretarial work. Our special thanks are due to Smt K Parvathy Devi of the Biochemistry Research Department for sustained coordination and giving the final shape to the book.
S Ramakrishnan
KN Sulochana