Part 2
Part 2
-          ~- --_,-er-------=.,.;.------
                                    . .,- - ~
                                                                            -       ~
                                                                                        ~
                                                                                            20
                                                                                                 r,
                                                                                                 e:;
• ~ pl.p.eru_ ~ 0 ~ ~ ~ with O
                                      ~ G6 na .e m D ~ m ~
                                                           .
 9f   ~ AJ.,()_W   fo"r   ~
 -                        erform . Cost of estimatio n i s rnin ·
         •    Easy top                                                     'tnai anc1
                                                                                        le~~ r
                                                                                             11').
                                                                                                 'r
   . adyantages
 DIS                              d      h"
 -         . . , ,, visual 111etho . mate m g of co lot1 r tnay
     • As 1t ,s ,, ·
                              GA                                Var
        (Ennr: Above 5- IO ~ ).                                     Y ftlJ'n
                                               . d                                                    \'Jo.,
                                                                                                                                   1
                     ost1·mate aJI type of haemogl obin.
     •       Do no t '- •
 ~ormal Values
     •       Adult males = 14 -18 (16 +/-2) g/dl of Blood.
     •       Adult female= 12-16 (14 +/-2) g/dl of Blood
     •       In newborns = 16-22 g/dl of Blood by 4 months it de creasestoq
     •       By 1o years = 12 -14 g/dl                                     ,
             1st reading Gust dark) ... ... .l.1-... ....... . . .. ... .. .. ... ... gjdl
             2 reading (same) ... .. . ... r~
              nd
                                                       ..... .. .. .. ..... ..... ... gm I dl                      Q. l Ho" will
                                                                                                                   amount ot" " hl
                                                                                                                                      l
              rd
             3 reading Gust light) ... .. _I~ ... . . . .. .. . . .. . . . . ... . . .. .. . gm I dl                Q..2 Can we u.,,
                                                                                                                     Q3. What ha
     ❖ The average of above three readings is taken as haemoe,olobin cont:~                                          distilled watc,
Q4. Out uf 1
% µn ~
                                                                   22
                                     Golden-twvwn                  20
                                      lllaa ■oda                   ••
                                                                   18
                                                                   ••
                                      Pla■llcbox                                                           0.02 ml
                                                                                                           (20 µ))
                                                             20
                    Com para tor
                                                        Hemoglobin tube
                                                                                                 Hemoglobin pipette
                                                                                                                                Stiffer
           Fig: Com pon ent s of Sah li's h
                                                      . meter.
                                              aemoglobmo
Questions
~ 0f-                                                                                           ~
                      lnCJ<Q!lQQlll Hamui\}Wb-(n ffiWlt (l, knswn_ a1, It) L Cf' THE M/ft /lfld &><
            (ERYlHRomos,s         .
             v.JJ c.ori9e.ru1cu ltW»U ~  ~~ ~ =:                   taJ   ~         - laituiut_Uow o?UJ'JRil WJelJ
                                                                                   _Questions
                                                                         ma peripheral smea r?
                                                          e can get f ro
                                                             .                                       .
                                  Q.1 What information on
                                                            . .      dafte r two minutes and not earlier?
                                  Q.2 Why Leishman 's stain is dilute
-1;rv J.l..P.k _ 2 ~ -        Jrn. stain          nao to         be,    R.Li)+ fa"r 2 rnmukD ~                            mru a L~~ .
              ~ Jhl! i!                                            fhQ_     ~                   .nrrto w-nm rmfuJf ~                          -
              ~~ ~ 0f) itlQ ~                                                       . NO J ~                 ~~                        -th1!
             Jirru         (ljJ   fu .&tain p~                            aJ{_Q,   .iJJ   mm ·- ~ ~ and                            (l__QN ) o  t
             enw -t          WJj .
                 PRECAU TIO NS
                                                                                         h
                        The qual ity of the sme ar shou ld be assessed before st artrng t e count.
                                                                                    ·
                    •
                                                                   '·
                                         th roug hout the leng th of the smear           h
                    •   Counting   cells
                                                                         .     ' except t e extreme ends of
                        head and tai I.
MONOCYTES 2-6 %
1 oil- Results
:d.
                 Record your results as under:
                 NEU TRO PHI LS                    --------    %
                 EOSINOPHILS                       -------- %
                                                   ___ Q ___
                 BAS OPH ILS                                   %
                                B. t\BSOLUTE W .B.C CO
                                                      UNT
                          . . l . nt typ e wh ite ce ll s
                e count   ot d1t et e                      is the expressio
   •   Ab solut                                           .
                              , . the blo od str ea m. Th is .               n of the
              . f the se cells u1                            inv olv es a differ . 1~1~
       wm ~1 0                                                                  ent1a1
       and      \W
            tot a
                   B c.
                    · ·
                         coun  t.                                                      '
CALCULATION :
Ab solute count of. a type o f white cells ==
                                                                           •
                                                                           l
                                                                                                   1111 \. . ,   , , ,   , , , ...
                                                               , . ,,   '''"   l , , , . \.I\. I
                                                        - -~
                                                 e b -1 ·                                       .
                      in an y tw o of th e au,·ac nt nn er Im es and neg lec t th e oth er tw o
                                             -
        PR EC AU TI ON S
                                                  ou ld he ct<'an <1 nd dr
                                                                              y.
           •          A l l th e eq uip me nt sh                                                    ·      ·
                                            ou ld  he  Llc' c) ,       I                                  ot blood . D o
                      Th e pu nc   tur e sh                                              ontaneo us I low
           •                                                 l l nn u g 1 l o t1 1l ow sp
                      no t sq ue c7e.
                                                up tn 0 ..1 ll Htrk s.
            •         Ta ke blo nd l'\t lct l y
                                                                              hlo od .
                                                  r be for e di lut in g th e
            •         W ipe the tip of pip ctt
                                                                                               blood c lot s in the
                                          "
                                          l 'lt e sh ou ld be dil ute d qui ck ly. oth erw ise
            •         Bl oo d in th e pip
                      pip ett e.
                                                                                                drawn mu c h abov e the
                                    ng   flu id   ex ac tl y  up to IOI ma rk . If fluid is
            •         Su ck dil uti
                                                                                          proce dure.
                            . dis ca rd  thi s. c lea n  the pip ett e and res tart the
                      ma rk
                                                                                               of the bulb .
            •                    ha rg ing   the   ch am   be r. ge ntl y mi x the co nte nt
                      Be fo re c
                                                                                                          t contain ce ll s .
                                                                 flu id as fluid in the stem do es no
            •         Di sc ard the fir st   tw  o  dr op  s of
                                                                                      ov erf low .
                                                      ed an d flu id sh ou ld no t
            •         Bu bb les mu st be av oid
                                                       un de rch arg ed .
            •         D o no t ov er ch ar ge d or
n~                                                                                            d rec ha rge .
                                                of  ce lls  is no t un ifo rm , dis ca rd an
            •         If the dis  tri bu tio n
                                                      me ce lls tw ice .
            •         A vo id co un tin g the sa
                                                                                                                                               ~~
                                                                                                                                                   LI     t '\.    i,-.)   1) I
                                                                                                                                                                           1
                                                                                                                                                          I   -
                                                                                                                                                              w      :)        :.i
.in1:
                                                                                                      ■
                                                                                                                                         =
                                                                 ~                                                                       -
                                                                                                                                         --
                                                                                     ■
ar 11
--
          -..-10 I C\           e       ct
                                                                        ■                               •                                               ',J
                                                                                                                                                        5
                                                                                                                                                        LI
                                                                                                                                                              l~     t\~ I 11
                                                                                                                                                                  11 I '
                                                                                                                                                                  ' O I?
                                                                                                                                                                               1
                                                                                                                                                                                 I ~
                                                                                                                                                                                        l
                                                                                                                                                                                       .)
                                                                                                                                                                                            I
er.
                                        rt                                                                                                               6 I6         i'         I     J
                       1 e
               '
                                                                                                                                               J
                                                                                                                                     I
                                             -
                /lJ     6       t   i Q
                                                                              colour)
                                                       eubauer's chamber (red
                            I       T
                         '              '\
                       ~ I 10
           -
         -Fig:°' AreaI s for red bl ood ceII count on
                                                      N
                                                                                                                                                                                       11 3
-
 CALC l lLATION                                                                                                      Q .·1 List   ll
                                                    . , I (di luti on factor )
                             . . . )11 nl)t.-1111n
             1-ulatinn i )t d1h1t11                         , . , of th e pipcll r to m ark I ) co ntain u·1
                                                                                                          1
                                                                                                            ll Ing   Q2. Wh y
        ❖ C at                     .   'Ill' ( frOtl  l  th < 111
                        111  nf  pipt                 , rt in dilutio n .
                                                                                                                     pipet te b
          • 111c stl'
                                        )1 1·1kc pa
              flui d tlllll dnCS 111 •                                                                                Q3. Wh ~
                                                ill l)ltlb
                     •      ) ,c111-s 0 11 ly                 ) I 1- 1()())
          • Oilutl\)11 l l           .
                                               . . I 00 ( l ( - -
                                    .                                                                                 Q4. Ho"
          • 1l1C , •,1hl11H' 1)f t)lllb lS
                                                                                                                       Q5. G iv
                                                   Fin al vo lume attain ed ( I 00 parts)
                                         =         Volum e of blooJ taken (0.5 parts)
  The dilution factor is
= 200
RESULT
    •                                               s·,~,           ..
           RBC count ofmy blood ·•s .... ·'· .. .. .. . m1lhons / Cu.mm of blood
Q 4 · 1--tow '
- 200
                                              .
                            = I -' mm·
                   •   Dt-,pth ,"': the chamber             = I /IO mm
               •       , ,,Ju:nt"   (1 1   flui d in five RBC sq uares
                           = 1 5mm : x 111 0 mm
                                              ,
                           = I 50 mm
               • u cell , 1n 1/50 mm ' vo lume of diluted blood                               is ' N '
                                                         3
               •       Therefore . number of RBCs in I mm of diluted blood = N x 50
                                                                                    3
               •       Therefore. number of RBCs in I mm of undiluted blood
                          =~    x 50 x Diluted factor (200)
                          =~    X    J0.0QQ
:RESLLT
                                                                                                                       1-ud
                       1Ylb~um.Qflt .
                        '3 + l1    ~ () Llf.lQci CU:>      <1JJ0J. -\1·-·nao fX-PWe.. -
                   ~ ~ \ ) ~ ~ a.n.ol ~                                                                   .                  115
- - - --   ~ -   --   - --- -
                                ---- -
                         C' ' " c- ll IC en 1
          •   o tscard
                ·     the f trst two dr   · a 11be1.. ~oenu y rni, th.... \ llll' pr ncedure .
          •   Bubbl es must b .
                                 e avoided. opsa of t7 u1<.1
                                                         • a tl . e cnnt ent nr th
                                                             s U1d in th                 e h11lh .
          •   Do not overch at
                            · .ged .     nd fi11id sh
                                                   · nu ld n     e stern line ". nnt c un
          •   If ti d'            O ' un,krch                nt nvern                     tarn cell,
                   1t'   istribut'                         arged                  ow
                                  1011 ofL·rll ·.                .
          •   A .                                 s is n t
               vnid l'otmt i 11 ~o tl 1l' <.'•.l,    , o uni fnrrn • C1·I SC '> I
                                          •Hl ll{' ce ll '    . .
                                                        s twice           ' nr( and recharge .
OBSERVATION
rto
10
                                                                                          1   mm
:ll
                                                             3"""
Fig: Areas for white blood cell count on Neubauer's chamber (L).
      CALCULATION
      •   Calculation of dilution obtained (dilution factor)
              • The stem of pipette (from the tip of the pipette to mark l) contains
Q l. Why RBCs ar
                    ocytosis?. G.ive so
                                        counti. ng WBC?
                                        me causes respon
                                                                  Questions
                                                  '4     ~   , ~                                                                J
                  •   .
                              ~ -~                                                                                          L-lJ.UY)
~ 2> i - J~ tew n ~ l2. ©-btm
                                                    ~ Q.{_Q_,Q_,uil         {fwrn_       ~ pM-0 cll,LUW7) ~                            w~ -
                  ~p .m i.u . ~t
                      W--l ~ M\--            ~u um 09-L'Dofu .) ~ ,
                                                           LUili£oJ1.Bn OJtd                                  '.J
                                                       m etnct unrnune -
                      ~ ~ ~~ m m '.) ~      1
                                                            ,
                       VJD ~ ~ to ~ ~ ·
                                                                                                                                                         7
                                                                                                                                12 l
                                                                                                                                              ....
         RESUL TS
      ❖ Nornia lly it is I to 5 Mi          t
                                          nu es by Duke's method .
     ❖ Definit ion: It is the measure of the time taken by blood to form coagulam
     •!• The two method s commo nly used to determine the C .T .                        .
                     •    Wright 's Capillary Glass Tube Method
                     •    Lee and White Methods
 •           The Wrigh t's Capilla ry glass tube method is routinely used in clinical
             laborat ories to determi ne CT.
                                  Wright 's Capillary Glass Tube Method
PRINCIPLE
         •      A deep punctu re is made in the skin and blood is taken into a capillary glass
                tube. The time that it takes for the blood to clot. as detected by the appearance
     •        Stopwatch,
              Wright ' s capillary glass tube
     •
                                                                                        -
                                                                                                  ()I .. ,pt •, ln It\\> fnrt,,
,.                                                                                                4) ! t- , plc,in lh\>   r l\ In
                                                                                                  () '    \\ In '"' dntt1 n11 11
I I
               look for.
      OBSERVATION
     RESULT
       • Clotting time .                                                            .
                             ot my blood by Wright method is .. -~ .. / .. .. 01inu1~
     ❖ NormaUy       ·t.
                    I IS   3-8 mi
                                     notes by Wright's method.
                                  QI. Explain lht> fa<'t
                                              .          ors affl'<'ling and . .
                                 Ql-. Explam lht> fa<'tors fli .             s1g111ficance of hi      .
                                        ,   .                a ecbng and si                      eed,ng time.
                                 Q.l \\ h~• 1s clotting t'                     gnificance of 1 •
                                                         ime longer th      b .               c otting time
                                 Q4. What is normal I                     an leeding time?                  .
                                                         P atelet count?
                                 Q5. \\'hat is the effect on bl       .
                                                                 eechng ti111e d
                                 Q6. What is the effect O bl          .        an clotting time in P
                                                            n eedang ti                                 urpura ?
                                                                           me and clottin .         .
                                                                                           g lime 111 hemophilia?
              H liYIAA-L,'I.{_     1   2, - ~~                  C:().M,t f.fr1rl             ·
                                                w; cen_
                                                      ~              -;/     Uj     ~ hlm. Wu ~
                                                (lo] Fwlm_~                  ~           woJf.
                                                ( L)   Te / r l . p ~              -tempo~              ~ C WC ~
                                   :=
                     ~ CLIN! CfH_ Sl C>I.NJFI CANcf_
                                                                                                  .~
                                                                                   DF    ~
                         0 G~                          WXBOUJ                                LEEO/NCJ,j TlfVlE
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                                                                                                        arLttwa.g.tili)J1j ~ .
\ \ \
                                                                                       .Q
                                                                  r i O ~ .b u t ~ .bJn
                             .5                        ttm..o_ ib
        ~
          ff g - ~n                  . ~ ,. -~
                                  P J~
                                  M
                                                                                      tfW.Q (i CUl
                                                                in2   }J,   ~ lli.U
                             6               , h u o r li n a t1
                   ~         ~
        ~ ;rg - 9h  ir l ~-~
                ~
                  PRocE orR E-..
                         1. As" 1                    .                                 . ._,nn l ,i nd let hi111 re '- l hi -; fmec1 n77   1111"
                                t le          ~llhft't t In   , it co111f nrHthh n il "                              .
                               t t1                                                       •I ,i nd 111ark th e rad 1<1 I arter y
                                                                                                             .                   ·
                                a k "ith the "n,t ,tig hth extende d . h'<'
                                                                                  i c; n i   ,1r1<J fix th e  111 strume  nt o n th e    .
                        ~-     w    ·                                     ·I 11111 ·                         .                        Wr1 ~1
                                    md the ~,wing nl the clock lll<'t
                                 .·                                     . .. , ,H.: tl y 0 11 th e rad ial artery.
                               " 1th ~trap. S('l'ing th at the 1-. noh reS t s c x
                         "                                                        • rin o lever to ob tain th e best put , .
                                                                   1                                                                  s a1 10 17 ~
                        ·"· Adjust the tension of the stra p o il t ic sp                     e-
                                                                    .            •   ntre ofreco rdings pace.
                               as w ell as to b1i ng till' po 111t al I1ie ce
I
                                                                 . , . l y th e writin g po int o n i t and start the
                        4.     lnsen the strip of smokctl pape, · app
                                                     .       . 1 leng th of Sphyg mogra m.
                               clnck mechanism. O btain a goou
                  OBSE R\ .A TION:
                                                                             t              tic lirnb)
                  E,·ery pulse record shows an ascending gradient (upS roke or anacro
                  ~ 11owed by a summit• and t hen a desc end1·noo gradien t (down stroke or ca ta erotic
                       b)
                                                                                                         s
                    e p wa,·e (percussion wave) occurs due to ejectio n of blood from the ventricle
                                                                                               against the
                 during systole. The d wave (dicrotic wave) occurs due to reboun d of blood
                                                                                                    of the
                 closed aortic valve during diastole. Then (dicrotic notch) represe nts the closure
                                                                                         filling in
                aortic valve. From the sphygmogram, we can derive pulse rate, rhythm and
                many rypes of heart ailments, abnormal sphygm ograms are recorde d.
                          b <2 be.OJ.! I W1U1 in ttu -U.f)t Hl.lolWJ ~ 0.1 ~
    1.1 ..,  w»_.e_ /~
                                                                                               p~
        .J_W ~ r::f)Yf r ~~ - f'YD n c'. '-ed. ,o r,d VLOJ\.d ~
                                                                               ~ 11 Orm_~ ~ '
                                                        &11 both 'trtd.il j Y? ~    C$1 "t~ ~
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                                                                  I u_o__QJ_J_0 f µ ~ ~ OJi_d
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                         ,                   .
             ~J ~JJ.A (~ .IA 6 ~ be.cu~ l rrv.,n .if> tt1.t. -U..l) t u.CJ..QJ.)_aj Q ~}{.,~
    r //~
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    !:J.r.i.JJ ( ~ IJJJJ-'o ~C9J~9 W<.m )JI ~mu - p'QO QQ., ~ ~ k9.n.d
                                                                                          ii                                                         %tt~J
    vJ.Jfti --, G"' oJ >-'_H~I in, b(QJ.!~ J-tP1 1~tirn .-:Jvi..u-u                                            .u
                                                                                      ~ 11..o1,1J t'"f\ ~o+t' "·<
    , r 1&J.) I r .oJ rJ, ncJJ .N:1ri ~b CIJ.U tlU OJ tA.) (LU
                                                               ? ~ tSl.J...(J Wt cllli ~ lQ..cl lJJ cu.V:
     1
       u !,) r);h - ~.()'HJ) ~J.J.o J~ 01'\.o,\ ptlW f ' ("( f... ( 1 )! rt 0.i ti l o·r, i