Khyber Medical Laboratory Township Bannu

13/11/2024

Urine R/E information

04/08/2024

Mental Health services. Psychotherapies

29/05/2024

29/05/2024

Blood transfusions

There are many reasons you may need a blood transfusion:

After knee or hip replacement surgery, or other major surgery that results in blood loss
After a serious injury that causes a lot of bleeding
When your body cannot make enough blood
A blood transfusion is a safe and common procedure during which you receive blood through an intravenous (IV) line placed in one of your veins. It takes 1 to 4 hours to receive the blood, depending on how much you need.

There are several sources of blood, which are described below.

Blood From the Public (Volunteer Blood Donation)
The most common source of blood is from volunteers in the general public. This kind of donation is also called homologous blood donation.

Many communities have a blood bank at which any healthy person can donate blood. This blood is tested to see if it matches yours.

You may have read about the danger of becoming infected with hepatitis, HIV, or other viruses after a blood transfusion. Blood transfusions are not 100% safe. But the current blood supply is thought to be safer now than ever. Donated blood is tested for many different infections. Also, blood centers keep a list of unsafe donors.

Donors answer a detailed list of questions about their health before they are allowed to donate. Questions include risk factors for infections that can be passed on through their blood, such as s*xual habits, drug use, and current and past travel history. This blood is then tested for infectious diseases before it is allowed to be used.

Directed Donor Blood From a Family Member or Friend
This method involves a family member or friend donating blood before a planned surgery. This blood is then set aside and held only for you if you need a blood transfusion after surgery.

Blood from these donors must be collected at least a few days before it is needed. The blood is tested to see if it matches yours. It is also screened for infection.

Most of the time, you need to arrange with your hospital or local blood bank before your surgery to have directed donor blood.

It is important to note that there is no evidence that receiving blood from family members or friends is any safer than receiving blood from the general public. In very rare cases, though, blood from family members can cause a condition called graft-versus-host disease. For this reason, the blood needs to be treated with radiation before it can be transfused.

Autologous Blood Donation (Your own Blood)
Although blood donated by the general public and used for most people is thought to be very safe, some people choose a method called autologous blood donation.

Autologous blood is blood donated by you, which you later receive if you need a transfusion during or after surgery.

You can have blood taken from 6 weeks to 5 days before your surgery.
Your blood is stored and is good for a few weeks from the day it is collected.
If your blood is not used during or after surgery, it will be thrown away.

27/05/2024

HDL: The "Good" Cholesterol
Also called: High-density lipoprotein

What is cholesterol?
Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But having too much cholesterol in your blood raises your risk of coronary artery disease.

What are HDL and LDL?
HDL and LDL are two types of lipoproteins.They are a combination of fat (lipid) and protein. The lipids need to be attached to the proteins so they can move through the blood. HDL and LDL have different purposes:

HDL stands for high-density lipoproteins. It is sometimes called the "good" cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.
LDL stands for low-density lipoproteins. It is sometimes called the "bad" cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.
How do I know what my HDL level is?
A blood test can measure your cholesterol levels, including HDL. When and how often you should get this test depends on your age, risk factors, and family history. The general recommendations are:

For people who are age 19 or younger::

The first test should be between ages 9 to 11
Children should have the test again every 5 years
Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke
For people who are age 20 or older::

Younger adults should have the test every 5 years
Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years
What should my HDL level be?
With HDL cholesterol, higher numbers are better, because a high HDL level can lower your risk for coronary artery disease and stroke. How high your HDL should be depends on your age and s*x:

Group Healthy HDL Level

Age 19 or younger More than 45mg/dl
Men age 20 or older More than 40mg/dl
Women age 20 or older More than 50mg/dl

How can I raise my HDL level?
If your HDL level is too low, lifestyle changes may help. These changes may also help prevent other diseases, and make you feel better overall:

Eat a healthy diet. To raise your HDL level, you need to eat good fats instead of bad fats. This means limiting saturated fats, which include full-fat milk and cheese, high-fat meats like sausage and bacon, and foods made with butter, lard, and shortening. You should also avoid trans fats, which may be in some margarines, fried foods, and processed foods like baked goods. Instead, eat unsaturated fats, which are found in avocado, vegetable oils like olive oil, and nuts. Limit carbohydrates, especially sugar. Also try to eat more foods naturally high in fiber, such as oatmeal and beans.
Stay at a healthy weight. You can boost your HDL level by losing weight, especially if you have lots of fat around your waist.
Exercise. Getting regular exercise can raise your HDL level, as well as lower your LDL. You should try to do 30 minutes of moderate to vigorous aerobic exercise on most, if not all, days.
Avoid ci******es. Smoking and exposure to secondhand smoke can lower your HDL level. If you are a smoker, ask your health care provider for help in finding the best way for you to quit. You should also try to avoid secondhand smoke.
Limit alcohol. Moderate alcohol may lower your HDL level, although more studies are needed to confirm that. What we do know is that too much alcohol can make you gain weight, and that lowers your HDL level.
Some cholesterol medicines, including certain statins, can raise your HDL level, in addition to lowering your LDL level. Health care providers don't usually prescribe medicines only to raise HDL. But if you have a low HDL and high LDL level, you might need medicine.

What else can affect my HDL level?
Taking certain medicines can lower HDL levels in some people. They include:

Beta blockers, a type of blood pressure medicine
Anabolic steroids, including testosterone, a male hormone
Progestins, which are female hormones that are in some birth control pills and hormone replacement therapy
Benzodiazepines, sedatives that are often used for anxiety and insomnia
If you are taking one of these and you have a very low HDL level, ask your provider if you should continue to take them.

24/05/2024

Calcium oxalate is a compound that consists of calcium and oxalate ions. It is a common constituent of kidney stones and can also be found in small amounts in urine.

Calcium oxalate has several important roles in the body:

1. Kidney stone formation: Excess calcium and oxalate in the urine can combine to form calcium oxalate stones.
2. Urine chemistry: Calcium oxalate helps regulate the pH and concentration of urine.
3. Bone health: Calcium oxalate is involved in bone mineralization and remodeling.
4. Cell signaling: Calcium oxalate can influence cellular processes, including muscle contraction and nerve function.

However, excessive levels of calcium oxalate in the urine can increase the risk of kidney stone formation. Factors that contribute to this include:

1. Dehydration
2. High oxalate intake (found in foods like spinach, rhubarb, and beets)
3. High calcium intake
4. Kidney disease
5. Genetic predisposition

To manage calcium oxalate levels, it's essential to:

1. Drink plenty of water
2. Limit oxalate-rich foods
3. Maintain a balanced calcium intake
4. Manage underlying medical conditions
5. Consider consulting a healthcare professional or a urologist for personalized advice.

24/05/2024

ABO incompatibility

A, B, AB, and O are the 4 major blood types. The types are based on small substances (molecules) on the surface of the blood cells.

When people who have one blood type receive blood from someone with a different blood type, it may cause their immune system to react. This is called ABO incompatibility.

Due to modern testing techniques, this problem is very rare.

Causes
The different blood types are:

Type A
Type B
Type AB
Type O
People who have one blood type may form proteins (antibodies) that cause their immune system to react against one or more of the other blood types.

Being exposed to another type of blood can cause a reaction. This is important when someone needs to receive a blood transfusion or have an organ transplant. The blood types must be compatible to avoid an ABO incompatibility reaction.

For example:

People with type A blood will react against type B or type AB blood.
People with type B blood will react against type A or type AB blood.
People with type O blood will react against type A, type B, or type AB blood.
People with type AB blood will not react against type A, type B, type AB, or type O blood.
Type O blood does not cause an immune response when it is given to people with type A, type B, or type AB blood. This is why type O blood cells can be given to people of any blood type. People with type O blood are called universal donors. But people with type O can only receive type O blood.

Both blood and plasma transfusions must be matched to avoid an immune reaction. Before anyone receives blood, both the blood and the person receiving it are tested carefully to avoid a reaction. Usually, a reaction occurs because of a clerical error causing someone to receive incompatible blood.

Symptoms
The following are symptoms of ABO incompatible transfusion reactions:

Low back pain
Blood in urine
Chills
Feeling of "impending doom"
Fever
Nausea and vomiting
Shortness of breath
Increased heart rate
Pain at infusion site
Chest pain
Dizziness
Bronchospasm (spasm of the muscles lining the lung; causes cough)
Yellow skin and whites of the eyes (jaundice)
Acute kidney failure
Low blood pressure
Disseminated intravascular coagulation (DIC)
Exams and Tests
The health care provider will perform a physical exam. Blood tests will usually show:

The bilirubin level is high
The complete blood count (CBC) shows damage to red blood cells or anemia
The recipient's and donor's blood are not compatible
Elevated lactate dehydrogenase (LDH)
Elevated blood urea nitrogen (BUN) and blood creatinine; in case of renal injury
Prolonged prothrombin time or partial thromboplastin time (findings of DIC)
Positive direct antiglobulin test (DAT)
Urine tests show the presence of hemoglobin due to breakdown of red blood cells.

Treatment
In case of any reaction, transfusion should be stopped immediately. Treatment may also include:

Medicines used to treat allergic reactions (antihistamines)
Medicines used to treat swelling and allergies (steroids)
Fluids given through a vein (intravenously)
Medicines to raise blood pressure if it drops too low
Outlook (Prognosis)
ABO incompatibility can be a very serious problem that can result in death. With the right and timely treatment, a full recovery is expected.

Possible Complications
Complications that may result include:

Kidney failure
Low blood pressure needing intensive care
Death
When to Contact a Medical Professional
Contact your provider if you have recently had a blood transfusion or transplant and you have symptoms of ABO incompatibility.

Prevention
Careful testing of donor and recipient blood types before transfusion or transplant can prevent this problem.

22/05/2024

CCP Antibody Test

What is a CCP antibody test?
This test looks for CCP (cyclic citrullinated peptide) antibodies in the blood. CCP antibodies, also called anti-CCP antibodies, are a type of antibody called autoantibodies. Antibodies and autoantibodies are proteins made by the immune system. Antibodies protect you from disease by fighting foreign substances like viruses and bacteria. Autoantibodies can cause disease by attacking the body's healthy cells by mistake.

CCP antibodies target healthy tissues in the joints. If CCP antibodies are found in your blood, it can be a sign of rheumatoid arthritis. Rheumatoid arthritis is a progressive, autoimmune disease that causes pain, swelling, and stiffness in the joints. CCP antibodies are found in more than 75 percent of people who have rheumatoid arthritis. They are almost never found in people who don't have the disease.

What is it used for?
A CCP antibody test is used to help diagnose rheumatoid arthritis. It's often done along with or after a rheumatoid factor (RF) test. Rheumatoid factors are another type of autoantibody. RF tests used to be the main test to help diagnose rheumatoid arthritis. But RF factors can be found in people with other autoimmune diseases and even in some healthy people. Many studies have shown that CCP antibodies provide a more accurate diagnosis of rheumatoid arthritis compared with RF testing.

Why do I need a CCP antibody test?
You may need this test if you have symptoms of rheumatoid arthritis. These include:

Joint pain
Joint stiffness, especially in the morning
Joint swelling
Fatigue
Low-grade fever
You may also need this test if other tests couldn't confirm or rule out a diagnosis of rheumatoid arthritis.

What do the results mean?
If your CCP antibody results were positive, it means these antibodies were found in your blood. A negative result means no CCP antibodies were found. The meaning of these results may depend on the results of a rheumatoid factor (RF) test as well as a physical exam.

If you have symptoms of rheumatoid arthritis, and your results show:

Positive CCP antibodies and positive RF, it likely means that you have rheumatoid arthritis.
Positive CCP antibodies and negative RF, it may mean you are in the early stages of rheumatoid arthritis or will develop it in the future.
Negative CCP antibodies and negative RF, it means you are less likely to have rheumatoid arthritis. Your provider may need to do more tests to help find out what is causing your symptoms.
Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a CCP antibody test?
Rheumatoid arthritis can be difficult to diagnose, especially in its early stages. Your provider may order one or more tests in addition to CCP antibody and RF tests. These include x-rays of your joints and the following blood tests:

Erythrocyte sedimentation rate (ESR)
Synovial fluid analysis
C-reactive protein
Antinuclear antibody

17/05/2024

Fatty Liver Disease
Also called: Alcoholic Fatty Liver Disease, Alcoholic Steatohepatitis, NAFLD, NASH, Nonalcoholic Fatty Liver Disease, Nonalcoholic Steatohepatitis

What is fatty liver disease?

Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Fatty liver disease is a condition in which fat builds up in your liver. There are two main types:

Nonalcoholic fatty liver disease (NAFLD)
Alcoholic fatty liver disease, also called alcoholic steatohepatitis
What is nonalcoholic fatty liver disease (NAFLD)?
NAFLD is a type of fatty liver disease that is not related to heavy alcohol use. There are two kinds:

Simple fatty liver, in which you have fat in your liver but little or no inflammation or liver cell damage. Simple fatty liver typically does not get bad enough to cause liver damage or complications.
Nonalcoholic steatohepatitis (NASH), in which you have inflammation and liver cell damage, as well as fat in your liver. Inflammation and liver cell damage can cause fibrosis, or scarring, of the liver. NASH may lead to cirrhosis or liver cancer.

What is alcoholic fatty liver disease?

Alcoholic fatty liver disease is due to heavy alcohol use. Your liver breaks down most of the alcohol you drink, so it can be removed from your body. But the process of breaking it down can generate harmful substances. These substances can damage liver cells, promote inflammation, and weaken your body's natural defenses. The more alcohol that you drink, the more you damage your liver. Alcoholic fatty liver disease is the earliest stage of alcohol-related liver disease. The next stages are alcoholic hepatitis and cirrhosis.

Who is at risk for fatty liver disease?

The cause of nonalcoholic fatty liver disease (NAFLD) is unknown. Researchers do know that it is more common in people who:

Have type 2 diabetes and prediabetes
Have obesity
Are middle aged or older (although children can also get it)
Are Hispanic, followed by non-Hispanic whites. It is less common in African Americans.
Have high levels of fats in the blood, such as cholesterol and triglycerides
Have high blood pressure
Take certain drugs, such as corticosteroids and some cancer drugs
Have certain metabolic disorders, including metabolic syndrome
Have rapid weight loss
Have certain infections, such as hepatitis C
Have been exposed to some toxins
NAFLD affects about 25% of people in the world. As the rates of obesity, type 2 diabetes, and high cholesterol are rising in the United States, so is the rate of NAFLD. NAFLD is the most common chronic liver disorder in the United States.

Alcoholic fatty liver disease only happens in people who are heavy drinkers, especially those who have been drinking for a long period of time. The risk is higher for heavy drinkers who are women, have obesity, or have certain genetic mutations.

What are the symptoms of fatty liver disease?

Both NAFLD and alcoholic fatty liver disease are usually silent diseases with few or no symptoms. If you do have symptoms, you may feel tired or have discomfort in the upper right side of your abdomen.

How is fatty liver disease diagnosed?

Because there are often no symptoms, it is not easy to find fatty liver disease. Your doctor may suspect that you have it if you get abnormal results on liver tests that you had for other reasons. To make a diagnosis, your doctor will use:

Your medical history
A physical exam
Various tests, including blood and imaging tests, and sometimes a biopsy
As part of the medical history, your doctor will ask about your alcohol use, to find out whether fat in your liver is a sign of alcoholic fatty liver disease or nonalcoholic fatty liver (NAFLD). He or she will also ask which medicines you take, to try to determine whether a medicine is causing your NAFLD.

During the physical exam, your doctor will examine your body and check your weight and height. Your doctor will look for signs of fatty liver disease, such as:

An enlarged liver
Signs of cirrhosis, such as jaundice, a condition that causes your skin and whites of your eyes to turn yellow
You will likely have blood tests, including liver function tests and blood count tests. In some cases you may also have imaging tests, like those that check for fat in the liver and the stiffness of your liver. Liver stiffness can mean fibrosis, which is scarring of the liver. In some cases you may also need a liver biopsy to confirm the diagnosis, and to check how bad the liver damage is.

What are the treatments for fatty liver disease?

Doctors recommend weight loss for nonalcoholic fatty liver. Weight loss can reduce fat in the liver, inflammation, and fibrosis. If your doctor thinks that a certain medicine is the cause of your NAFLD, you should stop taking that medicine. But check with your doctor before stopping the medicine. You may need to get off the medicine gradually, and you might need to switch to another medicine instead.

There are no medicines that have been approved to treat NAFLD. Studies are investigating whether a certain diabetes medicine or Vitamin E can help, but more studies are needed.

The most important part of treating alcohol-related fatty liver disease is to stop drinking alcohol. If you need help doing that, you may want to see a therapist or participate in an alcohol recovery program. There are also medicines that can help, either by reducing your cravings or making you feel sick if you drink alcohol.

Both alcoholic fatty liver disease and one type of nonalcoholic fatty liver disease (nonalcoholic steatohepatitis) can lead to cirrhosis. Doctors can treat the health problems caused by cirrhosis with medicines, operations, and other medical procedures. If the cirrhosis leads to liver failure, you may need a liver transplant.

16/05/2024

Jaundice
Also called: Icterus

Jaundice causes your skin and the whites of your eyes to turn yellow. Too much bilirubin causes jaundice. Bilirubin is a yellow chemical in hemoglobin, the substance that carries oxygen in your red blood cells. As red blood cells break down, your body builds new cells to replace them. The old ones are processed by the liver. If the liver cannot handle the blood cells as they break down, bilirubin builds up in the body and your skin may look yellow.

Many healthy babies have some jaundice during the first week of life. It usually goes away. However, jaundice can happen at any age and may be a sign of a problem. Jaundice can happen for many reasons, such as:

Blood diseases
Genetic syndromes
Liver diseases, such as hepatitis or cirrhosis
Blockage of bile ducts
Infections
Medicines

Bilirubin blood test

The bilirubin blood test measures the level of bilirubin in the blood. Bilirubin is a yellowish pigment found in bile, a fluid made by the liver.

Bilirubin can also be measured with a urine test.

How the Test is Performed
A blood sample is needed.

How to Prepare for the Test
You should not eat or drink for at least 4 hours before the test. Your health care provider may instruct you to stop taking medicines that affect the test.

Many drugs may change the bilirubin level in your blood. Make sure your provider knows which medicines you are taking.

How the Test will Feel
When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon goes away.

Why the Test is Performed
A small amount of older red blood cells are replaced by new blood cells every day. Bilirubin is left in the blood after these older blood cells are removed. The liver helps break down bilirubin so that it can be removed from the body in the stool.

A level of bilirubin in the blood of 2.0 mg/dL can create jaundice. Jaundice is a yellow color in the skin, mucus membranes, or eyes.

Jaundice is the most common reason to check bilirubin level. The test will likely be ordered when:

The provider is concerned about a newborn's jaundice (most newborns have some jaundice)
Jaundice develops in older infants, children, and adults
A bilirubin test is also ordered when the provider suspects a person has liver or gallbladder problems.

Normal Results
It is normal to have some bilirubin in the blood. A normal level is:

Direct (also called conjugated) bilirubin: less than 0.3 mg/dL (less than 5.1 µmol/L)
Total bilirubin: 0.1 to 1.2 mg/dL (1.71 to 20.5 µmol/L)
Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or may test different samples. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean
In newborns, bilirubin level is higher for the first few days of life. Your child's provider must consider the following when deciding whether your baby's bilirubin level is too high:

A blood disorder called erythroblastosis fetalis
A red blood cell disorder called hemolytic anemia
Transfusion reaction in which red blood cells that were given in a transfusion are destroyed by the person's immune system
The following liver problems may also cause jaundice or a high bilirubin level:

Scarring of the liver (cirrhosis)
Swollen and inflamed liver (hepatitis)
Other liver disease
Disorder in which bilirubin is not processed normally by the liver (for example, Gilbert disease)
The following problems with gallbladder or bile ducts may cause higher bilirubin levels:

Abnormal narrowing of the common bile duct (biliary stricture)
Cancer of the pancreas or gallbladder
Gallstones
Risks
There is little risk involved with having your blood taken. Veins vary in size from one person to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Risks associated with having blood drawn are slight, but may include:

Excessive bleeding
Fainting or feeling lightheaded
Multiple punctures to locate veins
Hematoma (blood collecting under the skin)
Infection (a slight risk any time the skin is broken)
Alternative Names
Total bilirubin - blood; Unconjugated bilirubin - blood; Indirect bilirubin - blood; Conjugated bilirubin - blood; Direct bilirubin - blood; Jaundice - bilirubin blood test; Hyperbilirubinemia - bilirubin blood tes