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Hearful Wellness Medical Diagnostic Center -SSD, Juba (2026)

06/08/2025

Genotype Test (Hemoglobin Electrophoresis Method)
1. Objective:
The objective of the genotype test was to determine the genetic type of hemoglobin present in an individual, especially to identify conditions like sickle cell disease (SS, AS) or thalassemia.
2. Principle:
The test was based on the principle of electrophoresis, where different types of hemoglobin (e.g., HbA, HbS, HbC, HbF) migrated at different rates on an electrophoretic medium due to differences in their charge and structure.
3. Materials:
• EDTA blood sample
• Hemolysing reagent
• Electrophoresis apparatus (agarose or cellulose acetate gel)
• Power supply
• Buffer solution (alkaline pH)
• Staining dye
• Sample applicator
• Capillary tubes or pipettes
• Filter paper, gloves, and PPE
4. Procedure:
1. A venous blood sample was collected in an EDTA tube.
2. Red blood cells were lysed to release hemoglobin.
3. The hemolysate was applied to the electrophoresis gel strip.
4. Electrophoresis was carried out at alkaline pH using an electric current.
5. After separation, the bands were stained and interpreted by comparing with controls.
6. The migration pattern indicated the genotype (e.g., AA, AS, SS, AC).
5. Result:
• AA – Normal hemoglobin only
• AS – Sickle cell trait (carrier)
• SS – Sickle cell disease
• AC/SC – Other variant hemoglobins
6. Uses:
• It was used to screen for sickle cell disease, thalassemia, and other hemoglobinopathies.
• Also important for prenatal counseling, marriage counseling, and blood donor screening.
7. Consultation:
Patients with abnormal genotypes were referred to a hematologist or genetic counselor. Genetic counseling, preventive advice, or treatment plans were initiated based on the results.

22/07/2025

Why is this tube (catheter) always inserted into patients during surgery?

Have you ever wondered why before any surgical procedure is started, this tube MUST always be inserted inside the patient?

Let me tell you why.

You see, the human body is like a clock-work…… it actually never stops working until dëãth.

So, even when a patient is unconscious, under anesthesia, their body still produce urine. Their kidneys continue to produce urine as they used to, and that urine collects in the bladder as usual.

However, since they are unconscious and unable to control their bladder muscles, they can’t empty it themselves..

Here’s what typically happens:

1. For long surgeries (or those near the bladder), doctors will insert a urinary catheter after the patient is asleep. This thin tube collects the urine from the bladder and continuously drain it into a collection bag throughout the period of the surgery.

2. Even in short procedures, if the patient hasn't emptied their bladder beforehand or has issues with bladder control, a catheter might still be used for eventualities.

3. Fluids given during surgery: Sometimes the anesthesiologist gives the patient IV fluids to maintain blood pressure. This extra fluid quickly increases the amount of urine being produced, hence, filling the bladder faster than normal.

- Without this tube in place, the patient can have a full bladder during the period of a surgery Which can become distended, leading to discomfort, damage, or even delaying the recovery of the patient.

- If the surgery involves the pelvic area or organs near the bladder, a full bladder can obstruct the view of the surgeon which can cause him/her to accidentally injure the bladder.

So, as you can see, this tube isn’t only to help the surgical team do their job seamlessly, it also helps the patients during and after the surgery.

I hope you now know why this tube is used?

And I hope you’ll not feel uncomfortable next time when they tell you they’ll be inserting

10/07/2025

♦️Wound Swab Culture♦️
1. Objective
To isolate and identify bacterial or fungal pathogens from a wound infection site and determine their antibiotic susceptibility, guiding appropriate treatment.
________________________________________
2. Principle
A sterile swab is used to collect exudate or tissue from the base of the wound. The sample is cultured on appropriate media under aerobic and/or anaerobic conditions. Grown organisms are identified, and antimicrobial susceptibility testing is performed using standard methods.
________________________________________
3. Materials
• Sterile wound swab with transport medium (e.g., Amies)
• Blood agar, MacConkey agar, Chocolate agar
• Anaerobic media (e.g., CDC anaerobe blood agar, thioglycollate broth)
• Inoculating loop or swab
• Gram staining reagents
• Incubator (aerobic and anaerobic, 35–37°C)
• Mueller-Hinton agar + antibiotic discs
• PPE (gloves, lab coat, mask)
________________________________________
4. Procedure
A. Specimen Collection
1. Clean the wound surface to remove contaminants.
2. Using a sterile swab, collect specimen from the wound base or exudate.
3. Place the swab in transport medium and send to the lab promptly.
B. Culture
1. Inoculate the sample onto:
o Blood agar (detects hemolytic organisms)
o MacConkey agar (detects Gram-negative organisms)
o Anaerobic media if anaerobes are suspected
2. Incubate at 35–37°C:
o 24 hours for aerobes
o 48–72 hours for anaerobes
C. Identification
1. Observe colony morphology and hemolysis.
2. Perform Gram stain from colonies.
3. Confirm identity via biochemical tests or automated systems.
4. Perform antibiotic susceptibility testing (e.g., Kirby-Bauer).
________________________________________
5. Result Interpretation
Organism Typical Culture Finding
Staphylococcus aureus Golden-yellow colonies, Gram-positive cocci
Pseudomonas aeruginosa Green pigment, fruity odor, NLF on MacConkey
Streptococcus pyogenes Beta-hemolytic on Blood agar
Anaerobes Growth only in anaerobic

08/07/2025

♦️SEXUALLY TRANSMITTED MICROORGANISMS (STIs)♦️
🦠 Know their names. Know their forms. Stay protected.

🔬 1. HPV – Human Papillomavirus
🧬 Non-enveloped, double-stranded DNA virus
🔹 Most common STI
🔹 Linked to cervical, a**l, and pe**le cancers
🔹 Prevention: HPV vaccine (Gardasil)

🔬 2. HSV – Herpes Simplex Virus
🧬 Enveloped, double-stranded DNA virus
🌀 HSV-1 = oral herpes | HSV-2 = ge***al herpes
🔹 Painful sores, lifelong latency
🔹 Managed with antivirals like acyclovir

🔬 3. HIV – Human Immunodeficiency Virus
🧬 Enveloped, single-stranded RNA retrovirus
🔹 Attacks CD4+ T cells
🔹 Leads to AIDS if untreated
🔹 Treatment: Antiretroviral Therapy (ART)

🔬 4. Chlamydia trachomatis
🔬 Obligate intracellular, gram-negative bacteria
🔹 Often asymptomatic
🔹 Can cause infertility, PID
🔹 Treated with azithromycin/doxycycline

🔬 5. Neisseria gonorrhoeae
🔬 Gram-negative diplococci (kidney-shaped)
🔹 Causes burning urination, discharge
🔹 Can infect eyes, throat, re**um
🔹 Drug resistance is a concern

🔬 6. Treponema pallidum
🔬 Spirochete (thin, spiral-shaped), not seen on Gram stain
🔹 Causes syphilis (4 stages: primary → tertiary)
🔹 Crosses placenta → conge***al syphilis
🔹 Treated with penicillin G

🔬 7. Ureaplasma urealyticum
🔬 Cell wall-less, pleomorphic bacteria (Mollicutes group)
🔹 Causes urethritis, infertility
🔹 Part of normal flora; overgrowth causes disease
🔹 Treated with macrolides

🔬 8. Candida albicans
🔬 Gram-positive yeast (fungus)
🔹 Thick white discharge, itching
🔹 Opportunistic overgrowth
🔹 Treated with fluconazole or other antifungals

🔬 9. Trichomonas vaginalis
🔬 Motile, flagellated protozoan parasite
🔹 Frothy green discharge, itching, odor
🔹 Seen on wet mount as moving organism
🔹 Treated with metronidazole

✅ PREVENTION TIPS:
✔️ Use condoms
✔️ Get regular STI testing
✔️ Get HPV & Hep B vaccines
✔️ Practice hygiene & avoid multiple partners

📚 KNOW. TEST. TREAT. PROTECT.
🔬 Science saves lives.

08/07/2025

Stool Routine Examination (RE)
________________________________________
1. Objective
The objective of this test was to perform a routine examination of stool to detect the presence of parasites, undigested food particles, mucus, blood, pus cells, and other abnormal constituents.
________________________________________
2. Principle
Stool routine examination was based on macroscopic, microscopic, and chemical a**lysis of stool. The test aimed to identify gastrointestinal infections, parasitic infestations, and digestive disorders through visual and microscopic findings.
________________________________________
3. Materials
• Fresh stool sample in a sterile stool container
• Normal saline and iodine solution
• Glass slides and cover slips
• Lugol’s iodine
• Microscopes
• Applicator sticks
• Gloves
________________________________________
4. Procedure
A. Physical Examination
• Observed color, consistency, odor, presence of mucus, blood, or worms.
B. Microscopic Examination
1. A small amount of stool was emulsified in saline and iodine on two separate slides.
2. Coverslips were placed, and slides were examined under a microscope.
3. Identified:
o Ova and cysts of parasites
o Pus cells, RBCs, macrophages
o Undigested food particles, fat globules
C. Chemical Examination
• Tests such as occult blood, reducing substances, or pH were performed if required.
________________________________________
5. Result (Example)
• Color: Yellowish brown
• Consistency: Semi-solid
• Mucus: Present
• RBCs: 2–3/HPF
• Pus cells: 5–7/HPF
• Parasites: Giardia lamblia cysts seen
• Occult blood: Negative
________________________________________
6. Uses
• Diagnosed parasitic infections, bacterial enteritis, malabsorption, or IBD
• Evaluated digestive health
• Monitored therapy response
________________________________________
7. Conclusion
The stool routine examination was a simple, non-invasive, and essential test to evaluate gastrointestinal and parasitic diseases and helped guide further clini

03/07/2025

(TB) infection is caused by the bacterium Mycobacterium tuberculosis, primarily affecting the lungs but potentially spreading to other organs. TB is an airborne infectious disease that spreads when a person with active TB coughs, sneezes, talks, or sings, releasing tiny droplets containing the bacteria into the air, which others can inhale.

of TB Infection
1. Primary TB infection: This is the initial stage after exposure. The immune system attempts to capture and destroy the bacteria. Most people do not show symptoms at this stage, though some may experience mild flu-like symptoms such as low fever, tiredness, or cough.
2. Latent TB infection: If the immune system contains the bacteria but does not eliminate them, the bacteria remain dormant within the body without causing symptoms or spreading to others. This stage is asymptomatic, and people with latent TB are not contagious. However, the bacteria can become active later, especially if the immune system weakens.
3. Active TB disease: This occurs when the immune system fails to control the bacteria, allowing them to multiply and cause illness. Active TB usually develops gradually and can cause symptoms such as a persistent cough (sometimes with blood), chest pain, fever, night sweats, fatigue, weight loss, and loss of appetite. People with active TB are contagious and can spread the disease to others.

and Risk Factors
• TB spreads primarily through prolonged close contact with someone who has active lung TB.
• People with latent TB do not spread the infection.
• Risk factors for developing active TB include weakened immune systems (e.g., HIV/AIDS, diabetes), malnutrition, to***co use, alcohol abuse, living in crowded or poorly ventilated conditions, and young age (under 5 years).

and Treatment
• TB infection is diagnosed through skin tests (tuberculin skin test) or blood tests (interferon-gamma release assays).
• Active TB requires treatment with multiple a

03/07/2025

Laboratory diagnosis of Mycobacterium leprae (causative agent of leprosy)
—
🧪 1. Objective
The objective of this test was to detect the presence of Mycobacterium leprae in skin or tissue samples to confirm the diagnosis of leprosy.
—
🧪 2. Principle
Mycobacterium leprae, an acid-fast bacillus, was detected using various methods including:
• Ziehl-Neelsen staining of slit-skin smears
• Fite-Faraco stain for biopsy samples
• PCR (Polymerase Chain Reaction) for detecting M. leprae DNA
• Serological tests (e.g., PGL-1 antibody detection) for supportive diagnosis
The bacteria retained the carbol fuchsin dye even after acid-alcohol decolorization, appearing bright red against a blue background.
—
🧪 3. Materials
• Slit-skin smear or skin biopsy specimen
• Glass slides and staining reagents
• Ziehl-Neelsen or Fite-Faraco stain
• Microscope (1000x with oil immersion)
• PCR machine and primers (for molecular diagnosis)
• Gloves, lancet, forceps, PPE
—
🧪 4. Procedure
A. For Ziehl-Neelsen (Acid-Fast) Stain:
1. Slit-skin smear was collected from lesion sites (earlobes, elbows).
2. The smear was air-dried and heat-fixed.
3. Stained with hot carbol fuchsin for 5 minutes.
4. Decolorized with acid-alcohol.
5. Counterstained with methylene blue.
6. Examined under oil immersion microscope.
B. For PCR (optional):
1. DNA was extracted from tissue sample.
2. M. leprae-specific primers were used to amplify target gene regions.
3. Amplification products were visualized on gel electrophoresis.
—
🧪 5. Result (Example)
Test Type Result
AFB Smear Positive (acid-fast bacilli seen)
Bacterial Index 3+ (moderate bacillary load)
PCR for M. leprae Positive
🧾 Interpretation: Presence of acid-fast bacilli and/or M. leprae DNA confirmed a diagnosis of leprosy.
—
🧪 6. Uses
• Confirmed diagnosis of leprosy (especially multibacillary cases)
• Aided in classification (paucibacillary vs multibacillary)
• Helped in monitoring response to multidrug therapy (MDT)
—
🧪 7. Conclusion
The test for Mycobacte

17/06/2025

🩸 Blood Grouping – Easy Notes★★★

🔹 Definition:-

Blood grouping is the process of identifying a person’s blood type based on the presence or absence of specific antigens—A, B, and D—on red blood cells.

🔹 Types of Blood Groups:-

ABO Blood Group System:-
There are four main blood groups in this system:

Group A has A antigens on red cells and Anti-B antibodies in plasma.

Group B has B antigens and Anti-A antibodies.

Group AB has both A and B antigens, with no antibodies.

Group O has no antigens but has both Anti-A and Anti-B antibodies.

Rh Factor (D Antigen):-
The Rh system classifies blood as:

Rh Positive (Rh⁺) if the D antigen is present.

Rh Negative (Rh⁻) if the D antigen is absent.

🔹 Details of All Blood Groups:-

A⁺ has A and D antigens, and Anti-B antibodies.

A⁻ has only the A antigen, and Anti-B antibodies.

B⁺ has B and D antigens, and Anti-A antibodies.

B⁻ has only the B antigen, and Anti-A antibodies.

AB⁺ has A, B, and D antigens, and no antibodies.

AB⁻ has A and B antigens, and no antibodies.

O⁺ has only the D antigen, with both Anti-A and Anti-B antibodies.

O⁻ has no antigens, but has both Anti-A and Anti-B antibodies.

🔬 Blood Grouping Method – Slide Method:-

Steps:

Place three separate drops of the person's blood on a clean glass slide.

Add Anti-A serum to the first drop, Anti-B serum to the second, and Anti-D serum to the third.

Observe each drop for clumping (agglutination). If clumping occurs, it means the corresponding antigen is present. If no clumping occurs, the antigen is absent.

Examples:-

If clumping occurs with Anti-A and Anti-D, the blood group is A⁺.

If clumping occurs with Anti-B only, the blood group is B⁻.

If there is no clumping at all, the blood group is O⁻.

🌟 Importance of Blood Grouping:-

Helps ensure safe and compatible blood transfusions.

Prevents dangerous reactions from mismatched blood.

Plays a vital role during pregnancy to avoid Rh incompatibility.

Used in organ transplantation for compatibili

16/06/2025

HUMAN DIGESTIVE SYSTEM

15/06/2025

♦️Antigen-Antibody Reaction & Hemolysis Detection in Tubes♦️

This powerful immunohematology test helps us identify antibodies, antigens, and complement-mediated lysis. Let’s walk through this visual step-by-step 👇

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🧫 1️⃣ Positive Control

🩸 Red blood cells + known antigen = Clear agglutination (clumping)
✅ Confirms the system is working.

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🧪 2️⃣ Positive Control (No Hemolysis)

🔍 Agglutination occurs, but no lysis of RBCs
🧠 Used to separate agglutination vs hemolysis reactions

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🧬 3️⃣ Sample Tube

🧫 Patient’s blood + reagents → Observe for specific antigen-antibody reaction
📌 Color and clarity indicate type of immune response

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❌ 4️⃣ Negative Control

🚫 No antigen-antibody reaction occurs
🔍 Blood remains unchanged → test is valid

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💥 5️⃣ Hemolysis Begins – Specific Reaction

🧫 Hemolysis occurs when antibodies activate complement → RBC destruction

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🔍 6️⃣ Sample with Antigen Added

🧪 Confirms if patient’s serum reacts with specific antigen on cells
⚡ Reaction = Antigen specificity confirmed

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🧬 7️⃣ Complete Hemolysis & Antibody Reaction

💣 Full lysis of red cells
✅ Strong antigen-antibody-complement activation = definitive result

📌 Labels:
🔴 Ansidon → untouched RBCs
🔴 Anteddy → interacting RBCs
🔴 Anteddy Reaction → lysis zone

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🧠 Why This Matters:

✅ Confirms immune-mediated hemolysis
✅ Identifies autoimmune reactions or transfusion risks
✅ A key tool in blood bank, serology & immunology labs

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🔬 In immunohematology, it’s not just red and clear—it’s science in action.

15/06/2025

🔴 MRSA (Methicillin-Resistant Staphylococcus aureus):
It is a strain of Staphylococcus aureus that has acquired resistance to beta-lactam antibiotics, including methicillin, oxacillin, penicillin, and amoxicillin.

✅ This resistance is primarily due to the acquisition of the mecA gene, which encodes an altered penicillin-binding protein (PBP2a) which has low affinity for beta-lactam antibiotic, allowing MRSA to survive treatment with these antibiotics.

🧫 OF MRSA Using FOX (Cefoxitin) Drug

Cefoxitin (FOX) is a cephamycin antibiotic that is structurally similar to methicillin and is commonly used in laboratory testing to detect MRSA. It is preferred over methicillin or oxacillin in susceptibility testing due to its higher reliability and stronger induction of the mecA gene, making it a better marker for resistance.

🔎 CEFOXITIN IS USED

1. Strong inducer of mecA → It more effectively triggers the expression of resistance mechanisms.
2. Reliable results → Produces clearer and more consistent results than methicillin or oxacillin in disc diffusion tests.

♦️ case :
Case Title “A Tattoo Gone Wrong – MRSA-Induced Necrotizing Fasciitis in a Young Healthy Adult”

A patient presented to the emergency department with severe pain, swelling, and redness around a fresh tattoo on his thigh. The tattoo was done in a non-professional setting three days prior.

presentation

The patient presented with a rapid onset of severe pain at the tattoo site, which was notably disproportionate to the visible skin findings. The affected area showed marked swelling, erythema, and patches of skin discoloration. Within a short time, the patient developed systemic signs of infection, including a high-grade fever of 39°C, tachycardia, and hypotension, indicating possible sepsis.

As the condition progressed, crepitus was detected on palpation, and bullae began to form within hours, suggesting the development of necrotizing fasciitis

12/06/2025

𝘾𝙤𝙖𝙜𝙪𝙡𝙖𝙩𝙞𝙤𝙣 𝘾𝙖𝙨𝙘𝙖𝙙𝙚 ( 𝙎𝙚𝙘𝙤𝙣𝙙𝙖𝙧𝙮 𝙃𝙚𝙢𝙤𝙨𝙩𝙖𝙨𝙞𝙨):-
The coagulation cascade, or secondary hemostasis, is a series of steps in response to bleeding caused by tissue injury, where each step activates the next and ultimately produces a blood clot. The term hemostasis is derived from "hem-", which means "blood", and "-stasis", which means "to stop." Therefore, hemostasis means to stop bleeding. There are two phases of hemostasis. First, primary hemostasis forms an unstable platelet plug at the site of injury. Then, the coagulation cascade is activated to stabilize the plug, stopping blood flow and allowing increased time to make necessary repairs. This process minimizes blood loss after injuries.

The coagulation cascade involves the activation of a series of clotting factors, which are proteins that are involved in blood clotting. Each clotting factor is a serine protease, an enzyme that speeds up the breakdown of another protein. The clotting factors are initially in an inactive form called zymogens. When placed with its glycoprotein co-factor, the clotting factor is activated and is then able to catalyze the next reaction. When a clotting factor becomes activated, it is denoted with an "a" following its respective Roman numeral (e.g. when activated, Factor V becomes Factor Va).

𝙒𝙝𝙖𝙩 𝙖𝙧𝙚 𝙩𝙝𝙚 𝙩𝙝𝙧𝙚𝙚 𝙥𝙖𝙩𝙝𝙬𝙖𝙮𝙨 𝙤𝙛 𝙘𝙤𝙖𝙜𝙪𝙡𝙖𝙩𝙞𝙤𝙣?
Coagulation consists of three pathways, the extrinsic, intrinsic, and common pathways, that interact together to form a stable blood clot. The extrinsic and intrinsic coagulation pathways both lead into the final common pathway by independently activating factor X. The extrinsic pathway involves initiation by factor III (i.e., tissue factor) and its interaction with factor VII. Whereas, factors XII, XI, IX, and VIII are utilized in the intrinsic pathway. Then, the common pathway uses factors X, V, II, I, and XIII.

Hearful Wellness Medical Diagnostic Center -SSD

06/08/2025

22/07/2025

10/07/2025

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03/07/2025

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