Practical Manual of Biochemistry
Practical Manual of Biochemistry
Biochemistry
As per the latest
CBME Guidelines |
Competency Based Undergraduate Curriculum
for the Indian Medical Graduate
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Preface to the Second Edition
W e are happy to present the second edition of this book. In this edition we have added one new chapter of
DNA extraction. The author of this chapter is Dr Dharamveer Yadav. The zeal to share our knowledge and
experience has driven us to write this book. It has been written in a simple language for easy understanding of
basic concepts of practical biochemistry. The book caters the need of all the health professionals. We hope students
and teachers will find this book useful.
GG Kaushik
Neha Sharma
Sabira Dabeer
Ruchi Jindal
Acknowledgments
F irst and foremost, we would like to thank God Almighty for his kind blessings on us. Our sincere thanks and
gratitude to Dr FS Mehta, Dean, Geetanjali Medical College, and our colleagues of Geetanjali Medical College
and Hospital, Udaipur.
Our special thanks to Dr Ankita Sharma, Assistant Professor and the entire Department of Biochemistry
of JLN Medical College, Ajmer, Rajasthan. We are thankful to our reviewers and special thanks to
Dr Dharmveer Yadav, Associate Professor, Department of Biochemistry, AIIMS, Jodhpur, for their valuable
suggestions and addition of a new chapter “DNA Extraction and its Applications: An Overview.”
Our humble and sincere thanks to Mrs. Ritu Chawla, Mr. Dinesh S Dheek and CBS Publishers & Distributors
for their trust on us.
We would also like to acknowledge the support of technical staff and postgraduate students for their help. We
wish them good luck in their future endeavour.
Last but not the least, our thanks to our families, we cannot repay the constant support and encouragement
from them.
GG Kaushik
Neha Sharma
Sabira Dabeer
Ruchi Jindal
Contents
Section 1
Qualitative Analysis
1. Carbohydrate Analysis 3
2. Lipid Analysis 12
3. Protein Analysis 19
4. Urine Analysis 28
Section 2
Quantitative Analysis
5. Colorimeter 43
6. Estimation of Blood Glucose 46
7. Kidney Function Test 50
8. Lipidogram 63
9. Liver Function Test 75
10. Estimation of Blood Calcium 97
11. Estimation of Blood Phosphorus 102
Section 3
Demonstration
12. pH Meter 109
13. Chromatography 110
14. Electrophoresis 112
viii Practical Manual of Biochemistry
Section 4
Miscellaneous
15. Body Fluids 119
16. Reagents Preparation 121
17. Biological Waste Disposal 123
18. Blood Gas Analyzer 126
19. DNA Extraction and its Applications: An Overview 139
Carbohydrate Analysis ix
Index of Competencies
As per Medical Council of India: Competency Based Undergraduate Curriculum for the Indian Medical Graduate
8. Lipidogram 63
A. Serum Total Cholesterol
B. Serum Triglycerides
C. Serum HDL Cholesterol, Serum LDL, VLDL BI 11.9, BI 11.10, BI 11.9
Section 3: Demonstration
12. pH Meter BI 11.2 109
Section 4: Miscellaneous
15. Body Fluids BI 11.15 119
Colorimeter Spectrophotometer
pH meter Microscope
Autopipettes Urinometer
xii Practical Manual of Biochemistry
Balance Weights
1. Carbohydrate Analysis
2. Lipids Analysis
3. Protein Analysis
4. Urine Analysis
1
Carbohydrate Analysis
Definition
• Carbohydrates are aldehyde or ketone derivatives of polyhydroxy alcohols.
• Their main function is to provide energy.
• Glucose is the main form of carbohydrate absorb from the gut.
• Humans can synthesize glucose from non-carbohydrate sources like lactate, glucogenic amino acids, propionic
acid, glycerol, pyruvate by a process known as gluconeogenesis.
Oligosaccharides: Made up of less than ten monosaccharide subunits.
Classification of Carbohydrates
3
4 Practical Manual of Biochemistry
Fig. 1.1: Reagents for carbohydrates identification Fig. 1.2: Molisch’s test
Fig. 1.3: Iodine test Fig. 1.4: Benedict test: Green, yellow, orange, red
VIVA VOCE
Q1. Name of the group test of carbohydrates.
Ans. Molisch’s test
Q2 Why Benedict test is semiquantative test?
Ans. Color of precipitate indicate quantity of sugar in solution.
Q3. Name of test for polysaccharides.
Ans. Iodine Test.
Q4. How to differentiate monosaccharide’s glucose and fructose?
Ans. By Seliwanoff’s test is positive for fructose.
Q5. Different shape of crystal by osazone test.
Ans. Needle shape—Glucose, fructose
Sunflower shape—Maltose
Cotton ball shape—Lactose
Q.6. Name of common sugar.
Ans. Sucrose
Q7. Carbohydrates preferred in diabetic patients.
Ans. Polysaccharides.
8 Practical Manual of Biochemistry
Carbohydrate Analysis 9
10 Practical Manual of Biochemistry
Carbohydrate Analysis 11
12 Practical Manual of Biochemistry
2
Lipid Analysis
Definition: Lipids are esters of fatty acids with alcohol, which are soluble in organic solvents and insoluble in
water.
Classification of Lipids
12
Lipid Analysis 13
Saponification test: When oil and fat are boiled A white ppt of insoluble Calcium salt of fatty acid is
Procedure: Take 5 drop oil with alkali than both are calcium soap is formed formed
and 5 ml of alkali in test hydrolyzed and liberated fatty
tube. Keep test tube in acid form salts with alkali called
boiling water bath and boil soap and process is known as
it till the solution become saponification
soapy
+
Cool it take out test tube
and add CaCl2
Emulsification test: When oil and water are shaken • Oil and water separate quickly • Emulsification is unstable
Reagents (0.5% Na2CO3 together the oil is broken down • Separation does not take place • Emulsification is stable with
solution in water + 5% of into small droplets which are with soap, bile salt, Na2CO3 soap, bile salt, Na2CO3
Bile salt solution) dispersed in water. This is
Procedure: Take 5 ml of known as oil in water emulsion.
each water bile salt, The water due to their high
Na2CO3, soap solution in surface tension has a tendency
separate to close together and separate
+ as a layer. Bile salt, Na2CO3,
Add 5 drop of oil each soap solution lowers the surface
+ tension so they are best
In first tube oil and water emulsifying agents
layer separates immediately
indicating. Emulsion is
unstable but in case of
Na2CO3 layer separate
longer time indicating
emulsion is more
stable
Grease spot test reagent: All lipids are grease in nature Ether evaporates and leaving Grease nature of lipid
(Ether) procedure: Take so this test is used as a group behind a translucent spot on
3 ml of ether in test tube test for lipid paper (Fig. 2.3)
+
Add 5 drop of oil to it shake
well and put 1–2 drop of
solution on filter paper
wait 5
14 Practical Manual of Biochemistry
Glycerol Analysis
Test Principle Observation Inference
Dunstan’s test Reagents: Borax hydrolyzed into NaOH Medium is alkaline-pink color Presence of glycerol
(borax solution (strong base) and boric acid disappear. Medium is acidic
+ (weak acid) after addition of than color will reappear
phenolphthalein indicator) glycerol it react with boric acid (Fig. 2.1)
Procedure: 3 ml of borax and forms strong acid
solution in test tube (glyceroboric acid)
+
add drop of
phenolphthalein indicator
pink color produced
indicate medium is alkaline
+
add 20% glycerol drop by
drop until pink color
disappears indicate
medium is acidic. Heat
again until pink color
reappears that indicate
medium has become
alkaline again
Acrolein test: Reagents- On heating with KHSO4 Pungent smell is produced Presence of glycerol
solid KHSO4 glycerol is dehydrated to form
Procedure: Take dry test an unsaturated aldehyde
+ (acrolein)
add 1–2 drop of glycerol
+
add pinch of KHSO4+ heat it
Cholesterol Analysis
Procedure Principle Observation Inference
Salkowski’s test Reagent: When sample is dissolved in Two layer separated chloroform Presence of cholesterol
con H2SO4 chloroform and equal volume layer-cherry red (Fig. 2.2) acid
Procedure: Take 2 ml of of H2SO4 is added. If cholesterol layer–green fluorescence
cholesterol in dry test tube is present solution become blue
+ add 2 ml of conc H2SO4 red and change to violet red and
shake well and allow to H2SO4 become red with green
stand fluorescence
Libermann-Burchard’s Cholesterol is dehydrated by Red color develops followed by Presence of cholesterol
test reagent: Con H2SO4 con H2SO4 and acetic blue and finally whole solution
Acetic anhydride anhydride leading to formation becomes green
Procedure: Take 3 ml of of 2,4 or 3,5 cholestadienes
cholesterol in dry test tube +
add 10 drop of acetic
anhydride + add 1–2 drops
of con H2SO4 mix well
Fig. 2.1: Dunstan’s test Fig. 2.2: Salkowski’s test Fig. 2.3: Grease spot test
VIVA VOCE
Q1. Name of essential fatty acids.
Ans. Lionlic acid, linoleic acid.
Q2. Name of the test for cholesterol.
Ans. Salkowski, Liberman-Burchard reaction.
Q3. Name of ring present in cholesterol.
Ans. CPPP (cyclopentaperhydrophenenthrene).
Q4. Name of the test for unsaturation of fatty acids.
Ans. Hubl’s iodine test.
Q5. What is the importance of emulsification?
Ans. Digestion of lipids.
16 Practical Manual of Biochemistry
Lipid Analysis 17
18 Practical Manual of Biochemistry
Protein Analysis 19
3
Protein Analysis
Classification of Proteins
Color Reactions
A. Biuret Test, Ninhydrin Test [Group Color Reaction for Amino Acids]
Test procedure Principle Observation Inference
Biuret test Violet color formation because Violet color presence (Fig. 3.1) Peptide linkage, presence of
Reagents: 40% of peptide linkage of protein protein
NaOH with CuSO4 in alkali medium
Procedure: 2 ml protein provided by NaOH
solution + 1 ml NaOH mix +
1–2 drops of 0.5% CuSO4
Ninhydrin Heating with ninhydrin Violet—purple color (Fig. 3.2) Presence of α amino acids
Reagents: 0.1% (oxidizing agent) α amino acids Exception: Proline and
Freshly prepared give purple color hydroxyl proline
ninhydrin solution
Procedure: 1 ml protein
solution + 1 ml freshly
prepared 0.1% ninhydrin
solution mix and boil for
1 min, cool
19
20 Practical Manual of Biochemistry
Fig. 3.1: Biuret test: Fig. 3.2: Ninhydrin test: Fig. 3.3: Xanthoproteic test:
Albumin, casein, gelatin, peptone Albumin, casein, gelatin, peptone Albumin, casein, gelatin, peptone
Fig. 3.4: Million Nasse’s test: Fig. 3.5: Hopkin’s Cole’s test: Fig. 3.6: Sakaguchi’s test:
Albumin, casein, gelatin, peptone Albumin, casein, gelatin, peptone Albumin, casein, gelatin, peptone
Fig. 3.7: Lead sulphide test: Fig. 3.8: Neumann’s test: Casein Fig. 3.9: Heat coagulation’s test:
Albumin, casein, gelatin, peptone Albumin
Note: From left to right albumin, casein, gelatin, peptone
Protein Analysis 23
VIVA VOCE
Q1. Name of the group test for proteins.
Ans. Biuret test.
Q2. Name of the test for aromatic ring containing amino acids.
Ans. Xanthoproteic acids.
Q3. Specific test for tyrosine.
Ans. Millons test.
Q4. Test name for tryptophan.
Ans. Hopkin’s cole’s.
Q5. Specific test for sulphur test.
Ans. Lead acetate.
Q6. Test for casein.
Ans. Neumann’s test.
Q7. How to differentiate albumin and gelatin by saturation test?
Ans. Gelatin gives half saturation, while albumin gives full saturation.
Q8. Name of first class protein.
Ans. Albumin.
24 Practical Manual of Biochemistry
Protein Analysis 25
26 Practical Manual of Biochemistry
Protein Analysis 27
28 Practical Manual of Biochemistry
4
Urine Analysis
NORMAL URINE
Urine is the excretory product of body, formed by kidneys. It is made up of water and water soluble waste
products. Examination of urine gives us idea of renal function.
1. Appearance Freshly void urine is clear, it becomes turbid on standing due to precipitation of
phosphates
5. pH Usually acidic, pH ranges from 4.5 to 8 post meal, pH of urine is alkaline; it is called
alkaline tide
6. Specific gravity 1.010–1.025, measured with the help of urinometer, it tell us about the concentrating
ability of kidneys
28
Urine Analysis 29
Calcium test reagents: Formation of calcium White ppt of calcium Presence of calcium
Ammonium oxalate oxalate oxalate (Fig. 4.4)
Procedure: Take 2–3 ml
ammonium oxalate +
1–2 ml urine
Phosphate test reagents: Formation of phospho- Canary yellow ppt Presence of phosphate
Ammonium molybdate molybdate (Fig. 4.5)
Procedure: Take 1–2 ml
urine + add con
HNO3 + heat +
ammonium
molybdate
Creatinine test Jaffe’s test Formation of creatinine Orange red color Presence of creatinine
reagents: Alkaline picrate picrate (Fig. 4.3)
Procedure: 3–4 ml urine + 1 ml
alkaline picrate
Uric acid Benedict’s test In alkaline medium, Blue color develop Presence of uric acid
reagents: Sodium tungstste, arsenophosphotungstate of
arsenic pentoxide, phosphoric Benedict’s uric acid regent
acid, HCl, anhydrous sodium is reduced to blue colored
carbonate arsenophosphotungstate
Procedure: 4 ml urine + pinch
of sodium carbonate + mix +
4–5 drop of above reagent
+ mix
Ammonia test reagents: Ammonia is alkaline in Tip of rod turns pink Presence of ammonia
Phenolphthalein indicatior nature which turns
Procedure: 9 ml urine + drop phenolphthalein indicator
of phenolphthalein indicatior + pink
drop of 0.1 N NaOH hold
glass rod at the mouth of
tube
30 Practical Manual of Biochemistry
Fig. 4.2a: Test for urea, soybean meal Fig. 4.2b: Sodium hypobromite test Fig. 4.3: Test for creatinine
Fig. 4.4: Test for calcium Fig. 4.5: Test for phosphate
Urine Analysis 31
PATHOLOGICAL URINE
Ketone bodies: Rothera’s Ketone bodies form a purple Purple ring formed at the Presence of ketone bodies
nitroprusside test reagents: colored complex with junction of two liquid
Ammonium sulfate, sodium sodium nitroprusside in (Fig. 4.7)
nitroprusside, liquor ammonia alkaline medium.
Procedure: 5 ml urine saturate β-hydroxybutyrate does not
with ammonium sulfate + give this test
sodium nitroprusside + shake +
liquor ammonia side of tube
Bile salt Hay’s sulfur test Bile salt reduces the surface Sulfur powder sinks Presence of bile salts
reagents—sulfur powder tension of water towards bottom
Procedure: 4–5 ml of sample in (Figs 4.9a, and b)
tube + add pinch of sulfur
powder on surface
Bile pigments Fouchet’s test BaCl2 reacts with sulfur to Green blue color appear Presence of bilirubin
reagent: (FeCl3+TCA ) 6 ml form barium sulfate
BaCl2 add 10–11 ml urine
sample + filter Add 1–2 drop
of reagent
Urobilinogen Ehrlich’s test- Urobilinogen in acidic Pink, red color Presence of urobilinogen
reagent: (p-dimethyl- medium react with Ehrlich’s
aminobenzaldehyde) reagent to form colored
Procedure: 5–6 ml urine + 5 ml compound
of reagent + wait 8–10 min +
add 10 ml saturated sodium
acetate
Blood pigment benzidine test- Peroxidase like activity of Blue green color develop Presence of blood pigment
reagents: H2O2 hemoglobin H2O2 →
Procedure: 2–3 drop saturate H2O + O (O) oxidizes the
benzidine solution + add 3 ml benzidine to form blue/
sample + 4 drop H2O2 green colored oxidized
product
Urine Analysis 33
Fig. 4.6: Benedict’s test Fig. 4.7: Rothera’s test Fig. 4.8a: Heat coagulation test
Fig. 4.8b: Heller’s nitric acid test Fig. 4.9a: Hay sulfur test Fig. 4.9b: Control hay sulfur test
VIVA VOCE
Q1. What is the specific gravity for normal urine?
Ans. 1.010–1.025
Q2. How specific gravity changes in diabetes insipidus?
Ans. It is low, fixed below 1.010.
Q3. In which conditions color of urine sample can be changed?
Ans. Jaundice-deep yellow, red—hemoglobinuria, blood, dark amber—vitamin B complex therapy.
Q4. Name of ketone bodies.
Ans. Acetone, acetoacetate, beta hydroxy butyric acid.
Q5. When ketone bodies appear in urine?
Ans. Uncontrolled diabetes mellitus, severe starvation.
34 Practical Manual of Biochemistry
5. Colorimeter
6. Estimation of Blood Glucose
7. Kidney Function Test
8. Lipidogram
9. Liver Function Test
10. Estimation of Blood Calcium
11. Estimation of Blood Phosphorus
5
Colorimeter
The instrument commonly used is colorimetry which uses the basic principle of photometer. Colorless compounds
are converted into colored compounds using chemical reactions. It uses light only in the visible region (400–
760 nm).
Principle of colorimetry: It obeys beer lambert law. It is a combination of two laws.
Beer’s law: Beer’s law states that the absorption of light is directly proportional to the concentration of substance.
AαC
C—concentration of substance
A—absorbance
Lambert’s law: This law states that the absorption of light is directly proportional to the path length travelled
by the light.
Aαt
A = KCt
Log1/T = KCt
K = constant
Log1/T = optical density (OD) or tranmittance
A—Absorbance
C—Concentration of substance
Parts of Colorimeter
1. Source of light: Tungsten lamp
2. Filter: Visible range (400–760 nm)
3. Cuvette: Plain tube
4. Photocell: Convert light energy into electrical energy
Light energy → Electrical energy
5. Measuring device: Galvanometer it can read transmittance and absorbance.
43
44 Practical Manual of Biochemistry
Calculation
OD of test Vol of standard
conc of substance = × × conc of std
OD of std Vol of serum/sample
SPECTROPHOTOMETER
More sensitive and accurate than colorimeter
Works on Beer Lambert’s law.
It covers UV, visible and IR region.
Range Region
200–400 nm UV
400–700 nm Visible
>700 nm IR
Auto Analyzer
• Fully automatic device to measure the absorbance of substance.
• It display results on screen and can also be printed by printer.
Colorimeter 45
Principle
• It covers Beer Lambert’s law in chemistry.
• In immunochemistry (endocrinology) it follows the principle of chemilumnisence (ECLIA).
Component
• Spectrophotometer/colorimeter component
• Sample tray
• Reagent tray
• Probes
• Cuvette
• Heating and cooling device
• Waste
• Internal and external computer (display)
• Barcode reader
• Printer.
VIVA VOCE
Q1. Difference between colorimeter and spectrophotometer.
Ans.
Spectrophotometer Colorimeter
More accurate Less accurate
More sensitive Less sensitive
Filter: prism Filter: visible (400–700)
Region: UV, visible, IR Region: visible
Cuvette: Quartz Cuvette: plain tube
Light source: Quartz, deuterium lamp Light source: Tungsten lamp
6
Estimation of Blood Glucose
Introduction: Estimation of blood glucose use for routine diagnosis of diabetes mellitus hyperglycemia.
Hexokinase Method
Method based on reducing property: Folin and Wu method.
Nelson and somogyi method.
Asatoor and king method.
Ortho-toludine method.
Aim: Estimation of blood glucose by colorimeter.
Principle: GOD-POD (End point method glucose oxidase-peroxidase method)
Glucose oxidase
Glucose + O 2 ⎯⎯⎯⎯⎯⎯→ Gluconic acid +H 2 O 2
Peroxidase
H 2 O 2 + phenol + 4-aminoantipyrine ⎯⎯⎯⎯⎯
→ Red quinine dye + H 2 O
Procedure: Take 1 ml reagent in tube
Add 10 μl serum
↓
Mix well and incubate for 10 min at 37°C
↓
Read at 520 nm
Observation Table
Blank Standard Test
Reagent 1 ml 1 ml 1 ml
Standard – 10 μl –
Serum – – 10 μl
Calculation
Results: ………………..
Interpretation
Conditions when blood glucose elevated Hyperglycemia
Fasting >110 mg/dl
Pp >140 mg/dl
1. Hyperactivity of endocrine gland (thyroid, pituitary and adrenal)
2. Emotional stress
3. Disease of pancreas
4. Diabetes mellitus
1. Insulinoma
2. Over dose of insulin
3. Prolong starvation
4. Hypoactivity of adrenal gland
VIVA VOCE
Q1. Which vial is used for glucose estimation?
Ans. Sodium fluoride.
Q2. Name of method for glucose estimation.
Ans. GOD-POD.
Q3. What is the range for fasting and PP glucose?
Ans. F-70–110 mg/dl.
PP up to 140 mg/dl.
Q4. What are the causes of hyperglycemia?
Ans. DM, hyperactivity of adrenal and pituitary.
Q5. What are the causes of hypoglycemia?
Ans. Over dose of insulin, prolonged starvation.
48 Practical Manual of Biochemistry
Estimation of Blood Glucose 49
50 Practical Manual of Biochemistry
7
Kidney Function Test
Procedure
Blank Test Standard
Reagent 1 1 ml 1 ml 1 ml
Distilled water 10 μl – –
Urea standard – – 10 μl
Serum – 10 μl –
Incubate for 5 mins
Reagent 2 1 ml 1 ml 1 ml
Calculation
OD of test Amt of std
× × 100
OD of std Volume of std
Results ……………
Interpretation
Normal blood urea = 10– 40 mg/dl.
Normal urine urea = 23–30 g/day.
Normal blood urea nitrogen (BUN) = 7–25 mg/dl
(1 mg of BUN = 2.14 mg of urea).
50
Kidney Function Test 51
Urea clearance:
Clearance is defined as volume of plasma cleared of a substance in one minute by kidney.
It is the measure of glomerular function of kidney.
Expressed in ml/min
U×V
C =
P
U = concentration of substance in urine.
V = volume of urine excreted per min.
P = concentration of substance in plasma.
Urea clearance depends on flow of urine.
When flow of urine is >2 ml/minute clearance is 60–95 ml/minute (average = 75 ml/min), it is called maximum
clearance.
When urine flow is <2 ml/minute clearance is 40–65 ml/minute (54 ml/min), it is called standard clearance.
If urea clearance is
Urea clearance Renal impairment
70% Normal
40–70% Mild impairment
20–40% Moderate impairment
<20% Severe impairment
Urea clearance is not a better index of glomerular function as only 10% of urea is excreted.
52 Practical Manual of Biochemistry
VIVA VOCE
Q1. What is normal level of urea in blood?
Ans. 20–40 mg/dl.
Q2. What are the causes of increased blood urea level?
Ans. Prerenal, renal, postrenal.
Q3. Explain few prerenal conditions.
Ans. Fever, CHD, dehydration.
Q4. Explain renal and postrenal conditions.
Ans. See on last page.
Q5. Conditions when blood urea level decreased?
Ans. Cirrhosis of liver.
Kidney Function Test 53
54 Practical Manual of Biochemistry
Kidney Function Test 55
INTRODUCTION
Creatine is synthesized in liver from glycine, arginine and methionine. It then reaches muscle via blood. Creatine
kinase converts creatine into creatine phosphate. Creatine phosphate acts as a storage form of ATP. Creatinine is
formed spontaneously and non-enzymatically from creatine phosphate at the rate of 2% of total body creatine
per day.
Amount excreted in urine remain constant for a given person and depends only on muscle mass and is
independent of protein in diet. Therefore, serum creatinine is a better index of renal function.
Procedure
Blank Standard Test
Jaffe’s reagent 1 ml 1 ml 1 ml
Standard – 100 μl –
Serum – – 100 μl
Mix well and allow stand for 15 minutes and read at 520 nm.
Calculation
Results ………………………
Interpretation
Normal range
Males: 0.7–1.4 mg/dl.
Females: 0.6–1.2 mg/dl.
Creatinine Clearance
Clearance is defined as volume of plasma cleared of creatinine in one minute by kidney.
It is the measure of glomerular function of kidney.
Expressed in ml/min
56 Practical Manual of Biochemistry
U×V
C=
P
U = concentration of substance in urine.
V = volume of urine excreted per minute.
P = concentration of substance in plasma.
Cretinine is negligibly reabsorb and is not secreted by renal tubules; therefore, its clearance is almost similar to
GFR.
VIVA VOCE
Q1. What is the normal serum creatinine level?
Ans. Males: 0.7– 1.5 Mg/dl.
Females: 0.4–1.2 mg/dl.
Q2. Amino acids involved in creatinine synthesis.
Ans. Glycine, arginine, methionine.
Q3. Why is estimation of serum creatinine a better index of KFT than blood urea?
Ans. Its level depends on glomerular filtration not affected by diet and other factors.
Q4. What is the normal daily excretion of creatinine in urine?
Ans. 1–2 gm/day.
Q5. Name of method for creatinine estimation?
Ans. Jaffe’s method.
Kidney Function Test 57
58 Practical Manual of Biochemistry
Kidney Function Test 59
Procedure
Blank Standard Test
Working reagent 1 ml 1 ml 1 ml
Standard – 25 μl –
Serum – – 25 μl
Distilled water 25 μl – –
Calculation
OD of test Vol of standard
conc of uric acid = × × conc of std
OD of std Vol of serum/sample
Results ………………………
60 Practical Manual of Biochemistry
Interpretation
Normal range
Males: 4.5–7.5 mg/dl.
Females: 2.3–6.5 mg/dl.
Causes of Hyperuricemia
Hyporuricemia: When uric acid concentration <2 mg/dl. It is a rare condition seen in:
1. Severe liver disease, purine synthesis decreases.
2. Defective renal tubular reabsorption.
VIVA VOCE
Q1. What is the normal level of uric acid?
Ans. 2–7 mg/dl.
Q2. What are the causes of hyperuricemia?
Ans. Renal failure, leukemia, HGPRTase deficiency.
Q3. Is there any correlation between cancer and uric acid?
Ans. Yes, hyperuricemia, because of increased cell growth, increase breakdown of purines cause to Gout.
Q4. How alcohol affect uric acid level?
Ans. Alcohol increase NADH it is promote formation of monosodium urate, that is less soluble.
Q5. What is tophi?
Ans. Deposition of uric acid crystals in joints or skin or cartilage. Most common site of deposition of crystal in
big toe.
Q6. Why do cancer patients have high levels of uric acid?
Ans. Cancer patients have high cell turnover this causes increase breakdown of purine and hence increase
formation of uric acid.
Kidney Function Test 61
62 Practical Manual of Biochemistry
Lipidogram 63
8
Lipidogram
Procedure
Take 1 ml reagent in tube
↓
Add 20 μl serum
↓
Mix well and incubate at room temperature for 10 minutes AT 37°C
↓
Read at 520 nm
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Observation Table
Blank Standard Test
Reagent 1 ml 1 ml 1 ml
Standard – 20 μl –
Serum – – 20 μl
Calculation
OD of test
× conc of standard
OD of standard
Results: …………………..
Normal range of cholesterol in blood 200–250 mg/dl.
Interpretation
Hypocholestremia 1. Hyperthyroidism
2. Abetalipoproteinemia
Hypercholestremia 1. Hypothyroidism
2. von-Gierke’s disease
3. Nephrotic syndrome
4. Alcohol intake
5. Obstructive jaundice
6. Diabetes mellitus
VIVA VOCE
Q1 What is the normal blood cholesterol range?
Ans. 150–250 mg/dl.
Q2. Number of carbon atom present in cholesterol structure.
Ans. 27.
Q3. Name of products formed by the degrading of cholesterol.
Ans. Bile acids, vitamin D, steroid hormones.
Q4. Name of dietary sources for cholesterol.
Ans. Milk, egg, meat.
Q5. Condition for Hypo- and hyper-cholesterolemia
Ans. See on last page.
Lipidogram 65
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Lipidogram 67
Principle
Lipase
Triglycerides + H2O ⎯⎯⎯→ Glycerol + FFA
Glycerol kinase
Glycerol + ATP ⎯⎯⎯⎯⎯⎯ → Glycerol 3-PO4 + ADP
Glycerol 3PO4 + O2 ⎯⎯⎯⎯
Oxidase
→ DHAP + H2O2
H2O2 + 4-aminoantipyrine + phenol ⎯⎯⎯⎯⎯
Peroxidase
→ Quinoneimine dye
(Red/pink color)
Procedure
Take 1 ml reagent in tube
↓
Add 10 μl serum
↓
Mix well and incubate at room temperature for 10 minutes (37°C)
↓
Read at 520 nm
Observation Table
Blank Standard Test
Reagent 1 ml 1 ml 1 ml
Standard – 10 μl –
Serum – – 10 μl
Calculation
OD of test
× conc of standard
OD of standard
Results:………………
Normal range of TG in blood 25–170 mg/dl.
Interpretation
TG level ↑ 1. Diabetes mellitus
2. Nephrosis
3. Hypothyroidism
4. Pregnancy
5. Alcoholism
6. Atherosclerosis
7. Ischemic heart disease
8. Intake of OCPs
68 Practical Manual of Biochemistry
VIVA VOCE
Q1. What is the normal range of TG in serum?
Ans. 25–170 mg/dl.
Q2. Conditions when increases serum TG levels ?
Ans. See on last page.
Q3. Name of method for TG estimation.
Ans. Trinder method.
Q4. Which color filter use for TG estimation?
Ans. 520 nm green filter.
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Lipidogram 71
Mixing and stand for 10 minutes at room temperature centrifuge at 4000 rpm for 10 minutes supernatant
↓
Take 1 ml reagent (cholesterol)
↓
Add 50 μl serum
(supernatant)
↓
Mix well and incubate 10 min at 37°C
↓
Read at 505 nm
Observation Table
Blank Standard Test
Reagent 1 ml 1 ml 1 ml
Standard – 50 μl –
Serum (supernatant) – – 50 μl
Calculation
OD of test
× conc of standard
OD of standard
Results: ……………………………
Normal range of HDL in male 30–65 mg/dl.
Normal range of HDL in female 30–80 mg/dl.
Interpretation
HDL level ↓ Atherosclerosis
Smoking
Alcoholism
Myocardial infraction
Coronary heart disease
72 Practical Manual of Biochemistry
VIVA VOCE
Q1. What is the normal HDL level in serum?
Ans. 30–70 mg/dl.
Q2. Name of the enzyme which take part in reverse cholesterol transport?
Ans. LCAT.
Q3. Why HDL is known as good cholesterol?
Ans. Because of reverse cholesterol transport, it esterifies cholesterol and transfer to liver.
Q4. Name of Apo protein present in HDL.
Ans. Apo A, Apo E, Apo CII.
Q5. How to calculate VLDL?
Ans. TG/5.
Lipidogram 73
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Liver Function Test 75
9
Liver Function Test
Liver function test is routinely done to assess the function of the liver.
Principle
Bilirubin + diazotized sulphanilic acid → azobilirubin (pink).
Bilirubin direct—directly react in acidic medium (water soluble).
Indirect bilirubin—Indirect bilirubin solubilised after addition of surfactant.
Procedure
Total Bilirubin Reagent (R1)
Surfactant 1%
HCl 100 mmol/L
Sulphanilic acid 5 mmol/L
Reagent Preparation
Test Volume of working reagent Add
R1 R2 R3
Bilirubin total 10 ml 10 ml 0.2 ml
Bilirubin direct 10 ml 10 ml 0.1 ml
Observation Table
Mix well incubate for 5 minutes at 37°C for total bilirubin and direct bilirubin. And read at 540–630 nm.
Calculation
OD of test
× conc of standard
OD of standard
Normal range of total bilirubin—0.2–1 mg/dl.
Indirect bilirubin 0.2–0.6 mg/dl.
Direct bilirubin 0.2–0.4 mg/dl.
Results. ................................
Interpretation
Indirect bilirubin • Hemolytic Jaundice
• Gilbert syndrome
• Neonates
• Crigller—Najjar type I
• Crigller—Najjar type II
Direct bilirubin • Obstructive jaundice
• Hepatocellular jaundice
• Rotor syndrome
• Dubin-Johnson syndrome
Liver Function Test 77
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Liver Function Test 79
Procedure
Take 1 ml reagent in tube
↓
Add 20 μl serum
↓
Mix well and incubate 10 min at 37°C
↓
Read at 540 nm
Observation Table
Blank Standard Test
Reagent 1 ml 1 ml 1 ml
Standard – 20 μl –
Serum – – 20 μl
Calculation
OD of test
× conc of standard
OD of standard
Results. ..........................
Interpretation
Conditions when serum protein elevated Hyperproteinemia
1. Dehydration
VIVA VOCE
Q1. Bilirubin is the catabolic end product of which substance?
Ans. By catabolism of heme.
Q2. Write names of water soluble and insoluble bilirubin.
Ans. Conjugated is water soluble and unconjugated is insoluble in water.
Q3. How to define jaundice?
Ans. Yellow discoloration of skin, conjunctiva, mucosa and increase level of bilirubin is known as jaundice.
Q4. Types of jaundice?
Ans. Prehepatic, hepatic, posthepatic.
Q5. Causes of prehepatic, hepatic and posthepatic jaundice.
Ans. Prehepatic—G6PD deficiency, blood transfusion mismatch.
Hepatic—Alcohol intake, hepatitis A, B, C, E, drug induced.
Posthepatic—Stone, cancer of head of pancrease.
Liver Function Test 81
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Liver Function Test 83
Procedure
Take 1 ml reagent in tube
↓
Add 10 μl serum
↓
Mix well and incubate 10 min at 37°C
↓
Read at 630 nm
Observation Table
Blank Standard Test
Reagent 1 ml 1 ml 1 ml
Standard – 10 μl –
Serum – – 10 μl
Calculation
OD of test Vol of standard
conc of substance = × × conc of std
OD of Std Vol of serum/sample
Results: ……………
Interpretation
Conditions when serum albumin elevated Hyperalbuminemia
1. Dehydration
2. Shock
3. Hemoconcentration
84 Practical Manual of Biochemistry
ESTIMATION OF SGOT/AST
INTRODUCTION
SGOT is a serum enzyme high concentration of SGOT found in liver, heart muscle.
Aim: Estimation of serum glutamate oxalotransaminase/aspartate aminotransferase (SGOT/AST).
Method: IFCC method (international federation of clinical chemistry).
Principle
L-Aspartate + 2-oxoglutrate ⎯⎯⎯
AST
→ Oxaloacetate + L-glutamate
Oxaloacetate + NADH ⎯⎯⎯
MDH
→ L-Lactate + NAD
Sample pyruvate + NADH ⎯⎯⎯
LDH
→ L-Lactate + NAD
AST—Aspartate aminotransferase.
LDH—Lactate dehydrogenase.
MDH—Malate dehydrogenase.
Procedure
Pipette Volumes
Working reagent 1000 μl
Test 100 μl
Calculation
3
(ΔA/min) × TV × 10
IU/L =
SV × Absorption × P
P: Cuvette light path = 1 cm.
TV: Total reagent volume in μl.
SV: Sample volume in μ.
Results: ...........................
Interpretation
Increased level of SGOT are seen in:
1. Heart diseases.
2. Myocardial infraction.
3. Liver diseases.
VIVA VOCE
Q1. Parameters included in LFT profile.
Ans. Bilirubin total, direct, indirect, total protein serum albumin, globulin, A/G ratio SGOT, SGPT, ALP.
Q2. Normal value of SGOT.
Ans. 10–45 IU/L.
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Principle
Procedure
Pipette Volumes
Working reagent 1000 μl
Test 100 μl
Calculation
3
(ΔA/min) × TV × 10
IU/L =
SV × Absorption × P
P: Cuvette light path = 1 cm.
TV: Total reaction volume in μl.
SV: Sample volume in μ.
Results: .........................
Interpretation
Increased level of SGPT are seen in
• Liver diseases
• Viral hepatitis
• Toxic hepatitis
• Liver cirrhosis
• Dengue.
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Liver Function Test 93
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Principle
ALP
Phenyl phosphate ⎯⎯⎯
→ phenol + pi
Potassium ferricyanide
Phenol + 4-aminoantipyrine ⎯⎯⎯⎯⎯⎯⎯⎯⎯
→ Orange/red color
Procedure
Blank Standard Control Test
Calculation
OD of test − OD of control
= × Conc of standard
OD of standard − OD of blank
Results
Normal range of blood ALP: 29–130IU/L.
Increased levels are found in children.
Interpretation
Conditions when ALP elevated Bone disease
Obstructive jaundice
Bone carcinoma
Paget disease
Liver cirrhosis
Disease of intestinal tract
Third trimester of pregnancy
Growing children
Conditions when ALP decreased Severe anemia
Malnutrition
Liver Function Test 95
VIVA VOCE
Q1. Which enzyme increase in obstructive jaundice?
Ans. ALP.
Q2. What is the normal range of ALP in serum?
Ans. 29–129 IU/L.
Q3. How many isoenzymes of ALP are there?
Ans. Six isoenzymes (bone liver, placenta).
Q4. Which enzyme increase in bone disease?
Ans. ALP.
Q5. Various conditions where increased ALP levels are seen?
Ans. Hyperparathyroidism, disease of intestinal tract.
Q6. What is the normal range of ALP in children?
Ans. 104–345 U/L in 1–3 years.
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Estimation of Blood Calcium 97
10
Estimation of Blood Calcium
INTRODUCTION
99% of calcium is present in bones. In blood calcium is present in three forms:
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Role of Calcium
1. Present in bone along with phosphorus as hydroxyl apatite crystals.
2. Plays important role in blood coagulation cascade.
3. Muscle contraction.
4. Membrane permeability.
5. Neuromuscular transmission.
6. Act as secondary and tertiary messenger for hormone action.
7. Excitation of muscle and nerve tissue.
Procedure
Blank Standard Test
Working reagent 1 ml 1 ml 2.5 ml
Calcium standard – 20 μl –
Distilled water 20 μl – –
Serum – – 20 μl
Calculation
OD of test Volume of standard
× × 100
OD of std volume of serum
Result: ……………….
Interpretation
Normal range
Total calcium: 8–10 mg/dl.
Ionic calcium: 4.6–5.3 mg/dl.
Hypocalcemia Hypercalcemia
1. Osteomalacia in adult 1. Hyperparathyroidism
2. Rickets in children 2. Hypervitaminosis D
3. Hypothyroidism 3. Bone cancer
4. Steatorrhea 4. Milk alkali syndrome
5. Pregnancy and lactation 5. Thyrotoxicosis
6. Nephritic syndrome 6. Multiple myeloma
7. Hepatocellular disease 7. Polycythemia vera
8. Hypomagnesemia 8. Sarcoidosis
Estimation of Blood Calcium 99
VIVA VOCE
Q1. What is the normal range of serum calcium?
Ans. 9–11 mg/dl.
Q2. How many forms of calcium present in body?
Ans. Three forms. Ionized calcium, protein bound calcium, complexed calcium.
Q3. Write down regulation of calcium.
Ans. See on last page.
Q4. What is corrected calcium?
Ans. Serum calcium + 0.8 (4-serum albumin in gm%).
Q5. Write sources of calcium.
Ans. Milk, egg, dairy product.
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Estimation of Blood Calcium 101
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11 Estimation of
Blood Phosphorus
INTRODUCTION
90% phosphorus is present in bones. In blood phosphorus is present in two forms:
1. Organic form: Phospholipids, glycerophosphate, nucleoside phosphate.
2. Inorganic form: Phosphates bound to various inorganic cations like Na+, K+, Ca2+, etc.
Parathyroid hormone regulates the level of PO43– in blood. PTH increases the excretion of PO43– in urine and
decreases its level. Vitamin D increases the level of PO43– by increasing its absorption from intestine and reabsorption
from renal tubules.
Methods of Estimation
1. Using reaction of phosphate ions with ammonium molybdate.
2. Vandate—molybdate method.
3. Enzymatic methods by monitoring the formation of NADPH, H2O2 and NADH.
Aim: Estimation of blood phosphate by ammonium molybdate method, end point.
Principle: Phosphate react with ammonium molybdate to form ammonium phospho molybdate which is reduced
by reducer aminonaphthol sulphonic acid (ANSA) to form blue color.
Procedure
Blank Standard Test
Reagent 1000 μl 1000 μl 1000 μl
Distilled water 20 μl – –
Standard – 20 μl –
Test – – 20 μl
Mix well and incubate at room temperature for 10 min, then read absorbance at 340 nm.
Calculations
OD of test Vol. of std
× × 100
OD of std Vol. of serum
Result: ……………….
Interpretation
Normal range
Adults: 2.5–4.5 mg/dl.
Children: 4–7 mg/dl.
102
Estimation of Blood Phosphorus 103
Hyperphosphatemia Hypophosphatemia
1. Renal failure 1. Hyperparathyroidism
2. Hypoparathyroidism 2. Fanconi’s syndrome
3. Acromegaly 3. X-linked hypophosphatemia
4. Rhabdomyolysis 4. Malabsorption
5. Chemotherapy 5. Acidosis
6. Aggressive phosphate therapy 6. Respiratory alkalosis
VIVA VOCE
Q1. What is the normal range of serum phosphorus?
Ans. 3–5.5 mg/dl
Q2. Causes of decrease phosphorus level.
Ans. Hyperparathyroidism, diabetic coma, decrease renal tubular reabsorption.
Q3. Causes of increase phosphorus level.
Ans. Renal failure, hypoparathyroidism, hypervitaminosis D.
Q4. Is there any role of phosphorus in buffer system?
Ans. Yes, phoshphate buffer is main intracellular buffer.
Q5. Write biochemical functions of phosphorus.
Ans. See on last page.
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Estimation of Blood Phosphorus 105
3
Demonstration
12. pH Meter
13. Chromatography
14. Electrophoresis
12
pH Meter
INTRODUCTION
pH meter is an instrument used to determine the pH of a solution.
Principle: pH meter is based on the principle of measurement of ECF (electromotive force), generated between
two electrode. This force occurs due to difference in hydrogen ion concentration.
When metal plate kept in a solution of its own salt, it loses ions into the solution and it becomes negatively
charged.
• Metal plate—negatively charged (zinc).
• Solution—positively charged (zinc sulfate).
If two different metal plate (electrode) are used in which one act as reference electrode (known potential) and
other electrode whose potential we want to measure.
Reference Electrode
• Standard hydrogen electrode.
• Calomel electrode.
• Glass electrode.
• Combined electrode.
Precautions
1. Always wash electrode after use, dip into DW.
2. Followed any specific guideline provided by instrument manual.
3. Temperature correction is also required for assessment of pH.
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13
Chromatography
DEFINITION
This technique is used for the separation of closely related compounds, present in a mixture solution like
carbohydrates, lipid, amino acids, vitamins, etc. The term was given by Mikhail Tswett.
Principle: Separation of mixture by chromatography depends on Stationary and Mobile phase. There is
movement of solute mixture in Mobile phase, which move on Stationary phase. This interaction, results in separation
of compounds.
Migration of substance is measured as Rf (ratio of front) value
Distance travelled by substance (solute)
Rf =
Distance travelled by solvent
Classification
Paper Chromatography
Aim: Separation of individual amino acids from a mixture.
Requirements
• Lead pencil.
• Filter paper strip, (Whatman no 1).
• Amino acid mixture (tyrosine, aspartic acid, alanine) (Fig. 13.2).
• Solvent mixture (Butanol: Acetic acid: DW, 12 : 3 : 5).
• Chromatography chamber (Fig. 13.1).
• Capillary tube, pipette, oven, dryer.
• Ninhydrin.
Procedure
• Make 2% solution of amino acid mixture (0.2 gm in 100 ml).
• Cover beaker with aluminum foil to prevent it from oxidation and protection from direct sunlight and air.
• Make buffer solution 12 : 3 : 5.
• Take A clean TLC chamber.
• Take paper and mark two line-one horizontal, one vertical.
110
Chromatography 111
Fig. 13.1: Chromatography chamber Fig. 13.2: Amino acids for chromatography
Result
Calculate Rf value
Distance travelled by substance
Rf =
Distance travelled by solvent
14
Electrophoresis
DEFINITION
It is a technique widely used for the separation of biological molecules like plasma proteins, lipoproteins,
immunoglobulin, etc.
Principle: When charged particles are subjected to electric field they move towards the opposite poles, negatively
charged particles move towards the anode and positively charged particle move towards the cathode.
For example, in alkaline medium proteins are negatively charged, when electric field is applied they move
towards the anode.
Procedure
• Sample is applied on a support media.
• The medium is then placed in a buffer solution, filled in electrophoresis chamber.
• Electric current is passed through the media to carry out electrophoresis.
• Support medium is removed and stained to visualize the separated bands.
Types of Electrophoresis
Free electrophoresis Zone electrophoresis
It is of two types: It has following types:
1. Microelectrophoresis 1. Paper
2. Moving boundary electrophoresis 2. Cellulose acetate
Out dated, mostly used for non-biological experiments 3. Capillary
4. Gel: Further classified into:
a. Agarose gel
b. SDS-PAGE
c. PFGE
d. Two dimensional
Paper electrophoresis: Support medium is a filter paper having adsorptive capacity and uniform pore size.
Filter paper is moistened with buffer and ends of the strip are immersed into buffer reservoirs containing the
electrodes.
112
Electrophoresis 113
Cellulose acetate electrophoresis: It is a modified version of paper electrophoresis, where instead of filter
paper, cellulose acetate membrane is used.
Capillary electrophoresis: Capillarity of narrow bore tube is employed to separate the samples based on their
size: charge ratio.
Gel electrophoresis: Gel is used as a support media for the separation of DNA, RNA and proteins under the
influence of electric current. It is the most commonly used technique.
Instruments required:
1. Electrophoretic chamber (Fig. 14.1).
2. Power supply.
3. Trans-illuminator, to visualize the DNA in gel.
4. Agarose gel support media.
5. Buffer: TAE buffer or tris acetate EDTA (Fig. 14.2).
6. Ethidium bromide dye to stain the DNA.
Procedure
1. Formation of agarose gel: Dry agarose gel powder is mixed with electrophoresis buffer to the desired concentration
and heated till it completely melts.
2. Ethidium bromide 0.5 mg/ml is added at this point.
3. After cooling at 60°C it is added into the casting tray containing sample comb and allowed to solidify at room
temperature. Once the gel is dry sample comb is removed.
4. The gel is removed and placed in electrophoretic chamber and covered with buffer.
5. Sample containing the mixture of DNA and buffer is applied on sample well.
6. Lid and power leads are placed on the apparatus and current is applied.
7. Current flow is confirmed by the presence of bubbles.
8. DNA being negatively charged move towards the positive electrode.
9. Ethidium bromide gets incorporated into the DNA. Once separation has occurred the fragments of DNA can
be visualized in a UV trans-illuminator.
Preparation of Buffer
Tris buffer: 3 gm tris, 0.39 gm EDTA and 0.23 gm boric acid are dissolved in 250 ml distilled water.
1% agarose: 0.1 gm of dry agarose powder is dissolved in 10 ml tris buffer and boiled till it is completely
dissolved.
DNA Extraction
Procedure of DNA extraction.
Types of Fluid
• Milk
• CSF (cerebrospinal fluid)
• AF (ascites fluid)
• PF (pleural fluid)
• Amniotic fluid
• Synovial fluid
• Pericardial fluid.
CSF: Collection of sample by lumbar puncture.
• Fluid is collected in 3 to 4 plain tubes.
• CSF in first tube act as a reserve sample.
• Biochemistry and immunological tests are performed on second tube.
• Culture and other tests related to microbiology are performed on third test tube.
• Tests related to hematology are performed on forth test tube.
If CSF fluid is available in only three test tubes then, biochemistry, immunology and hematology, tests related
to all three are performed on third test tube.
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RBC’s are normally absent in CSF, but it can be present in case of traumatic tap or subarachnoid hemorrhage,
to differentiate between the two conditions RBC count is performed on first tube and third/fourth tube:
In case of traumatic tap, RBC’s will be present in only in tube since first tube is filled first.
In case of subarachnoid hemorrhage RBC’s will be present in both tubes 1 and 3/4
Pleural Fluid
Collection done in 4 mL in lavender top spray coated EDTA tube or dark green top sodium heparin tube.
Biochemical Analysis
• Protein 0–2 gm/dl, sugar 50–70 mg/dl, Cl 95–108 mEqμl/L.
• ADA (adenosine deaminase estimation in pleural fluid is done) 0–10 normal, >10 infection.
AF (Ascites Fluid)
• Sample required > 25 Ml.
• Protein 0–2 gm/dl, sugar 50–70 mg/dl , Cl 95–108 mEq/L, SAAG (serum albumin—ascites albumin).
Also acceptable
• Sterile container (no additive).
• Red top tube.
• Lavender top spray coated EDTA tube.
Synovial fluid for glucose and protein: 0.5 ml in gold top SST or light green (mint) top PST tube.
Dialysate: 3–5 mL in lavender top spray coated EDTA tube.
Precautions
• Always indicate priority of test orders on the requisition.
• Pleural fluid pH must be collected in a blood gas syringe.
• Do not send other fluids in syringes (with or without needles attached).
• All body fluids must be taken to the laboratory immediately after collection. Hand the specimen directly to the
laboratory personnel (do not leave on counter).
16
Reagents Preparation
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17
Biological Waste Disposal
Any material containing infectious material is called biomedical waste. Biological waste is segregated into
appropriately colored plastic bags.
I. Red category: Recyclable infected waste.
1. Tubes
2. Bottles
3. Soiled gloves
4. Urine bags
5. Syringes
6. IV sets
7. ET tubes
8. All medical plastic equipment.
Disposed by: Autoclaving/microwaving, hydroclaving followed by
shredding or mutilation or combination (Fig. 17.1).
II. Blue category: Recyclable waste (glassware)
1. Broken glass
2. Contaminated glass
3. Medicine vials
4. Ampoules
5. Metallic body parts.
Disposed by: Disinfection by sodium hypochlorite treatment or
through autoclaving, microwaving, hydroclaving (Fig. 17.2).
III. White category: Infected sharp waste
1. Needles
2. Blades
3. Scalpels
4. Burnt needle
5. Syringes with fixed needles
6. All medical used metallic sharps.
Disposed by: Autoclaving or dry heat, sterilization, followed by
shredding, mutilation or combination (Fig. 17.3).
IV. Yellow category: Waste contaminated with blood body fluid and
infected cytotoxic waste.
1. Discarded medicine Fig. 17.1: Autoclaving/microwaving,
hydroclaving followed by shredding or
2. Human anatomical waste multilation or combination
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18
Blood Gas Analyzer
INTRODUCTION
Measurement of blood gases, pH and electrolytes, metabolite,
bicarbonate concentration by blood gas analyzer (Fig. 18.1).
Principle: pH, PCO2, PO2 can be directly measured by analyzer.
Generation of potential difference between two electrodes is
responsible for measurement of pH, PCO2 and PO2. Hb is measured
in percentage saturation. Bicarbonate concentration calculated by
Handerson–Hasselbach equation. For the measurement of electrolytes
Na+, K+, Ca++, Cl–, Li+ ion selective electrode (ISE) method is used.
Sample: Arterial heparinised whole blood sample, volume 70–
100 μl.
Procedure: As per the manual provided with instrument.
Precaution
• Arterial blood sample should be used.
• Blood sample should not be clotted.
• Analyze the sample as soon as possible within half an hour.
• Instrument should be washed after or between uses of samples.
Clinical Applications
• Acid-base disorders.
• Critical care patients.
• Burn cases.
Fig. 18.1
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Blood Gas Analyzer 127
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Blood Gas Analyzer 129
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Blood Gas Analyzer 131
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Blood Gas Analyzer 133
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Blood Gas Analyzer 135
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Blood Gas Analyzer 137
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DNA Extraction and its Applications: An Overview 139
Isolation of nucleic acids (DNA or RNA) is a basic and essential step in molecular biology. The main purpose of
this procedure is to obtain a relatively purified form of DNA for doing the downstreaming techniques like PCR
analysis, mutation or polymorphism studies using restriction fragment length polymorphism (RFLP). Since the
quality and quantity of DNA affect the results of the above downstreaming procedures, procedure of isolation of
DNA plays a crucial role in the molecular biology.
There are several methods for isolation of DNA (Flowchart 19.1). All these methods involve four basic essential
steps:
1. Cell lysis,
2. Digestion/removal of protein,
3. Concentration/precipitation of DNA, and
4. Determination of the purity and quantity of DNA.
1. CELL LYSIS
Cell lysis is the most crucial step in the DNA isolation. Lysis can be done by different methods, i.e. physical
methods (sonication and grinding) or by chemical/enzymatic methods (detergents/lysis buffer). The strong forces
applied in physical methods lead to shearing of DNA. So the best way to do the cell lysis is by chemical/enzymatic
methods
2. DEPROTEINIZATION
The second step in the isolation of DNA is removal of proteins from the cell lysate. This procedure is also called
deproteinization. Depending on the property of solubility differences, different methods were developed. Methods
that exploit solubility differences are: Solubility differences in organic solvents, solubility differences of salts or
detergent complexes and differences in absorption to charged surfaces.
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Organic solvents: Most commonly used organic solvents are phenol and chloroform with isoamyl
alcohol. Due to the hydrophobic nature of the phenol, it helps in unfolding and precipitation of
proteins.
Detergents: Detergents help in deproteinization by forming insoluble complexes with nucleic acids and proteins
(e.g. CTAB). At high NaCl concentrations, CTAB will form insoluble complexes with protein but not with nucleic
acids. These insoluble complexes are removed from solution by centrifugation and the DNA is collected from the
aqueous phase by ethanol precipitation.
Silica based: The principle of silica matrices purification is based on the high affinity of the negatively charged
DNA backbone towards the positively charged silica particles. In the presence of a high concentration of salts,
DNA will bind to a silica surface, whereas proteins, due to the predominance of hydrophobic characteristics in
high salt, will not. The bound DNA is washed to remove impurities and eluted from the glass beads by lowering
the salt concentration. Besides silica matrices, nitrocellulose and polyamide membranes such as nylon matrices
are also known to bind with nucleic acids, but with less specificity.
Enzyme based: Proteins can be removed from DNA or RNA preparations using an enzyme protease that can
digest all proteins. Proteinase K and pronase are 2 such enzymes which are used DNA purification.
4. QUANTIFICATION OF DNA
The last step of any DNA isolation procedure is the determination of concentration and purity of DNA. Method
of choice used for the determination of DNA concentration is ultraviolet (UV) spectrophotometry. Nucleic acids
have maximum absorbance at 260 nm and for proteins at 280 nm. So, the 260/280 is used to measure the purity of
isolated nucleic acids. A 260/280 ratio of 1.8 and 2.0 is generally accepted as pure for DNA and RNA repectively.
Any lower ratio may indicate the presence of protein or other contaminants in the isolated DNA. Similarly other
substances like phenol tend to have absorbance at 230 nm, so the ratio of A260/A230 is also frequently calculated.
A ratio ranging from 2.0 to 2.2 is considered pure. Any contamination from the phenol or guanidine leads to low
260/230 ratio.