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Cholesterol


HDL

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Triglycerides

IgA, IgG, IgM

%5

Phospholipids
% 10

% 10



() %

9.

2.

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13

61

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AST 90
CK

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15

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48

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20-

CK

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- .

: :

"

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:

24 .

1025 1015 :

-:

( )Urinometer 1000 1060 ( )20 .

40 3

: ( )1 3 20

( )1 ( 3) ( 20)
: 26 ( ) 1021 6)
()1023

:
:
:

3 1 .

5 3 %3


()Amorphous Phosphate

:
:
5 3 8

++

+++

++++

:
( )


( ) :

( )
.
.1

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.3

) .

.4

.
.5 .
.6

:
(: ) Hay's Test

.....

( ) :

( : ) Gemelin's Test

10 4 - %10 -

( - ) .

(: )Iodine Test

4 4 (

0.5

100 ) .

:
.1

.
.2 .
. 3
.

.4 1000 1500

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.6 ( ).
.7

.8 ()Cover
.
.9 .
.10 .
.11 .
.12
.13

" X 10 "Low Power

"Power X 40 "High

7 ( )

. ()H.P.F

( ):

12
( )
.
4 1 ( )HPF
.

(:)Cells Epithelial

( )

( .... )

( )

( )

()CASTS
:

()Hyaline casts

()granular Casts

()Epithelial Casts

()Blood Casts

()Pus Cell casts

/ ()Fatty Casts

( )

15

700 .

( )E. COLI

:
.


................................................:
/ / :
:
-

:
-

:
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- /

......................

:

( )LATEX

11 .

:
.

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.

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.
.




.


.


.


1\ .
CO2
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.

%90


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.


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(Sterile disposable Iancet


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.7 .
:
- ( serum
37 .
- :
.
(Anticoagulants
-1

Ethylene diamine tetra acetic acid EDTA


.
-2

((H2 O) Trisodium Citrate2 Na3 C6 Hs07

( 32 / 4
( 1.6 0.4 + .
9
.
-3

.
20 15 / .

-4 :
30 20 10 / .

-5 :

10 / ( 3 +
( Metabolism .
serum
.

,
Antiserum
antigene
antiserum

()PH
3
* : 7.45
.
.
* : 7.35
CO2

* :

--------------



-1
- :

(
:
( % (
:
.1 ( 0.02] .
.2 .

.3
( 10/1 .%20
.4 10 .
.5 :
.
.6 ( % .
:

.
- Drabkin Method :

(Spectrophotometer

540 (Blank

.
.
:
.1 5 20 + ( ul20 (
.
.2 5 3 .
.3 540 .
.4 ( Standard
:

.
:
Standard 2:1 : 3:1
4:1 5:1 .

/
.
:

11 13 %

1.15 1115 %

( )

1.15 1.15 %

( )

1315 .15 %

1315 11.5 %

1315 11.5 %

. 3

14 12 %

12 1.

1415 - 1115 %

11 %

-2 Counting R.B.Cs
Haemocytometer :
.1 200:1 20 4
( 101 1 0.5
0.5 101 .

.2 ( .
. 3 .
.4 X 10 X40
5 (
+ .
:

:
/ = 3 * 10000
:


.
-
.1 20 .
.2 .
.3 .
.4 .
.5 .
:
....
- :
.1 20 .
.2 .
.3 .
.4 .
.5 .
:

.15 415 /

511 311 /

( 3)

411 312 /

( . 3)

515 411 /

( 12 1.)

514 4 /

-3 Leucocytic Counting Total :


Haemocytometer

.
:

-1 2:1 11 1 0.5
0.5 .11
-2 20 0.38 (
.

-3 .
-4 .
-5 ( *10
.
:
/: 3
* = 2/100 * 50
:
.
.
:
.1
(/25000 18000. 3
.2
.
.
. .
:
. . .
:

/ 3

/ 111... 4...3

( )

/ 111... ....3

( 7 4)

/ 151... 5...3

( 12 1)

/ 1315.. 415..3

Sedimentation Rate

Westergren :
: 30 2.55
.200

. .
:
.1 1.6 0.4 %3.8 ( 4
.
.2 .
.3
.
.4 .

5. 17

7 1

5.

1. 2

5. 17

. 3

5.

15 5

:
.1

.2 .
.3 .
:
.1 .
.3.

.4 .

.5.

.2 .
.6 .

Differential Leucocytic Count

:
.1 .
.2 2 1 .
.3 (
45
.
.4 .
.5 .
:
.1 .

.2 .

.3 .

.4 .

( ):
.1 .
.2 3 2.
.3 .
.4 10 7 .
.5
.
:

100 .
200 .
(
.Absolute value
:


()Neutrophil

%75 4.

/ X 10 9 715 2

()Lymphocyte

%45 2.

/X 10 9 4 115

()Monocyte

%1. 2

/ X 10 9 .11 .12

()Eosinpohil

%.1

/ X 10 9 .14 .1.4

()Basophil

%1

/ X 10 9 .11 .1.2


-:

.

-:
-1 :

:

:
: .
: 12

( .

.
-2 -:

.
-3 ( )Haemolysis

.
-:

( )Thalassemia ( Sickle Cell Anaemia


)
.
: ( (
.
.

.
.
-4
.
. .
-5

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.
-: 0000
.
.
-:

( -:

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.
.
.
.
.
.
,
.

( 1 (
.

6 5
6 14

(
(

100/
11
12
13
12
11

( 1996
-:
:
:
( 37 ( 5 2
.
.
.
.

.
_:
:
.
. .

.

.
-:
.

.

.
:
. . .
.
:

( + ( .
.
:
( %80
( F Hb ( A Hb
,. ( %3.5-1.5
. A2 Hb (( 2

Hb
A
Hb 2

A
Hb

F
Hb

Bart
Hb
H

S Hb

%98

%3

%2

%0
%0

%0


%90

%0
%0
%0

= 16-13 100 /
= 15-12100 / .

(
( .
.
.
:
-1 ( (Comple Blood Count CBC):
( 7 10 100
.
.
. .
-2 "" ( sickling test) :


.
.
(
.sickle test) Positive

.
. .

-3 :

. (
HBs %50
.
.

2 ( Hb s
( A Hb ( . Hb F
.
4 ( Hb
A ( . s Hb

(s HB



......

.




spectrophotometers -Colorimeters or (
Specimen

Serum .
.
( Solution Standard

.

.
"Absorbance "A
"Transmittance "T

:

( A ( Blank
( T
( :
/ X = ... /
AT / AS X Cs = mg/dl
:

A

T

S
Cs
mg/dl 100 (
Kits

( ( Kits
.
(
(

Kits
.1 .
.2
.
.3 .
1
.
.
.
.
( .
.
:


.
R2- R3 ( R ......
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.
:


(
.
Cuvettes .


.
.

.

:

:
:Tungestic Acid
%10
3/2( 18.6
.
%1. 1%2.


.
117 07 177 8
11 157 117 177
)Physiological Hyperglycemia

( 18 11) 07 07 100
" " Physiological Hypoglycemia).
() ( )

) (Insulin
)(Anti-Insulin . ) (Glucagons )(Adrenaline

) ( Glucocorticoid ) (Growth Hormone (Thyroxin).


.
.

) ( Diabetes Mellitus :
.
:

" ".

:
- ( Hyperglycemic Coma):

, .

-1

-1 ( ) .
-3 .
-4 .

) ) Ketones Bodies

.

.
- ( Hypoglycemic Coma):


07 177 .
:
-1

-3

-4

-1


( 14) .
() (Diabetes Mellitus):

:
) (1 )( Insulin Dependent Diabetes Mellitus

( IDDM):

) ( Type 1 47 37

) ( IDDM
.
( )1 ( Non- Insulin Dependent Diabetes
)Mellitus ( NIDDM):

) ( Type

( ) .
))

-1 :

( )

) ( Fehling ) ( Benedict

) ( Strips ) ( Glucose Oxidase


.

) (Glucose Analyzer (Glucose


)Oxidase

) ( Oxygen Electrode

.
-2 ( Random Blood Glucose):

-3 ( Fasting Blood Glucose) :

11 8
117 07 177 117
137
3 .

-4 ( Post Prandial Blood Glucose):

( 05 )

.
140 .
-5 )( Glucose Tolerance Test
( GTT):

.
11 8

75 ( 1 ) 3

.
117 07 137 117
1 3
" )" ( Insulin Shot
.
137 180
.

3 1
.
-6 )( Glycosylated Haemoglobin - HbA 1c

) )

() Haem

A1c
%17 - 5 ( HbA1c).

) ( HbA1c

117 %8 - 5
.
-7( Fructosamine):

17 - 15 .

) (Glycosylated Proteins

()
-1
-3

:
.

-1 .

173 175 )

.
-4
.

-5
-0


-0

( )


:
: : 10



5.5 - 3.5 100 / ( 55 - 35 /(.
:
. . - .

. :
- .

. . . . . :
. " "
. " "
:

:

.

3.6 - 2 100 / ( 36 - 20 / )
:
-

. :
-

: 8

0.6 - 0.2 100 / ( 6 - 2 /( .


:
:

- :

: :

. :
. :

8 - 6 011 ( ( 60 - 80 /.
- : :


( )
( )


- : :

:

:
) (GGT ) ( ALT/GPT ) ( AST/GOT
.
( ) :

() ) ( AST/GOT )( ALT/GPT

) ( GPT 45 /.

) (GOT 41 /..

) ( GPT ) ( GOT

) ( GOT .
"

" 6 .

) ) ( )GGT


30
25

50 .
:-

()

:
)) )(ALP

" " .

) (PH 7

71 - 24 /
( 30) 350 /
:

- .

. :

) ) :


) ( ID - BIL

) ( D - BIL .

) ( T- BIL

19 - 3.5 /
7 /.
:-:

" ".

" "
" "

"

" " " .

.
- .

: Kidney Function Tests

:
) (1 ( Urea) :

) ( NH3 .

%50

.
40 - 20 100 / ( 7 - 3.5 /)
) Blood Urea Nitrogen ( BUN 25 - 8 100 / ( 8.9 - 0.9
/(

40 - 20 100 / 15 - 5 100 /
20 - 5 100 / .
:


Hepatic Coma

Hemodialysis

.
Cachexia Malnutrition Starvation
:


.
:


.
) (2 Creatinine :

Anhydrous

Creatine Phosphocreatine

14

1.5 - 7.5 177


1.5 24 /

1.0 24 /
:
0.5 100 / .
) (3 Creatinine Clearance Test:

24
24.

140 - 90 /
125 - 80 /

) Creatinine Clearance (c :
C= Uc Tv/24 60 Sc

Uc
Sc
14

Tv
24

60

:
Water Depletion ) (4 )( Uric Acid

Purine
Adinine Guanine.

0 - 3 177 ( 7.53 - 7.18 / )


0 - 1 ( 7.45 - 7.15 / .
% 87
.

077 - 377 14 /
) ) ( )

14 .

:
- Gout

Pre - Eclampsia &Eclampsia Leukaemia Glycogen Storage Disease - Type 1 -

Alcoholism :
-

Allpurinol Probenicid .

:
Total Lipids

( ) (
)

: ) (Triglyceride ) ( Fatty Acids) ( Waxes


) ( Steroid ) ( Terpenes
(

) Cholesterol ) (Triglyceride ,
1000 - 450 100 /

) )

-:


"" .

) ( Lipoproteins

.

() .
:

:
-

:-

1 - 20

120 - 230 1.. /

21 - 30

120 - 240 1.. /

31 - 40

140 - 260 1.. /

41 - 50

150 - 290 1.. /

51 - 60

160 - 300 1.. /

) " TG" :
% 90 ) ( Chylomicron
) 10 % ( Very

)Low Density Lipoprotein - VLDL


.

1 - 30

10 - 140 1.. /

31 - 40

10 - 150 1.. /

41 - 50

10 - 160 1.. /

51 - 60

10 - 170 1.. /

:
-

- ( LDL )

:-

( Fatty
)Liver

: Lipoproteins Analysis


-)( Chylomicrons

)( VLDL )( LDL- Low Density Lipoproteins- )( HDL - High Density Lipoproteins

:-

() )( HDL - High Density Lipoproteins

HDL ) ( - lipoprotein % 25
% 45 -

HDL HDL

.

HDL
HDL

HDL

HDL .

HDL 40 / 100 ( 0.83 2.5 / (


) )(LDL- Low Density Lipoproteins

) ( - Lipoproteins

% 75 - 50 LDL

LDL HDL

.
LDL 180 100 / ( 3.88 - 0.5 /)
LDL :
LDL Cholesterol (mg/dl) = Total Cholesterol - HDL Cholesterol - Triglyceride
5
Triglyceride mg/dl 400

LDL :

LDLCholesterol (mmol/L) = Total Cholesterol - HDL CholesterolTriglyceride


22
:
Triglyceride

LDL Cholesterol
HDL Cholesterol
Total Cholesterol

35 - 55 55

HDL-Chol mg/100ml
45 - 65 65
150 - 190 150
LDL-Chol mg/100ml
________ ________
LDL - 3.8 - 5.9 3.8
Chol
3.1 - 4.6 3.1

35
45
190
________
5.9
4.6



Electrochemiluminescence and Elecsys 1010 Elecsys 2010

.....

"

" ()53:

.....

" "

( ) " "

" "

( 1000/1)

-:

-1

-3

-5

-2
-4

-:

-1

" "

()DNA

-2 " "

-3 "
"

-4 " "

-5

: " Pituitary gland ":

TSH
ACTH
FSH
LH

)ADH(Anti- diuretic Hormones



Oxytocin


TSH

ACTH

GH

FSH +
LH

-:

( T4)Thyroxin ( ) T3
:

-1
-2
-3

-4

Calcitonin

.1 T3 T4

( )T4

T4 01-5 011/ ( 056-65 /).

T3 1000-1010 011 / ( 101 - 10.0


/)

T3 T4
T3 T4 :

() .

( )

() .
()

() T3

T3 T4 :

() .

( ) .

() .

-2 ( :)Hormone Thyroid Stimulating ( )TSH


( )Anterior Pituitary Gland
( ( )Hypothalamus - )
T3 T4

5-105 /.

TSH

( )TSH :
- .

- .

( ). - .

( )1 :

( )2 :

/ :

/ :

Myxodema

: -:

Parathrmone

-:

" "

- :

: ( ) -: Adrenal gland

: :
-1
-2

-3
:

.
: .

( )


-1

-2 glucagon
.

: . ovary

-1 :

-:
:

440 - 70 /

620 - 220 /

70

130000 - 20000 /

330

70

FSH

( . ) LH

-2 :
.

(
)

10


28
14-7

ng/dl

100

6-1

ng/dl

20-150

28-15

ng/dl

250-2800


ng/dl

900-4700

ng/dl

ng/dl

1700-14700
5500- 20000

ng/dl

100

1
8 .

: Testis

.
.

nmol/l
nmol/l

9-38
( 0.35-3.8 )

* 3.5 nmol/l

* nmol/l

(1.4 )

: -: LH ( )Hormone Luteinizing
( )Hypothalamus

( )LH
( )Glycoprotein (
)Estrogens ( )Progesterone .
( )LH ( )Testosterone
.

( )LH 11-1 / .

81-05 /

( )LH 808-0 /

( )LH 108 /.

( )LH :
( )Menopause Normal ( Premature

.)Menopause

( )LH :

.
.

( .)Shihan Syndrome

-: ( )FSH ( )Follicle Stimulating Hormone


( )FSH ( )LH
.
( )FSH .
( )FSH ( )LH :

( )Infertility

( )FSH

( )FSH :

( .)Menopause

( .)Failure Seminiferous Tublar

( . )Climacteric

( .)Ovarian

( )FSH :

( ).

( .)Panhypopituitarism

( .)Anorexia Nervosa

( .)Hypogonadism

( )FSH -1
01 /.

( )Ovulation 11-8

/.

( )FSH 0105-0 /

( )FSH 105 /

-: ( .)Prolactin



.
( )Follicular Phases

( .)Luteal Phases

( )Amenorrhea ( .)Oligomenorrhea

( .)Oligospermia

( )Galactorrhea ( .)Gynecomastia

( .)Galactorrhea


* 15-8 /.

* 15 611 /.
*

00-6 /.

( )Phenothiazine

( )Haloperidol
.
-:

Bulimia - (

-:
*
*

3 8

* 37


*
*
*

-: ( )GH ( :)Growth Hormone

( )Anabolic
.

( )Lipolysis .

( )GH 1088 /.
( )GH ( )Stress
( )GH .

( )GH
:

( )Dwarfism

( )Gigantism 01

( )GH

( :)GH

( )Stress

( .)Gigantism

( - - ).

( -).

( :)GH

( )Glucocorticoids 0

-: -:


.


:

.


Hepatitis C

"" (
. (
HIV
. ( 170
9 4 .
.
180,000
( 10,000 .
.
( .
()
.
( ) (A, B, C, E, D, G
.
15 . 30
" . " (
. .
%80 .
20 5
. (
. 600
.
( (
( 1989 .
( .1992
(ANTI-HCV).
()
:

( .

( .

( .


.

. 1991
( . (
( Hemophilia

.
.
( (
. (
.
:
(
.1
.
(
.2

.3

( HIV

.4

()

( .
.%15
.

()
.%70 - %85 %25
10 .

.

.
. (
.


. (

. .
(

( (
( HIV
( .

(
.
.
.

( .
( . (
.%6 .
.
.

( HIV . (
( .
.

.

ALT AST
( .

(

.
.

()

(
( .ANTI-HCV
( ELISA

( .
.
.

ALT.
5% (

( HCV-RNA.

( ALT
ANTI-HCV
.
( ANTI-HCV

(
HCV-RNA

.

()

(
:

( - .

( .

(

. (
( .
( ( ( .
( ( .
()
Alpha Interferon 3
ribavirin (
6 12.


( ) Biopsy









.


.


(


( excisional biopsy
(

( . incisional biopsy


( needle biopsy

( Core biopsy
1.5
12.5

.
( Fine needle aspiration

( CT scan

.


( Grading ( Staging


.


( biopsy

.


( )

( )

- / /



) (

-:

) Preanalytical ( -1
) Analytical( -2

) Postanalytical( -3

-:
-:

: 1
LE Cell (60%)
-1
ANA, Anti Dn\NA
-2
Infectious mononucleosis : 2
CBC Paul Bunuel Monospot (70%) -1
Serology for Epstein- Barr , Virus ( VCA,EIZNA) -2
VCA IgM
Stage
1- Primary EBV infection
+ve
(Early phase )
2-Primary EBV infection
+ve
(Transient phase )
3-Primary EBV infection
- ve
(Convalescent phase)

VCA IgG EBNA IgG

- ve

- ve

+ve

- ve

+ ve

+ ve

4- Reactivated infection

+ ve

+ ve
B

1-HBsAg
2-HBc IgM

+ ve

-: 3
Exposure &cusonicity
Recent infection
3-

HBc IgG
4-HBeAg
5-HBeAg
6-PCR
7-HBsAb
HCG in blood

Old infection
Infectivity
Partial convalescence
Viral replication(Viraemia)
complete recovery &Immunity
-: 4

: Latex -: 5
Rheumatoid factor, CRP, ASOT
Turbidimetry & Rephlonetry

( ) -: 6
Glycolated Hb

-:
Prgnancy Test
Thyroid function
Liver function
Kidney function
Diabtes profile
Antinatal and prenatal screening
Collagenic disease profile

) (

- -:
-1 -:

* -:

# 6 8 ( 12 )
# 10 12 ( 14 )
#

# Iron, ESR, CA19.9 :

* : 4 7

* -:

* -: & &

* :-PSA
0

* -:

* -: 24

-:

* -:

* -: TIBC , Iron , G6ph 3 4


* _: Catecolamine , VMA ,5HIAA 48


* -: Aldosterone

* -: Renin

* , , 3 -: 0

* -:

* -:

3-2( FSH )

23- 21( Progestrone ) 0

* 9 -: ACTH Cortisol 9
* -:

# , , , ,

# ( )

# , ( P.T , P.T.T

)
# ( )

# ( ) 0
# :

-:

* 24 -:
0

* -:

20
30 Container0

* -:

* -: ,
,

* -: 0

* -:

-:
# 0

# 0
#

# 0
# 0

# ,

1 3

4.9%

Total protein

6.7%

Iron

4.7%

Total Lipids

5.1%

Cholesterol

9.3%

AST

8.4%

Bilirubin

6.2%

Potassium

# 0
# 0

&

# 0
#
Citrate 0.2 ml ----- EDTA ----- Citrate 0.4 ml ----- Serum
# (
0) Vacutainer
#

2 3 " "

# CBC 0 EDTA
# 0

0 0 Hemolysis :K, Ck, LDH , SGOT , Mg


Bilirubin , Glucose
# :
Frozen 20 0 - Refrigerated 8-2 0

25 18

- CK 0 LDH

# 0
# 0

# :

20 37 2000 5 0
#

# 0
# 0
#
0

- -:

-1 0
-2 ( , , )
0 Quality Control

-3 Kits
0

-4 0 Standard $ Control
-5 0
-6 0

-7 0
-8 0
-9 ( )
0

-10 0
-11 0 Pamphlets
-12 :

* ( )
Reagent

* (

0
-13 0 Accuracy & Precesion

* : Accuracy Calibrator

: 90-89-90-91-90

* : Precesion Calibrator

:
91-88-92-95-90

-14 Reagent

0
-15 Pipetting 0 Pipettes

-16 CBC Coulter


:

Platelets : <1 oil immersion field --- decreased


: several oil immersion field --- normal
: >25 oil immersion field --- increased
WBCs :
2-4 /HPF --- 4000 7000
: 4 -6 /HPF ---- 7000 10000
: 6-10/ HPF --- 10000 12000
: 10 20/HPF --- 13000- 18000
-17 Duplicates %10 0
-18 Media (

)0

-19

0
-20 Lot 0
-21

0
-22 ( 2 3

) 0

- -:

# 0

# 0
#

#
0

-#
# -:
1- Bilirubin (Total) > Direct
2- 1 h value is the highest in sugar curve
.
3- HDL + LDL + VLDL = Total Cholesterol .
4- VLDL x5 = Triglycerides .
5- Cholesterol + Triglyceride < Total Lipids, usually 2/3.
6- CK Total > CKMB .
7- Drug peats > TCoughs.
8- Post Prandiel sugar > Fasting except in diabetics especially
insulin dependent.
-# GGT , Alk.phos. 0

-# Direct
1.5
-# PH 0
--- , 0 Amorph.urates ,
---

0 Amorph. Phosphates ,

-# %100 /
/ 0
-#

Gram +ve , -ve , Cocci , Bacilli 0

-#
-# :
TSH
T4,T3

1-

2- TSH
T4,T3
0
-# ( ) 0

:
Roche Hitachi 912 Chemistry Auto-analyzer

:
.


ELecsys 1010

Spectrophotometer 5010

Microlab 200

: 3

C.B.C
( BLOOD FILM )
R.B.Cs

R.B.Cs HB Content
Variation in Size
Variation in Shape

W.B.Cs

Granulocytes
Lymphocytes

Plateletes
Reticulocytes

!Error

Steps For Stain

THE GROWTH
OF BACTERIA
AFTER 24 hours.

(ELISA - PCR

Rapidlab 248
and 348 Systems

B C
C

PCR

Ventana

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