Clinical Laboratory Instruments

Ranjan Maheshwari
Professor, Electronics Engg.
Rajasthan Technical University, Kota
Many biochemical and
analytical tests
Human body is a bio-chemo-electro-mechanical
balance.
Signal and image may not give certain indications
that may be obtained by
Analysis of Blood
Analysis of Tissues
Analysis of body products like sputum, saliva, urine,
stool.
So, a combination of all is must…
The instruments
Analyze in two distinct method
Qualitative
Quantitative
In qualitative analysis, the presence, absence or
morphological abnormalities are sought.
In quantitative analysis, differential analysis with
component wise contribution is obtained.
Most of the tests are optical
Either a microscopic/visual examination is performed, which is
direct…
 Malaria parasite test,
 Erythrocyte Sedimentation Rate
 Some Pathogens
 Sputum etc…
Sometimes standard reagents are mixed and then observation is
done…
 Blood group test
 Cultures
 Immunological tests
Colorimetric, photometric
procedures
In some cases, sample is checked for some optical
properties.
In some cases, reagents are mixed which give a better
contrast/color and differentiation.
Comprehensive blood
constituents
Spectrophotometer
Very commonly used for photo-chromatic properties.
With change of light source, lens, filter, spectrum and
reagent, many tests can be performed on one
instrument.
Colorimeter
measures the absorbance of particular wavelengths of
light by a specific solution.
This device is most commonly used to determine the
concentration of a known solute in a given solution by
the application of the Beer-Lambert law,
which states that the concentration of a solute is
proportional to the absorbance.
A Typical Colorimeter
(1) Wavelength selection
(2) Printer button,
(3) Concentration factor
adjustment,
(4) UV mode selector (Deuterium
lamp),
(5) Readout,
(6) Sample compartment,
(7) Zero control (100% T),
(8) Sensitivity switch.
The normal and pathologic values
 for commonly ordered tests of the blood (cells and
chemistries), urine, cerebrospinal fluid, and other
serous fluids.
There are many more tests used in the diagnosis of a
specific disease. These tests are highly specific, but
may not be sensitive.
They are a useful means for confirming an
hypothesis, but should not be used until a narrow
differential diagnosis has been established. These
more specific tests are not discussed here.
Laboratory tests: four reasons
1. Screening: A small number of tests have been demonstrated to
find "silent" disease in the patient who has no symptoms or
signs or specific risk factors for the disease.
2. Case finding: Some tests are used to find disease in specific
clinical populations at risk, even if signs or symptoms are not
present. They differ from screening tests because they are not
used in the general population. An example is testing the bone
density of elderly women for osteoporosis.
3. Diagnosis: This is the use of tests to assist in making (or
excluding) a diagnosis suggested by the symptoms and signs in
patients.
4. Monitoring: Tests are often used to monitor the progress of
disease, response to therapy, or concentration of medication.
One of the most common tests…
Blood group
Erythrocyte sedimentation rate (ESR)
1. The ESR is a simple non-specific screening test that
indirectly measures the presence of inflammation in
the body.
2. It reflects the tendency of red blood cells to settle more
rapidly in the face of some disease states, usually
because of increases in plasma fibrinogen,
immunoglobulins, and other reaction proteins.
3. Changes in RBC shape or no. may also affect the ESR.
4. Average values, healthy men: <15mm/hr; in healthy
females: <20mm. The values are slightly higher in old
age, in both genders.
Westergren method
1. Requires collecting 2 ml of venous blood into a tube
containing 0 .5 ml of sodium citrate.
2. The blood is drawn into a Westergren-Katz tube to the
200 mm mark.
3. The tube is placed in a rack in a strictly vertical position
for 1 hour at room temperature, at which time the
distance from the lowest point of the surface meniscus
to the upper limit of the red cell sediment is measured.
4. The distance of fall of erythrocytes, expressed as
millimeters in 1 hour, is the ESR.
 Wintrobe method
1. The method is performed similarly except that
Wintrobe tube is smaller in diameter than the
Westergren tube and only 100 mm long.
2. EDTA (Ethylenediaminetetraacetic acid)
anticoagulated blood without extra diluent is drawn
into the tube, and the rate of fall of red blood cells is
measured in millimeters after 1 hour.
3. The shorter column makes this method less sensitive
than the Westergren method because the maximal
possible abnormal value is lower. However, this
method is more practical for demonstration purposes.
Leukocyte Count
The White Blood Cell (WBC) Count measures two
components:
the total number of WBC's (leukocytes), and the
differential count.
The differential count measures the percentages of
each type of leukocyte present. WBC's are composed
of granulocytes (neutrophils, eosinophils, and
basophils) and non-granulocytes (lymphocytes and
monocytes).
White blood cells are a major component of the
body's immune system. Indications for a WBC count
include infectious and inflammatory diseases;
leukemia and lymphoma; and bone marrow disorders.
Currently, manual and automated both
methods are employed. Recently, image
processing methods have also joined in.
Malaria Vivax and slide

18
Malaria falciparum

19
Malariae

20
Plasmodium Ovale

21
Electrode theory
When two dissimilar electrodes are dipped in an ionic
solution, they result in a potential difference.
The potential difference is highly specific to the
material of the electrode.
It is an algebraic difference of the potential
generating capacity of the two electrodes.
This capacity (called the half cell potential) has been
calibrated against a hydrogen electrode.
Requirements of electrodes
The electrodes can indicate the presence of certain
ions and pH of a certain solution.
It has found many applications in environmental
monitoring and chemical processes.
The method is online and provides instant results,
which is very important.
Different type of electrodes
Ion selective electrodes
Found applications in pH, O and CO partial pressure
2 2
measurements.
Homogeneous electrodes (skin, scalp, needle)
Found applications in ECG, EEG, EMG, ERG, EOG etc.
They simply provide a firm and consistent interface
between the subject and the measurement system.
Bio potential Electrodes
 Bio potential electrodes are based on the pH theory.
The potential between two electrodes depend upon
their chemical properties.
 The same theory is applicable on electrodes as well.
 The electrodes are ion selective electrodes, which
have selective permeability (semi-permeability) and
cause a potential difference.
pH electrode
The pH electrode exploits the Nernst equation
And can be simplified as
E=-0.615 log10 ([H+]i/[H+]o)
The difference of hydrogen concentration in inner
and external solution results in an electrode.
pH electrode
Blood gas electrodes
Here is an pO electrode
2

The Membrane is made of

polypropylene Which has
selective permeability.
The platinum cathode with
membrane makes it oxygen
electrode.
 Ag-AgCl electrodes
The skin, scalp or
needle electrodes are
Ag-AgCl electrodes.
Ag-AgCl interface
reduces the ohmic
contact using a wider
surface and adhesive.