GSE

Tools: light microscope; slides, coverslips; wooden sticks; plastic container; Lugols iodine,
marker (wax) pencil
Collection: Instruct pt to collect stool sample in clean, dry plastic container w/o
contamination with urine. (preferably collected in the lab).
Macroscopic (Gross) exam: As soon as the specimen is received in the lab, check
consistency (degree of moisture) & write one of the following letters on the container: F
(formed), S (soft), L (loose), or W (watery).
If mucus present write M, & if blood present write B. E.g., loose stool with blood & mucus
would be recorded as L, B, M. Consistency os stool, will be a guide as to whether the
trophozoite stage or cyst stage of protozoa is likely to be present.
Microscopic examination of wet mounts
1. With a wax pencil write the pt's name or number at left hand end of slide.
2. Put a drop of saline in the centre of left half of slide & put a drop of iodine solution in the
centre of right half of the slide.
3. With wooden stick, pick up a small portion of stool (size of match head); pick up a small
portion of mucus & mix with the drop of saline. The thickness of the film should be such that
one is able to see the printed letters of the newspaper through it.
4. Similarly, pick up a small amount of the stool & mix with the drop of iodine, to prepare an
iodine mount.
5. Cover the drop of saline & drop of iodine with coverslip. Hold coverslip at an angle, touch
the edge of the drop, & lower gently on to the slide. This will reduce the chance of including
air bubbles in the mount.
6. Put the slide on the microscope stage & focus on the mount with the X 10 or low-power
objective, until you
are able to see objects in the field distinctly.
7. Examine the entire coverslip area with the X 10 objective; focus the objective on the top
left-hand comer & move the slide systematically backwards & forwards, or up & down. Most of
the eggs are large enough to be recognized with the low-power (X 10) objective, but a few
small eggs require a high-power, dry lens.

Tests for detection of occult blood in feces: Many tests are available which differ in their
specificity & sensitivity.
These tests include tests based on peroxidase-like activity of hemoglobin (benzidine,
orthotolidine, aminophenazone, guaiac), immunochemical tests, & radioisotope tests.
Benzidine Test for Detection of Occult Blood in Stool
Principle: peroxidase activity of heme portion of hemoglobin present in stool liberation of
active oxygen from hydrogen peroxide. The liberated oxygen oxidizes benzidine in acidic
medium to form greenblue complex.
Procedure
In a test tube make suspension by adding ~ teaspoon bezindine powder with a spatula in
0.5 mL glacial acetic acid.

 Take a portion of stool sample in another test tube & add 7 mL of distilled water & mix well.
To this add the benzidine and acetic acid suspension.
Then add 2-3 drops of hydrogen peroxide solution.
Let stand for 1 minute. A blue-green color within 30 seconds means that occult blood is
present (+ve test)