Dr.

Pragasam Viswanathan
Professor, SBST
Is the study of chemical processes
in living organisms, governs all
living organisms and living
processes.
Much of biochemistry deals with the structures and
functions of cellula component such as
carbohydrates,r lipids s proteins,
biomolecules. , nucleic acids and other

Today the main focus of pure biochemistry is in understanding

how biological molecules give rise to the processes that occur
within living cells which in turn relates greatly to the study
and understanding of whole organisms.
 .

As an experimental science of biochemistry requires

numerous instrumental techniques that enable the
development and expansion, some of them are used daily in
any laboratory and others are very exclusive.

•Subcellular fractionation, •Flow cytometry

including multiple •Immunoprecipitation
techniques •ELISA
•Centrifugation •Electron Microscope
•Chromatography •X-ray Crystallography
•Electrophoresis •Nuclear magnetic resonance
•radioisotope techniques •Mass Spectrometry
•PCR

The most known is the use of
radioiodine (Iodine-131) in the
treatment of hyperthyroidism and
differentiated thyroid cancer.
Is a technique that uses specific antibodies
to a protein to remove these proteins from
the solution. Examples include protein A,
protein G, Zysorbin, or adding a second
antibody to the solution.
In medicine, diagnosis or
clinical propaedeutic is the
procedure by which a
disease is identified or any
condition of health-
disease.

The medical diagnosis is

based symptoms, signs
and findings of additional
tests to determine what
disease a person suffers.
Symptom Sign
s s

Physical Supplementar
Examinatio y
n Examinations
physical experiences are reported by the
patient . Not be observed
Example
:
 Fatigue  pain
The sings are findings in the patient and
are detected by the doctor. Can be seen

Example
 Fever :  Edema
It consists of various maneuvers
performed by the doctor in the patient

Inspectio
n

Palpation percusio
n

Auscultatio
n
INSPECTI
ON
• is the method of physical examination is
done by sight.

PALPATION
• is the process of examining the body using the sense
of touch. Provides information on shape, size, texture,
surface moisture, tenderness and mobility.
PERCUSION
• is a method that is tapped certain body parts during a
physical examination with fingers, hands or small
instruments to assess the size, consistency, borders
and presence or absence of fluid in the body's organs.
AUSCULTATION
is to listen, either directly or through instruments like
the stethoscope, normal or pathological sounds
produced by the human body.
They are a set of studies that provide valuable information to medical
analysis, and either to confirm or give more certainty to the diagnosis of a
disease.

Biops
y

Radiograph Ultrasoun
d
Biopsy: procedure in which
tissue samples under a
microscope to observe.

Radiograph: noninvasive
procedure, which shows soft
and solid structures of the
body.

Ultrasound: uses sound waves

to create images of internal
oraganos.
Tuberculous (TB) pleural effusion occurs in approximately
5% of patients with Mycobacterium tuberculosis infection.
The HIV pandemic has been associated with a doubling of the
incidence of extrapulmonary TB .

The diagnosis can be established in a majori ty of

patients from
the clinical features

 pleural fluid examination

 including cytology
 Biochemistry
 Bacteriology
 pleural biopsy
acid-fast bacilli in the sputum
The definitive diagnosis of TB
pleural effusions depends on the pleural fluid
demonstration of:
pleural biopsy specimens.
 TB pleural effusions can manifest as primary or reacti
vated disease.

is considered the initial event in the pathogenesis of

primary TB pleural effusions.

•predominantly from:

increased capillary permeability and

because of
•secondarily from: occlusion of
pleural stomata
impairment of lymphatic clearance of proteins and
fluid from the pleural space.
The definitive diagnosis of
TB pleural effusions depends:
demonstration of M tuberculosis
in:

 sputum
pleural fluid
pleural biopsy specimens.

others:

demonstration of classical
TB granulomas in the pleura
and elevated
adenosine
deaminase (ADA)
IFN-_ levels in pleural fluid.
 • A TB pleural effusion is
typically clear and straw
Pleural Fluid colored
• it can be turbid or
Examination serosanguinous
• Pleural fluid pH is
usually
between 7.30 - 7.40

• in patients with HIV

Pleural Fluid coinfection, the yield of
pleural fluid microscopy is
Smear and 20%
Culture • Culture requires a minimum
of 10 to 100 viable bacilli
Polymerase chain reaction (PCR) is based on amplification of mycobacterial
DNA fragments.
Advantages of PCR include rapid diagnosis, improved specificity and sensitivity,
a
nd no requirement of intact immunity.
The utilization of immunodiagnostics is hindered by its low sensitivity. The
Table lists the details regarding various studies using immunologic markers
in the diagnosis of TB pleural effusions. Further studies are required to
address the clinical utility of these markers.
for yOur attentiOn!!!