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FIGURE 28.3
Aminophenazone Test for Occult Blood
Reagents
Aminophenazone solution:
Procedure (Figure 28.4)
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Stool Examination
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Clinical Significance and Treatment
Epidemic cholera
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exhaustive diarrhoea.
('rice-water stools').
may
die within three hours due to dehydration
(oral rehydration therapy or ORT)
Specimen Collection and Processing
Stool and swab samples
cholerae.
Procedure
room
temperature.
Caution
Medical Laborato Technology: Volume 2
Dispatch of Specimen for Laboratory Culture
Transport Media
Ca-Blair transport medium:
2. Venkataraman-Ramakrishnan ) medium:
Immobzan test
cholera.
cholera.
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cholerae
Equipment and Reagents
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FIGURE 28.5
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Medical Laborato Technology: Volume 2
Laboratory Culture
brio cholerae
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ote:
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Stool Examination
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Oxidase Test of Colonies
Precautions to be Taken While Performing the Oxidase Test
Oxidase Test Results
PVNCH
PUNCH, where V or Vibrio is replaced by
2. V:
N:
6.
Chemical Tests
Staing and Biochemical Reacns of cholerae
(RIY)
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Serological Reactions
(slide agglutination
test).
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Medical Laborato Technology: Volume 2
REVIEW QUESTIONS
V cholerae
V cholerae.
Background
IntroductIon
Molecular Pathology
If one compares the role of pathology in medicine to a tree, it gets obvious that the roots are the foundations,
basic science, and the branches are dierent clinical specialties, Molecular pathology is based on the
principles, techniques, and tools of molecular biology as they are applied to diagnostic medicine in the
clinical laboratory. The eld of molecular pathology is “so rapidly changing that you cannot just focus
on one thing for the future. The diversi cation, the perception of transcending sequencing; it is evidently
going beyond genomics.
Though Informatics helps
us with the ever-increasing
complexity in molecular
data, there is a crying need
to embrace new technology
and products to exploit what’s
newly available. As molecular
biology methods are being
used to elucidate the genetic
and molecular basis of many
diseases, such discoveries have
ultimately led to the emergence
of predictive molecular
pathology2. In the current
situation, where our country
and the world faces a Covid-19
pandemic, the shining beacon
that helped turn the tide on this
pandemic was the ability of
molecular diagnostic testing, by laboratories worldwide. The practice of molecular pathology has been
and continues to be dependent upon new and robust molecular diagnostic technologies to interrogate
DNA and/or RNA sequences for detection of sequence variants associated with a particular diagnosis,
prognosis, or therapeutic response1.
Newer developments are taking place daily in the eld of molecular pathology as the need for genetic
disease, hematologic disease, infectious disease, pharmacogenomic, solid tumour, and identity testing
continues to increase. The rapid pace of change due to the advent of new technology, ongoing discovery
Medical Laboratory Technology: Volume 2
ii
of the nature of dierent diseases, and the development of new treatments all mean that molecular
pathology is in a ux of continuous evolution. As technologies become more robust, faster, and cheaper,
the adoption of the not-so-common tests will also increase. Hence, it is clear why research in molecular
pathology is the catalyst for a sea change in which pathologists, clinicians and key stakeholders from
across the care continuum need to be deeply involved with the common goal of improving molecular
diagnostics for today and for the establishing predictive molecular pathology as the cornerstone of
the future. Only by assimilating new information and technology into pathology practices can patient
outcomes be improved continuously and consistently. This is visibly evident from the irrefutable
contribution of molecular pathology to various facets of science.
Molecular Pathology and Onco Diagnostics
Molecular Pathology is evolving to address the challenge of cancer and improve cancer diagnostics /
therapies. It is well known that cancer is caused by a combination of inherited and progressively acquired
genetic mutations in specic cells that give rise to the tumour. Examining the tumour’s genetic material
can lead to a very complex yet highly specic diagnosis. Based on the detection of these point molecular
alterations, with a clear oncogenic role, treatments have been developed to block the activation of mutated,
amplied proteins or product of translocations by specic drugs. It is only with molecular pathology at the
molecular components of the cells, like DNA and RNA, and other cellular constituents such as proteins,
that many further divisions of these types can be identied. A diagnosis based on the genetic or molecular prole
of the tumour indicates which targeted therapies are likely to provide better ecacy, now and in the future
when new targeted therapies are available. Finding the optimal treatment for a patient based on an
indivi-dualised diagnosis is a move away from what has been referred to as the ‘trial-and-error’ approach
of prescribing. This approach also has the potential to improve patient quality of life by reducing
their experience of adverse events by choosing a therapy suited to the patient’s tumour prole. And
importantly, targeted therapies have been shown to enable patients to live longer when compared with
non-targeted therapies in a range of cancers3.
Hence, the identication of patients with therapeutic molecular targets in their tumours is currently
a standard of care. Notwithstanding that, the initial morphological diagnosis and the eventual tumour
classication by immunohistochemistry (IHC), as well as the acquisition, handling and processing
of tumour tissue play a pivotal role. As this aspect of molecular pathology grows more complex and
specialized, it is not easy for physicians and healthcare leaders to keep up-to-date with the changes–
particularly when contact time with pathologists is limited. For patients, pathology can just be a report,
but for the clinicians involved with the therapies, improved understanding and collaboration in molecular