What Medical Lab Tests Reveal [Archives:1998/09/Health]

March 2 1998

What is behind a visit to a biomedical lab when a Yemeni arrives and asks for a check-up. A check up means blood urine and feces analysis and after Eid there are many complaints. Only the ills of an affluent society? Not so These days whether here or abroad modern technology has made analysis results quick for the public and a lot of people suffer. They suffer from roundworm, tapeworm, amebiasis, malaria and lishmaniasis and hyperactive thyroids which can be detected in an equipped lab. This does not exclude diagnosing heart ailments through enzyme tests done.

A good biomedical lab whether in Sanaa or not will be equipped today with automatic spectrophotometers to measure uric acid in the blood, immunoassay analyzers to measure such things as the presence of HIV in the blood, or other viruses and hormone levels and blood counters to give blood cell counts and volumes. There are also microscopes for slide preparations and gel electrophoresis machines to measure the presence of abnormal amounts of certain lipoproteins in the blood which would be indicative of arteriosclerosis for example. Here are some of the common ailments found in Yemenis, as they have themselves tested after the Eid and what preventive measures they can take.

The roundworm which forms a cyst in a vector like cow meat, can end up in the human liver. Obviously the meat must be cooked well so as to kill the vector. A test at the lab can reveal its presence, the stool is diluted with normal saline solution which is at the same salt concentration as in physiological tissue and is smeared on a slide to be examined. Ascaris eggs have characteristics that can be identified under a light microscope. These worms can also be evacuated in the stool. A therapeutic agent for this and other roundworms is Pyrantel Pamoate. Rarer parasitic diseases like Tenia Saginata are also identified from stool smears which would reveal proglottides or eggs depending on whether the worm was sexually mature in the host organism or not.

The proglottides are the individual body segments of the worm which detach from the parent organism while attached in the digestive tract and from which a new organism can result. Each proglottide has an excretory, reproductive and digestive system. The eggs of the tapeworm may be laid near the anus of the infected individual. Treatment is Niclosamide Paromomycin.
Other parasitic ailments analyzed at the lab include giardiasis mentioned some months ago. The giardiasis produces cysts under unfavorable conditions or while passing out with the stool and can be detected by an appropriate laboratory smear. Alternately, duodenal contents can be obtained by aspiration through a gastric tube and its contents analyzed. This protozoan, usually prevalent in children at day care centers can be treated with Metronidazole. Dysenteric amebiasis is less common, although a threat in Yemen and the ameba can also be detected from saline smears made from the stool of the infected individual.
Blood flukes like Schitosomiasis, due to infected water and a cause for intestinal or hepatic fibrosis, can be diagnosed by examining embryonated eggs in the stool or urine. It can be treated by Niridazole.

Malaria which is quite common and can be detected through blood slides which are stained so as to reveal the protozoan. It is important to identify the type of plasmodium as this will influence the therapy and prognosis. Visceral leishmaniasis, on the rise in the Horn of Africa is also a threat here. The protozoan is transmitted by the sandfly and its manifestations may are visceral, affecting the liver, spleen and bone marrow, whereas other varieties of the same disease affect mucocutaneous or cutaneous tissue.
The cutaneous variety of leishmaniasis, prevalent in the Middle East, can be demonstrated in smears or cultures obtained from ulcer curettes. A good lab will equip itself with a needle biopsy facility, as sensitive serological tests are not generally available. Pentavalent antimony compounds are used for treatment. Antibiotic treatment is indicated for secondary bacterial infections.

What about the person who chews qat for years? Even heart ailments that qat chewing can provoke, can be detected at the laboratory. The chemical tested for is creatinine kinase, it is an enzyme normally present in heart tissue and an increased level of this enzyme in the blood is indicative of damage to the heart tissue. This is more true for the consistent qat chewer than for those who chew occasionally and damage might be due to the increase stimulation of the heart muscle in people who chew. But there is also an increase of SGOT, a transaminase usually involved in maintaining the aminoacid pool in the body.and LDH. An increased SGOT would mean that a certain amino acid is being produced in excess because the heart tissue is loosing protein which is made up of that aminoacid.
Pesticides are sprayed regularly on the qat to kill fungal parasites but can accumulate in the liver and cause destruction of that tissue. The damage can be measured through the analysis of SGOT and SGPT levels as mentioned above. SGPT also maintains the aminoacid pool.

And about the presence of oxalic acid crystals in the urine? If the Yemenis drink normal underground water they are more susceptible to the presence of this salt in the urine as the water does have a high salt content. A similar presence of other crystals in the urine might occur for those that eat an over abundance of meats. An abnormally high meat diet rich in proteins can be related here. The solution is to modify the eating behavior of the individual so that he eats a greater variety of food and less meat. An unchecked diet may eventually mean the build up of these crystals in the urine and therefore in the kidney which accumulates them, sometimes causing kidney stones which would further complicate matters.
Such ailments could make up a typical working day of a biomedical lab technician , who after performing tests, and analyzing the results forwards them to the individual who can get treatment as quickly as possible.

Martin Dansky ,
Yemen Times.