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LAB SERVICES

DEPARTMENT OF CLINICAL BIOCHEMISTRY

The Department of Clinical Biochemistry at Bristlecone Hospital is internationally renowned and highly specialised in the measurement of circulating biomarkers.

The department is dynamic, innovative and dedicated to excellence within the field of clinical biochemistry, haematology and coagulation disorders.

Focused on providing laboratory tests to benefit patient care, we perform analyses requested both from general practitioners and hospital-based doctors. We support patient-near analyses (POCT) performed both at the hospital and by general practitioners. In addition, we run a clinic for patients with thrombosis and haemophilia and a number of specialised tests on national and international request.

The biochemistry department offers a broad spectrum of tests for the diagnosis and monitoring of disease, and response to therapy. These will measure levels of specific chemical components of body fluids required to assess or monitor the function/dysfunction of organs such as the heart, kidney, liver, thyroid etc.

Tests include blood glucose, electrolytes, enzymes, hormones, lipids (fats), other metabolic substances, and proteins. These tests are performed using fully automated and sophisticated equipment, able to handle high volumes, and make results available within a very short turnaround time.

AUTOMATION

This section performs the high volume of routine and urgent tests required from clinical chemistry in a large NHS Trust. It is staffed 24 hours a day, but with minimum staffing levels outside core hours.

ENDOCRINOLOGY

This section offers a comprehensive range of endocrine tests including tumour markers, hormone assays and markers of cardiac damage.

SPECIAL CHEMISTRY

This section performs a range of assays, which require the use of specialist analytical techniques such as mass spectrometry and HPLC.

The biochemistry section is a new generation laboratory, fully equipped with the latest state of the art technology. Analytes of serum and other body fluids are measured like routine and specific assays of proteins in serum, urine and cerebrospinal fluid, including specialized tests like oligoclonal protein banding. The laboratory accepts stat requests and aims for a rapid turn-around time on all samples.

This laboratory also applies mass spectroscopy for rapid detection of a broader array of toxic agents and drugs than possible with less advanced technology. The monitoring of immunosuppressant drugs such as cyclosporine and immunoglobulins is also done. Mass Spectrophometry also permits analysis of renal calculi within 30 minutes. Immunology section performs hormonal and other non-infectious assays using Chemiluminiscent Immunoassay (CLIA) Fluorescence intensity Luminescence, Fluorescence polarisation, and Enzyme-linked Immunosorbent(ELISA) assays. Of special note are the fetal lung reactivity profiles and alpha fetoprotein assays in serum and amniotic fluid for neural tube defect screening and tumour marker studies.

HAEMOTOLOGY

The Department of Haematology treats malignant and benign hematologic diseases. Malignant diseases include acute and chronic leukemia, various lymphomas, myeloma and "pre - malignant" diseases like myelodysplastic syndrome (MDS) . Amniotic diseases include congenital anemias, especially thalassemia, various coagulation diseases and other benign diseases of the blood cells.  

OUR DEPARTMENT OFFERS:

  • Medical services - These services are provided by three separate units - the inpatient department, day care unit, and outpatient clinics.
  • Laboratories - Service laboratories that perform many diagnostic tests - some routine and some unique
  • Apheresis Unit - provides treatments for a wide range of diseases.

Another important area is the study of abnormalities of blood coagulation. Coagulation (blood clotting) measures the ability of the blood to clot, either as a check before surgery, patients who have unexplained bleeds, or monitoring patients on anticoagulants like warfarin & heparin.

DEPARTMENT OF IMMUNOLOGY

The Immunology Department provides a wide-ranging service for the investigation, diagnosis and treatment of conditions which result from dysfunction of the immune system. The integration of laboratory and clinical services allow us to provide a cutting edge laboratory testing service which is essential in the diagnosis and monitoring of complex immune diseases. Clinically, there are two main areas in which we specialise: Allergy and Primary Immunodeficiency.

ALLERGY

Allergy results from an immune reaction to a substance which would otherwise be harmless. We offer outpatient clinics for the diagnosis and management of allergies, including desensitisation immunotherapy where appropriate. Anaphylaxis represents the most severe end of the spectrum of allergic disease, and the Resuscitation Council UK guidelines advise that all patients who have suffered an episode of anaphylaxis are referred to a specialist allergy clinic to allow the identification of any triggers, reduce the risk of future episodes and to prepare the patient to manage any future episodes.

Summary of services:

  • Anaphylaxis
  • Urticaria
  • Food allergies
  • Aeroallergens (eg animal dander, pollens)
  • Investigation and diagnosis
  • Management
  • Desensitisation immunotherapy

MEDICAL MICROBIOLOGY - SEROLOGY

The Serology Laboratory performs tests for chlamydia and gonorrhea using Transcription-Mediated Amplification (TMA) methodology.

Acceptable sources include:

  • Endocervical
  • Male Urethral
  • Serologic tests are available for Syphilis, Hepatitis A, Hepatitis B, Hepatitis C,
  • HIV 1/2 + O Ab/Ag, Rubella (IgG and IgM), Tularemia and Brucella.
  • The mission of serology department is to provide state of art services in:
  • Screening all donated blood units for transfusion transmitted infections (TTIs).
  • ABO/Rh typing of all donated blood units.
  • Antibody Screening of all donated blood units.
  • NAT testing of all donated blood units.

The Serology Department consists of 3 main Laboratories:

  • The Microbiology Screening Laboratory.
  • The Red Cell Serology Laboratory.
  • The Nucleic Acid Amplification Technology (NAT) Laboratory.
  • Other Responsibilities

Training Programs:

The Serology Department develops Training Programs to all new staff, as well as on job trainings for all staff working in screening laboratories within the National Blood Transfusion Services.

The Quality Implementation:

The quality assurance program of the Serology Department encompasses: the development and maintenance of written procedures; training, continuing education and competency evaluation of staff; participation in proficiency testing programs; validation of software, hardware, equipment and procedures; and the analysis of errors and outcomes of routine audits and practices.

MICROBIOLOGY

WHAT WE DO

  • The Microbiology Department is part of the Laboratory Medicine.
  • The three main sections of the laboratory are:
  • Bacteriology is concerned with
  • Culture of a range of biological material (e.g. swabs, urine, blood, sputum) from human sources.
  • Isolation and identification of potentially pathogenic bacteria.
  • Determination of antibiotic susceptibilities.

Serology involves the diagnostic identification of antibodies in serum. Such antibodies are typically formed in response to an infection (against a given microorganism). Serological tests for antibodies to HIV, Hepatitis B & C and Syphilis are, among others, available in the Clinical Microbiology department.

Molecular Microbiology employs a highly sensitive technique known as Polymerase chain reaction (PCR) to amplify (replicate many times) a specific target DNA sequence in order to detect a particular pathogen.  Molecular Microbiology, like Serology, is employed when the suspected microbial agent either cannot be isolated in culture by any known method or can be isolated in culture only with great difficulty (e.g. Chlamydia).

  • We provide a routine clinical microbiology service for investigation of infectious disease.
  • We test a variety of specimens (including; urine, faeces, blood, tissue, fluids and swabs from different bodily sites, hair, skin and nail) for evidence of infection.
  • We look for infection caused by bacteria, viruses, fungi and parasites.
  • We process screening samples for the identification of MRSA and Clostridium difficile toxin detection in both community and hospital patients.
  • We determine which antibiotics are most useful to treat a particular infection using antibiotic sensitivity testing methods.
  • We test blood samples for viruses (including HIV, Hepatitis A, B and C, Rubella, syphilis, Chicken pox, measles, mumps) using automated analysers.
  • We screen specimens from  GP family planning and hospital clinics for sexually transmitted infections (STIs).
  • We work closely with the hospital and community infection control teams to help prevent the spread of infection within the hospital and other healthcare settings.
  • Tests and investigations are performed by Biomedical Scientists who are supported by Medical Laboratory Assistants.
  • We report results of investigations to other healthcare professionals.
  • We do not give results to patients, relatives or friends.  They will only be given to the requesting doctor (Data Protection Act and patient confidentiality legislation).
  • Turnaround times for microbiology samples vary due to the length of time taken for micro-organisms to grow.  Most micro-organisms will take 24 to 48 hours to grow and identify but some may take up to 6 weeks to grow.
  • The majority of investigations are performed on site, but some samples are sent to reference laboratories and may take longer to be completed.

HISTOPATHOLOGY

WHAT WE DO

Histopathology is the study of diseased tissues and organs through the examination of the microscopical architecture of tissues and the relationship between the different types of cells and tissue types found within tissues and organs.

The histopathology department receives tissue specimens from patients, taken at either surgical operation, outpatient or GP clinics, or at post-mortem examination. Specific pieces of tissue or cells or fluids removed from patients are taken that are associated with the condition under investigation and sent to the laboratory.

By examining the tissues or cells or fluids removed from patients the histopathologist can determine whether disease is present and, if so, what affect the disease will have on the patient. The report is then sent to the treating clinician who explains this diagnosis and its implications to the patient.

WHOM WILL YOU MEET

If you are a patient there should be no circumstances under which you would need visit the histopathology department as all specimens are sent to the department by the clinical team managing your care. However, if you are a healthcare professional, you can visit our department but please contact us before hand to arrange this.

The service includes:

  • Paediatric pathology
  • Neuropathology
  • Muscle pathology
  • Metabolic disease
  • Autopsy (including perinatal post mortem)

Our scientific team offer a range of specialist investigations including:

  • Immunohistochemistry
  • Electron microscopy

Molecular diagnostics is a technique used to analyse biological markers in the genome and proteome—the individual's genetic codeand how their cells express their genes as proteins—by applying molecular biology to medical testing. The technique is used to diagnose and monitor disease, detect risk, and decide which therapies will work best for individual patients.

By analysing the specifics of the patient and their disease, molecular diagnostics offers the prospect of personalised medicine.

These tests are useful in a range of medical specialisms, including infectious disease, oncology, human leukocyte antigen typing (which investigates and predicts immune function), coagulation, and pharmacogenomics—the genetic prediction of which drugs will work best. They overlap with clinical chemistry (medical tests on bodily fluids).

The rise of molecular biology has revolutionized the diagnosis and treatment of diseases. Modern test methods, based on the detection of DNA and RNA, offer many advantages over traditional methods for the detection of diseases. The new procedures can detect viruses, bacteria and genetic variations faster and much more accurately. Treatments can be tailored better to individual patients.

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            Bristlecone Hospitals, A unit of Virinchi, Banjara Hills is now accredited with NABH.             Now Accredited with             Bristlecone Hospitals, A unit of Virinchi, Banjara Hills is now accredited with NABH.             Now Accredited with