Saleem Hafiz ( Department of Urology and Transplantation, Civil Hospital, Karachi. )
Disease and Disease processes have existed since the creation of Universe, and it is neither the beginning nor the end but a continuous process which would last till eternity. Medicine has developed into a number of specialities in which laboratory Medicine has a special place in it. For diagnosis, prognosis and prevention we are dependent on laboratory results and as sophisticated tests are developed the cost is increasing. Pathology laboratories receive thousands of requests that cannot reasonably be expected to influence the management of patients. The best use of the laboratory involves sending only relevant specimens. This is especially important when the economic situation of a country greatly limits the laboratory resources. Screening investigations of large numbers of patients are rarely justified with few exceptions; on the other hand no investigations are criminal as proper investigations not only provide better tools to understand the disease but also reduce the recovery time, is economical and at the same time reduces the frequency of complications.We intend to publish a series of short articles in the forthcoming issues taking the significance and the ideal method for collections of appropriate specimens which would provide a basic guide to medical men and I am sure would help them a great deal in the management of their patients. Some of the basic principles which are common to all disciplines of pathology are as follows:
Clinically relevant specimen
It is extremely important that relevant specimen be collected for investigations.
Quality of specimens
When poor quality specimens are sent the laboratory produces many useless results! The collection of good quality specimens is dependent on:
1. The optimal time of specimen collection.
2. The correct type of specimen.
3. Well collected Specimen.
4. Adequate quantities of each specimen and an appropriate number of specimens.
5. Clearly labelled and safe specimens. Transport of specimens to the laboratory
The specimens should be transported to the laboratory as soon as possible because inmost cases holding the specimens would deteriorate the specimens and the rate of deterioration is directly proportional to the duration. If possible specimens be collected in the laboratory where tests would be performed.
Provision of essential clinical information
The request form be properly completed specially, age, sex, brief clinical details, date of onset of the illness, antibiotic history and if possible provisional clinical diagnosis. This assists the laboratory to evaluate the specimen in the best possible way. Start adhering to the basic principles and you would see the difference in the diagnosis and management of the patients.