and II, hepatitis B and hepatitis C, etc.
¾ Routine biochemistry investigation and organ profile
tests, e.g. lipid, cardiac, liver and renal profiles.
¾ Under hematology, these laboratories may also
provide RBC indices, platelet, reticulocyte count and
absolute eosinophil counts. They can also classify
anemias and should be able to indicate hematologic
malignancies. When headed by a pathologist, they
should be in a position to report bone marrow smears/
These kinds of laboratories should be able to perform all
kinds of sophisticated and delicate/precise investigations.
The tertiary laboratories can branch out in very special
fields and not cater to all aspects of specialized tests.
Besides doing all investigations that are conducted in
secondary laboratories, they also carry out the following:
They are equipped with 18 parameter cell counters with
differentials and flow cytometry
¾ Complete biochemical assays, commonly referred to
as SMA-12, SMA 27, etc. Also included are elemental
assays, e.g. zinc, magnesium, iron, total iron binding
capacity (TIBC), lithium, etc. special enzymes like
HBDH, lipase and isoenzymes, etc.
¾ Complete immunology based assays for hormones,
cancer markers, hepatitis markers, rheumatic/autoimmunity etiology-based profiles, TORCH profiles,
rare infectious diseases (e.g. brucellosis leptospirosis,
cysticercosis, echinococcosis, etc.)
¾ All microbiological processes, e.g. cultures—aerobic,
anaerobic, fungal, tubercular, etc. with antibiograms.
The techniques for these investigations may vary. They
may be ELISA, chemiluminescence, turbidimetry, PCR,
etc. These laboratories are totally automated and have
sizable workload. Furthermore, they also undertake all
histopathology (simple H and E, special staining techniques,
immunohistochemistry methods) and cytopathology
processing and reportings. They may also undertake
cytogenetic investigations, e.g. chromosomal analysis.
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