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Choosing the Correct Investigations for a Given Situation

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Dr Abhay Kantilal Shah, Ahmedabad    19 January 2018

Diagnosis of any medical illness depends on carefully elicited detailed clinical history, thorough clinical It is very important to send correct investigation at the correct time. The sample collected should be stored and transported as per recommendations and should be analyzed in laboratory by correct method. The lab results should be interpreted correctly and be correlated with positive findings.

Some of the common things that need to be observed in our day to day practice are as follows:

  1. Aseptic precautions while collecting the sample is must.
  2. Collect the specimens before starting antimicrobials or antimalarials.
  3. Always cultivate the culture of sending cultures before starting antibiotics.
  4. Store blood and CSF culture specimens at room temperature, whereas urine and stool culture specimens in refrigerator.
  5. Always differentiate between true infection, contamination and commensals.
  6. Always be aware of limitations of serology like Widal test, dengue serology, etc.
  7. Send Widal test for diagnosis of typhoid during second week and by tube method.
  8. Always insist for a microbial diagnosis in infectious diseases like tuberculosis.
  9. Molecular methods like CB NAAT for TB and rapid antigen tests are fast evolving as a point of care testing.

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