Specialties

The P. D. Hinduja Hospital Blood Centre is one among the few Blood Centres in the private sector which has the approval of the Food and Drug Administration (FDA) for preparing and issuing Blood Components to patients. Providing "safe blood" to the patients is the main aim of our Blood Centre. To ensure this, blood is collected only from healthy friends and relatives of patients who volunteer to do so.

A strict screening is carried out to exclude professional donors from donating blood units thus uaranteeing safety and quality. Further, all units of blood are screened for HIV antibodies HBsAg, HCV antibody, VDRL, etc. 90% of the blood collected is separated into various components such as packed RBC, platelets, cryoprecipitate and plasma.

Thus the patient is given only the component he/she is deficient in, thereby avoiding the side effects of whole blood transfusion. All types of blood components are available round-the-clock in the Blood Centre. Availability of machines such as Cell Separator allows us to harvest specific blood components in pure form & in large quantities from a 'single' donor.

The quality of blood components is closely monitored to ensure efficacy & safety. We carry out a large number of 'apheresis' procedures using the latest Cobe Spectra cell separator, in adults as well as in children. Apart from platelet apheresis which is done routinely, Therapeutic plasma exchange is also carried out in a variety of disorders like Hemolytic-Uraemic- Syndrome, Myaesthenia Gravis and Gullain-Barre Syndrome. We are also amongst one of the few centres carrying out Peripheral blood stem cell (PBSC) collection and cryopreservation.

Hematology offers an exhaustive menu of investigations. Routine blood counts are done by top of the line equipment such as LH 750 from Beckman Coulter and Sysmex XE-2100 Blood Cell Analysers which give multiple parameters for each blood cell in every sample within a minute. The equipments generate interpretative data, along with flags or signals for abnormalities of red cells, white cells and platelets. All such 'flagged' samples are reviewed by the hematologist and a descriptive report with advice is issued to the patient.

A large variety of tests for characterizing complex bleeding and thrombotic disorders are available. These include coagulation factor assays, tests for thrombophilia and platelet function tests. Reliable monitoring of oral anticoagulation is made possible with the help of high quality reagents.

Other specialized investigations being carried out include study of abnormal hemoglobins by high performance liquid chromatography (HPLC), hemolytic anemia studies, leukemia cytochemistry etc.

We also have a FacCanto II Flow Cytometer which is capable of performing a 6- colour analysis simultaneously. This is a powerful tool for diagnosis, monitoring, staging & prognosis of a large number of hematological malignancies (acute leukemias and lymphomas) & immunological disorders (immune deficiency syndromes such as HIV).

Molecular test for diagnosing thrombotic disorders and some myeloproliferative diseases are also available to facilitate diagnosis of these less commonly occurring conditions.

Heparin induced Thrombocytopenia (HIT) Test

Thrombocytopenia, a frequently occurring complication of heparin therapy is known as heparin induced thrombocytopenia (HIT). 1 – 5% of patients receiving heparin develop heparin induced thrombocytopenia. This is seen 5 – 15 days after starting heparin therapy if the patient is not previously exposed to heparin.

Clinical symptoms associated with HIT syndrome primarily include low platelet count and an increased risk of venous and/or arterial thromboembolism and the development of antibodies against a complex of heparin and Platelet Factor 4 (PF4). The HIT antibody test reveals detectable antibodies against the complex.

The Hematology Department has introduced a new test, the HIT Antibody Test. This is a Particle Gel Immuno Assay which reveals detectable antibodies against the heparin and Platelet Factor 4 (PF4) complex.

Sample Requirement: Blood (3-4 ml) sample should be drawn into Plain tube (no anticoagulant) as serum is required for the test. Patient need not be fasting.

Report Availability: The test will be performed on routine basis. Report of samples received by 1pm, available same day after 6 pm, else next day.

Histopathology offers services for processing of surgical specimens. In addition, 'frozen section' service is provided for urgent diagnosis, enzyme/muscle studies, fat stains, etc. Specialised study of kidney biopsies in chronic renal disorders & transplants by Immunofluorescence and Special Stains is possible due to the availability of the fluorescence microscope.

For more objective diagnosis of tumours, the Immunoperoxidase study utilising Monoclonal Antibodies and Immunohistochemical technique is available which makes diagnosis of undifferentiated and poorly differentiated tumours easier in more than 50% cases. This is also useful for hormone receptor analysis of tumors and oncogene studies.

The section also performs immunoperoxidase studies for dystrophin in frozen muscle tissue of muscular disorders. All surgical specimens are processed by standard technique and reported with grading and staging of tumours according to internationally used classifications. The cytopathology laboratory handles both gynaecological and non-gynaecological specimens sent for cytology.

About half of these are gynaecological 'PAP smears' for early detection of cervix cancer. The section has a standard cytospin for preparing concentrated smears of body fluids with low cell count or of small volume specimens like CSF, Urine etc. Fine needle Aspiration Cytology (FNAC) is also carried out for all palpable swellings in the body as the first line of investigative workup before a surgical biopsy.

Pneumocystis carinii detection in respiratory secretions is carried out by the immunofluorescent technique.

In addition to routine tests like Widal, VDRL, RA, CRP, etc., infection and autoimmune disease serology is performed. Serological investigations for "difficult to grow" pathogens as Mycoplasma, Leptospira, Pneumocystis, Cryptosporidium, Cryptococcus neoformans, Helicobacter pylori, Dengue, etc. are performed by Enzyme Immuno Assays, Immuno-fluorescence & Immunochromatographic techniques.

Polymerase Chain Reaction (PCR) for TB, HBVDNA, etc., is also carried out for rapid diagnosis of infection. ELISA Readers facilitate accurate results to ensure good sensitivity & specificity.

The Microbiology Laboratory is well equipped with sophisticated systems such as Bactec 9050 for Blood Culture (the percentage of recovery can reach upto 30%) and ATB (Automated Testing in Bacteriology).

Antimicrobial susceptibility testing is performed both by disc diffusion & at MIC breakpoints. NCCLS (National Committee for Clinical Laboratory Standards, USA) are followed for antimicrobial testing.

Rapid results for ICU and urgent cases are available within 6-8 hrs instead of 24 hrs by conventional methods. TB cultures are done by TB Bactec which is a rapid method (10 days to 3 weeks instead of 6 weeks by the conventional methods).

Anti TB drug susceptibility is also faster (12 days instead of 3 - 6 weeks We have got molecular based technologies as Transcription Mediated Amplification (TMA), and TB PCR also available with us (Result within 48 hrs).

In addition phage assay for Mycobacterium tuberculosis gives results within 48 hrs. Apart from routine isolation & identification of all clinical samples, aerobic, anaerobic, fungal & mycobacterial cultures are also done.

Smears for Acid Fast Bacilli are done on all samples routinely. Antimicrobial resistance data are kept for 10 yrs. Routinely microbiology surveillance of Operation Theatres & high-risk areas is carried out.

Definite policies for use of antibiotics, disinfectants & waste disposal are laid down by the Infection Control Committee and followed regularly. Protocols for all procedures are put up at all Nursing stations.

Needle-stick / post exposure prophylaxis (PEP) are followed for all Healthcare workers (HCWs) upto 6 months. Regular surveillance of all nosocomial infections and spot surveillance records are maintained.