Description
The RapiChek HomeCare – Atlas Liver Function Test is used to monitor bilirubin and urobilinogen from urine samples to aid in the diagnosis of liver and gallbladder problems. The test gives a result by visual comparison with the colour scale printed on the packaging.
DESCRIPTION
The liver is the largest glandular organ in the body. It weighs about 1.36 kg. It is reddish brown in colour and divided into four lobes of unequal size and shape. The liver is located on the right side of the abdominal cavity, below the diaphragm (the muscular partition separating the chest and abdominal cavity).
Abnormal liver function can cause one or more of the following symptoms :
Symptom 1 : Yellowing of the skin and whites of the eyes. A condition called jaundice.
2.Aünet: Pain in the right upper abdomen accompanied by the following symptoms:
– Abdominal swelling.
– Weakness and loss of muscle mass.
– Light coloured stools and/or dark coloured urine.
These are the first signs of liver problems. Of these, jaundice is considered the most significant.
Jaundice is caused when excess amounts of a compound called bilirubin are dissolved in the subcutaneous fat layer. Bilirubin is a compound produced by the breakdown of red blood cells. The blood vessels are transported to the liver and then to the intestines through a small channel connecting the liver to the intestine. This channel is called the bile duct. Bilirubin can also be stored in the gallbladder, which is a very small, sac-like organ that extends from the bile duct.
In the gut, bilirubin can be converted by gut bacteria into a compound called urobilinogen. A small percentage of this compound can be absorbed back into the bloodstream.
Elevated levels of urobilinogen and/or bilirubin in the blood lead to its appearance in the urine.
Conditions that may increase the concentration of urobilinogen and/or bilirubin in the blood include:
Condition 1 : Excessive breakdown of red blood cells. This Jaundice is common in newborn babies.
Condition 2 : Blockage of the bile ducts, resulting in gallstones, tumours or inflammation of the liver, which restricts the movement of bilirubin to the intestine by allowing it to leave the body.
Status 3 : Liver diseases, including hepatitis infection, liver cancer and cirrhosis (a chronic disease that causes scarring of the liver and interferes with the normal functioning of the liver. The main cause is chronic alcoholism.
By testing the presence of bilirubin and/or urobilinogen in the urine, reflecting their concentration in the blood, you can monitor liver health.
TEST PRINCIPLE AND EXPECTED VALUES
Bilirubin: This assay is based on the azo coupling reaction of bilirubin and diazotized dichloroaniline in a strongly acidic medium. The varying bilirubin level results in a pinkish brown colour proportional to its concentration in the urine. Even the most sensitive methods cannot detect bilirubin in normal urine. The presence of trace amounts of bilirubin also requires further investigation. Atypical results (colours other than the negative or positive colour blocks seen on the colour chart) may indicate that bile pigments from bilirubin are present in the urine sample and may mask the bilirubin reaction.
Urobilinogen: This test is based on the modified Ehrlich reaction between p-diethylaminobenzaldehyde and urobilinogen acid, which gives a pink colour in a strongly acidic medium. Urobilinogen is a major compound produced during haem synthesis and is a normal substance in urine. The expected range of normal urine for this test is 0.2-1.0 mg/dl (3.5-17 mol/l). A result of 2.0 mg/dl (35 mol/l) may be of clinical significance and the patient’s sample should be further investigated.
COLLECTION AND PREPARATION OF SAMPLES:
Collect a fresh urine sample in a clean and dry disposable container. Make sure that there is no detergent residue on the tank. Test the urine as soon as possible after collection.
PROCEDURE:
To obtain reliable test results, IMMEDIATELY FOLLOW THIS PROCEDURE!
1. Prepare a urine sample.
2. Remove the strip from the bag. Get to know the reaction sites of bilirubin and urobilinogens. The beige reaction region is for bilirubin and the yellow reaction region is for urobilinogens. Also check the colour chart on the packaging.
3. Immerse the test strip in the urine until the reaction areas are completely covered, up to 1 second.
4. Remove the dipstick from the urine and tap the test strip against the rim of the cup to remove excess urine, then place it horizontally with the reaction areas uppermost.
5. Leave the strip for 30-60 seconds to allow the reaction to take place.
6 Read the results by comparing the colour of the reaction on the strip with the colour of the table. While comparing, keep the strip in a horizontal position to avoid possible mixing of colours between the two reaction areas of the strip.
7. Identify the best colour match and the appropriate concentration range on the colour chart. A change in colour only at the edges of the reaction area indicates that the reaction has not taken place correctly, so it is recommended to repeat the test with another strip. Results read after 60 seconds are not valid.
HOW TO DETERMINE POSITIVE OR NEGATIVE VALUES:
A colour other than the colour indicating a negative result is considered positive. See the scoreboard below to clarify the result:
THE LIMITATIONS OF THE STUDY:
Substances that cause abnormal urine colour, such as certain medicines, can affect the colour of the stripe. Colour development in the reaction area may mask the colour, or a colour reaction may occur in the area that can be interpreted visually as a false positive. It is therefore recommended that, in case of doubt, the test should be done after stopping the medicine (after consulting the doctor
after) must be repeated.
– bilirubin
Since bilirubin in samples is sensitive to light, prolonged exposure of urine samples to light may give false negative results. Ascorbic acid concentrations of 25-50mg/dl can also cause false negative results. Even trace levels of bilirubin are abnormal enough to require further investigation. False positive results may be obtained if diagnostic or therapeutic dyes are present in the urine tested.
-Urobilinogen
The strip cannot detect the complete absence of urobilinogen in the sample tested. Normal urine samples usually give a light brown or light pink colour. Higher formalin concentrations may give false negative results.
QUESTIONS AND ANSWERS
Q: If the colours of the reaction areas on the test strip are different from what they should be, what should I do?
A: In such cases, it is not recommended to use this tape as it does not give accurate results. You must use a new strip. If the same problem occurs, contact your local distributor.
Q: If you read the results after more than a minute, are the results still reliable?
A: Best results are obtained at 60 seconds (1 minute), if this time is exceeded, the results will not remain the same and may lead to incorrect measurement results.
Q: What time of day should the test be done?
A: This test can be done at any time of the day. Try to minimise your fluid intake an hour before the test.
Q: Why use a fresh sample for this test?
A: Bilirubin and urobilinogen are sensitive to light and decompose if left for long periods of time. Accordingly, the results may not reflect the actual concentration of these two compounds in the urine sample, as they are partially degradable.
Q: Is there any indication of urine colour?
A: The presence of bilirubin in the urine makes the urine colour quite dark. In this case the colour is almost a brownish orange. Other compounds and certain foods can also cause urine discolouration. Urine colour should therefore not be used as the sole criterion for testing bilirubin.
Q: What is hepatitis?
A: Hepatitis is inflammation of the liver and can be caused by various organisms, including bacteria and viruses (Hepatitis A, B, C…etc.) or parasites. Chemical poisons such as alcohol, drugs and toxic fungi can also damage the liver and cause inflammation.
Q: What is “biliary obstruction”?
A: Bile duct obstruction means blockage of any of the ducts that transport bile (bilirubin and other salts)
from the liver to the gall bladder or from the gall bladder to the small intestine. This can be caused by gallstones, liver tumours or hepatitis. Jaundice and
right upper abdominal pain accompanied by back pain are the most common symptoms of the condition.
