Formal Name: Thrombin Time

What is Bleeding Time?

Bleeding Time test is to determine how fast your blood clots to stop bleeding. For performing this test, the technician will only make a small puncture on the skin. This test is a basic assessment how well the blood platelets work. The blood platelets are tiny fragments that circulate with the blood flow in our whole body. If there’s any puncture in any place, the platelets work quickly to clot the place and thus, save additional blood from escaping the blood vessels.

When to get tested?

Most of the time, patients don’t need to take the test. The doctor may suggest taking the test if you’ve experienced bleeding that doesn’t stop, especially from punctures, cuts or small incisions. Your doctor can choose a number of tests for evaluating your platelet function. This bleeding time test is really common for screening patients with the prolonged bleeding times.

The test procedure

There is no prior preparation necessary for the test. Around the upper arm, a blood pressure cuff will be inflated. While the cuff is on, the healthcare provider will make 2 small cuts on the lower arm. These cuts are just deep enough to cause a tiny amount of bleeding. Then, the technician will remove the blood pressure cuff. Bloating paper will be touched to the cuts every 30 seconds until the bleeding stops. The healthcare provider will note the time required for clotting the blood.

Why are Bleeding Time test done?

bleedingThis test is useful in diagnosing patients with bleeding problems.

What the test result means

Generally, the time required for bleeding to stop is 1-9 minutes. If there are any abnormalities found in the test, it means you need to be diagnosed with in-depth testing for finding out the cause of your prolonged bleeding. You may have acquired platelet function defect, a condition that develops after birth and impacts the working nature of platelets. Your body may also produce too much or fewer platelets than required, thus causing the abnormal functionality.

Abnormal results could also indicate the following conditions:

  • A blood vessel defect which is impacting how well your blood vessels transport blood throughout your entire body.
  • A genetic platelet function defect. This issue is present at birth and affects how the platelet functions. For example, hemophilia is such type of issue.
  • Primary thrombocythemia is a condition when the bone marrow generates too many platelets than needed.
  • Thrombocytopenia is a condition when your body produces too few platelets than needed.
  • Von Willebrand’s disease. It’s a hereditary condition and affects the clotting system of the blood.

Anything else I should know?

This test is a part of a series of tests to identify and evaluate a bleeding or thrombotic disorder. In most scenario, people with decreased/dysfunctional fibrinogen will show mild or no symptoms. The only way to discover the abnormality is while performing other tests or another reason.

Those having a genetic disorder often has to go through genetic molecular testing. This helps diagnosing inherited dysfibrinogenemia, afibrinogenemia or hypofibrinogenemia and identify the mutated gene(s).

Always perform this test at a laboratory instead of at the doctor’s office. Bleeding disorder tests require specialized equipment and reagents. So, the nearest laboratory is the best place to perform this test.



Malaria is caused by by the protozoan parasite Plasmodium. 4 species of Plasmodium (Plasmodium vivax, P. ovale, P. falciparum and P. malariae) cause malaria in the human body. The parasite spreads via mosquito bites (female Anopheles). This can be a deadly disease if left untreated.


Malaria is a fatal yet preventable disease. Generally, victims who get bitten by parasite-carrying Anopheles (female) do not show any symptoms until 10-28 days. The first symptoms may include the following.

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  • Chills
  • Muscle ache
  • Nausea
  • Fever
  • Vomiting
  • Diarrhea
  • Headache

These symptoms are non-specific, meaning that these can also be found in other diseases. For this reason, the best way to diagnose malaria is through laboratory testing where an expert technologist or technician can distinguish the 4 species of malaria parasites. To identify the parasites, the blood of the patient is collected and examined under a microscope.




A blood sample is collected from the patient’s body through a sharp needle from a vein.

Testing helps to diagnose malaria, to monitor relapses and to determine the parasite’s drug susceptibility. The diagnosis also includes blood smears. Laboratory Technologists and Technicians use thick and thin blood smears to identify any possible malaria parasites in the blood sample. A blood smear is a drop of blood which is spread onto a glass slide.

The presence of Plasmodium confirms malaria. It is also important to detect the species of Plasmodium  as each ones treatment may vary.


MalariaThe test looks for Plasmodium parasites in the blood. The test also determines which species of malaria is present in the body.

If the test results is negative, then you don’t have Plasmodium parasite in the patient’s blood. A positive result confirms that the patient is infected by malaria. The identification of the species is important to determine the risk level. Especially P. falciparum which is the most dangerous.

RDT (Rapid Diagnostic Tests) is another method of identifying malaria by checking the malaria antigens. Malaria parasites produce antigens that can be detected and said to be positive. If the antigens are not present, the result will be negative. Different RDTs identify different antigens. Some antigens are produced by specific parasites whereas other species may produce the same types of antigens (P. vivax, P. ovale, and P. malariae). If an antigen is present, the particles will stick to a band on the RDT that’ll create a visible colored line in the test area.


A few notes have to be kept in mind when you are diagnosed with malaria.

The parasites can be found in the blood. However, it is preferable to take a blood sample when the body temperature is rising to mitigate the chances of getting a false-positive.

If the test result does not detect any malaria parasite in the blood and doctor highly suspects malaria, the same test can be performed again after 8-12 hours, or whenever the patient is feeling a high fever.


In some cases, additional tests must be performed for checking complications. Those tests include CBC (Complete Blood Count) also known as Full blood count (FBC) and Blood Chemistry (electrolytes as well as kidney & liver function). The doctor may also suggest G6PD (Glucose-6-phosphate) test. G6PD is an enzyme. People with G6PD deficiency can have hemolysis if Primaquine is prescribed. In this case, Doxycycline is recommended.

Borrelia is a genus of the spirochete phylum. The disease caused by the bacteria is called Lyme disease.


The lab test detect two types of antibodies – IgM and IgG.

  • Borrelia IgM antibodies are generally detectable in the blood after about 2-3 weeks to the exposure of the bacteria. IgM level increases to the maximum within six weeks and then starts to decrease.
  • IgG antibodies are detectable after several weeks of exposure and reach the max level in about 4-6 months. The level tends to stay high for several years.

Borrelia1The Centers for Disease Control and Prevention (CDC) provides a recommendation for 2 different methods to detect the antibodies and confirm the diagnosis of Lyme disease. The first one is highly sensitive and can identify Lyme disease in almost all the cases. However, the result is also positive when the person is affected by any other disease like tick-borne diseases or the autoimmune disorder (lupus etc.). Therefore, for confirmation of the findings, the second method is followed.


If a patient shows the symptoms that suggest an infection with Borrelia. It is also important to know whether the patient lived or recently visited places where deer ticks are common. This increases the chance of getting infected by Borrelia.

Here are some common symptoms of Lyme disease.

  • Fever, chills
  • Fatigue
  • Muscle & joint pains
  • Swollen lymph nodes
  • Headache

If  ignored, Lyme disease may cause these problems.Borrelia

  • Severe headaches (meningitis) and neck stiffness
  • Pain and weakness in legs and arms
  • Spells of dizziness or shortness of breath
  • Change in sleep patterns, memory loss, and difficulty on concentrating
  • Irregular muscle and joint pain

The patient has to be diagnosed by Enzyme immunoassay (EIA) or immunofluorescence (IFA) tests. If the first test result is positive/intermediate, then the second test is performed – Western blot testing.

If the patient is highly suspected of Lyme disease but the reports are negative, then the patient has to be diagnosed again after a few weeks. The healthcare provider also has to be aware that if the patient didn’t have any history of a tick bite or didn’t visit the regions recently, or the symptoms don’t follow up with the typical Lyme disease symptoms, the possibility of Lyme disease can be ruled out.



IgM Antibody IgG Antibody Western Blot Possible Interpretation
Positive Positive Positive Most possibly Lyme disease, if other symptoms & signs match
Positive Negative Negative Early infection or a false-positive IgM test for cross-reactive antibodies
Negative Positive Positive Previous/late infection
Negative Negative (if IgM and IgG are negative, generally not tested) No infection. Symptoms may indicate other diseases or antibody level is too low to detect
Negative Positive Negative Patient recovered from any recent infection or false-positive IgG test for cross-reactive antibodies



Once someone gets Lyme disease, there will be the detectable amount of Borrelia IgG antibodies present in the bloodstream for the rest of the patient’s life.

Borrelia belongs to the bacteria class called spirochetes. Other spirochete diseases can result in a false-positive test, like leptospirosis and syphilis. Other diseases may also cause a false-positive test, like mononucleosis, HIV infection and various autoimmune disorders.


Formal name: Erythrocyte Sedimentation Rate

How is it used?

The erythrocyte sedimentation rate is a relatively simple, inexpensive, non-specific test that has been used to help detect inflammation associated with conditions such as infections, cancers and autoimmune diseases.IMG_6224

ESR is said to be non-specific test because an elevated result often indicates the presence of inflammation. For this reason, the ESR is typically used in conjunctions with other tests, such as C-reactive protein.

ESR is used to help diagnose certain specific inflammatory diseases, temporal arteritis, systemic vasculitis and polymyalgia rheumatica. A significantly elevated ESR is one of the main test results used to support the diagnosis.

This test may also be used to monitor disease activity and response to therapy in both of the above diseases some others for example Systemic Lupus Erythematosus (SLE).

When is it ordered?

An ESR may be ordered when a condition or disease is suspected of causing inflammation in the body. There are numerous inflammation and pain in the joints or when digestive symptoms that suggest polymyalgia rheumatica, systemic vasculitis, or temporal arteritis, such as headaches, neck or shoulder pain, pelvic pain, anemia, poor appetite, unexplained weight loss, and joint stiffness

What does the test result mean?

The result of an ESR is reported as the millimeter of clear fluid (plasma) that are present at the top portion of the tube after one hour (mm/hr).

Since ESR is a non-specific marker of inflammation and is affected by other factors, the results must be used along with other clinical findings, the individual’s health history, and results from other laboratory tests. If the ESR and clinical findings match, the health practitioner may be able to confirm or rule out a suspected diagnosis.

A single elevated ESR, without any symptoms of a specific disease, will usually not give enough information to make a medical decision. Furthermore, a normal result does not rule out inflammation or disease.

Moderately elevated ESR occurs with inflammation but also with anemia, infection, pregnancy, and with aging.

A very high ESR usually has an obvious cause, such as a severe infection, marked by an increase in globulins, polymyalgia rheumatica or temporal arteritis. A health practitioner will typically use other follow-up tests, such as blood cultures, depending on the person’s symptoms.

When monitoring a condition over time, rising ESRs may indicate increasing inflammation or a poor response to a therapy; normal or decreasing ESRs may indicate an appropriate response to treatment.


Is there anything else I should know?

A low ESR can be seen with conditions that inhibit the normal sedimentation of red blood cells, such as a high red blood cell count, significantly high white blood cell count (leukocytosis), and some protein abnormalities. Some changes in red cell shape (such as sickle cells in sickle cell anemia) also lower the ESR.

ESR and C-reactive protein(CRP) are both markers of inflammation. Generally, ESR does not change as rapidly as does CRP, either at the start of inflammation or as it resolves. CRP is not affected by as many other factors as is ESR, making it a better marker of inflammation. However, because ESR is an easily performed test, many health practitioners still use ESR as an initial test when they think a patient has inflammation.

Women tend to have a higher ESR, and menstruation and pregnancy can cause temporary elevations.

In a pediatric setting, the ESR test is used for the diagnosis and monitoring of children with rheumatoid arthritis or Kawasaki disease.

Drugs such as dextran, methyldopa, oral contraceptives, penicillamine procainamide, theophylline, and vitamin A can increase ESR, while aspirin, cortisone, and quinine may decrease it.