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The validity of laboratory results largely depends on proper preparation of the patient's particular analysis to be performed.

It should be taken into account that the laboratory results are influenced by parameters such as:

- Diet in the previous period

- Body Mass Index (BMI)

- Age

- Gender

- Received therapy

- Pregnancy

- Physical activity

- Certain lifestyle habits (consumption of coffee, alcohol, cigarettes)

The method of preparation depends on the type of analysis to be processed

- The time when samples are taken for analysis is important when examining such parameters where there are noticeable day-night variations (such as corticosteroids, iron).

- For most analyses, the material is recommended to be taken always in the morning, when the person is relaxed * on an empty stomach i.e. 10 hours after the last meal or after 12-16 hours of non-consumption of food in order to determine the fat.

* (Increased physical activity for up to 24 hours before taking the sample affects the increase in the value of certain enzymes and other analytes (such as CK, LDH, AST, K, Mg, creatinine)

- If the patient receives any type of therapy that may have an impact on the results (iron supplements, vitamins, hormone therapy, anticoagulants, diuretics, analgesics) it is recommended that they consume them after taking the sample of blood and urine.

Taking a sample for a complete blood test (erythrocytes, haemoglobin, leukocytes...) is possible during the whole day, and as an appropriate sample is the venous and the capillary blood taken.

Samples for determining the level of tumour markers, viruses and the majority of hormones can also be analysed regardless of the time of blood sampling, but it is recommended that patients do not consume food and liquids for at least 2-3h before the test. For the analyses of prolactin, cortisol and ACTH, 20 minutes of rest is required before venepuncture.

In women, the phase of the menstrual cycle or the week of pregnancy affect the result therefore it is necessary to consult a doctor before taking the sample, in order to obtain correct sample.

If you think you need additional instructions, or want to find out whether you require prior preparation for the analysis you need, please contact us.

Glucose tolerance test – OGTT

o During the glucose tolerance test etc. OGTT - a test load of glucose, the patient is given a certain amount of glucose.

o The test lasts from 120-180 minutes (depending on the protocol that the doctor has requested).

o In performing the test, the patient must rest, should not smoke or take food or any beverage except water.

Prior preparation for the test

o 10 -12 h before the test and during the execution itself the patient should not smoke or take food or any beverage except water.

o 3 days before performing the test the patient should adhere to the usual diet with intake of carbohydrates (not less than 150-200 grams per day).

o Stick to the usual physical activities but avoid larger physical efforts.

o Patient should stop taking certain medications that affect glucose metabolism (e.g.corticosteroids hormone contraception, nicotinic acid, thyroid hormones, non-steroidal antirheumatics.), but may take them only in agreement with the doctor, and if it does not harm the patient’s health.

o Test not performed during the menstrual cycle in women.

INSTRUCTIONS FOR TAKING MATERIAL OF URINE

• For the analysis, it is required a morning urine collected in a sterile container

• Hands and genitals have to be clean before the collection of urine in an appropriate container,

• The initial stream of urine is left to run in the toilet without interruption during the urination, whereas for the analysis only the midstream urine is collected in a sterile container *.

• With the lid (has to be clean) the container is well sealed and then delivered to the lab

* Sterile containers can be obtained in our laboratory

Instructions for taking a 24-hour urine

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For the following tests:

Adrenaline;

Dopamine;

Noradrenaline

Vanillylmandelic acid;

Metanephrines;

Before starting with the very collection of urine in the designated container, it is necessary to add 30 ml 6N hydrochloric acid .6N hydrochloric acid which can be purchased at pharmacies.

In the morning, the patient urinates but does not collect this urine.

All other portions of the urine must be collected and stored in a container at +2 to + 8 ° C.

The next morning the patient urinates and passes the urine in the same bowl with the remaining portions of urine collected the previous day.

24-hour urine should be weighed and recorded.

Then the urine in the container should be stirred, and poured into a smaller container less than 200 ml

On thecontainer, the patient should write their name and surname to indicate that it is a 24-hour urine and bring itto our laboratory.

INSTRUCTIONS FOR TAKING MATERIAL FOR -URINE CULTURE-

o The preparation for giving urine for the purpose of performing urine culture is of particular significance. It is necessary to wash the genitals externally with warm water and soap. Then the skin is left to dry, without using any creams. Particular attention should be paid to children, to let the skinretract back to the prepuce and then wash. Because the initial stream of urine virtually cleans off bacteria from the skin as well as the bacterial flora of the urethra,only a sample of the midstream urine should be taken in a sterile container, enough to fill the cup up to one third of its volume. When possible, the urine sample should be taken in the morning, so the patient at night doesnot urinate before they give the urine or at any time of the day at least 3 hours after the last urination. Considering that urine is a good nutritional foundation for the development of bacteria it should be delivered to the laboratory as quick as possible or stored in a refrigerator at 4 to 8 0C until is taken to the laboratory. For the purpose of examining the presence of chlamydia, mycoplasma or plasma urea in the urine, it is necessary to take a sample from the initial stream (first morning gush) of urine which usually collects the epithelial cells of the urethra where these microorganisms are found.

o Nasal swab should be taken before applying the antibiotic therapy and at least 3-4 hours since the last rinsing (blowing) of the nose.

o When taking swabs from the throat and nose in children, parents should keep the child in theirlap, putting one hand across the child’s hands, and the other on the child’s foreheadholding their head whilst the professional person takes the swabs.

Collecting semen (sperm) for clinical and microbiological tests

If the sperm material is collected in your home.

The sample should be delivered to D.L.B.M Chairchanka in CvetanDimov 33 or D.L.B.M located in Topansko Pole, BlagoeParov no.44A. Skopje, latest one hour after the sample collection which must be kept at 20 to 40 0C.

1. Before collecting the sample for clinical examination, the patient should refrain from sexual activity for 3 days

2. Before collecting the sample it is recommended that patients urinate and then rinse off the genitals, thereby preventing mixing of bacteria from other bodies with those of the sperm.

3. Semen collected should be accompanied by a process of masturbation, never in a condom.

4. Semen should be collected in a sterile container that you can buy in our labs or pharmacy.