The 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.