Time TableNo Program Responsible person

1 Introduction group Moderator

2 Explanation of material

Brazing

3 Debriefing Moderator

4 Closing presentation Moderator

Laboratory Procedure of Feces

By Group 5

Member of Group 5• Sinta Maharani• Stevy Andriani• Surya fatma• Suwastiko Puji Y N U• Umi Salamah

Moderator Name : Umi Salamah Born : Bontang, 22 June 1994Graduated: SMK N 1 Bontang

Presenter 1Name : Sinta MaharaniBorn : Samarinda, 19 April 1995Graduated: SMK Farmasi SamarindaExplan : Feces - Sampling feces

Presenter 2Name : Stevy AndrianiBorn : Balikpapan, 29 Oktober 1994Graduated: SMAN 3 SendawarExplan : Analysis Macroscopic

Presenter 3Name : Surya FatmaBorn : Muara Wis, 07 January 1996Graduated: SMAN 1 Muara WisExplan : Analysis microcopic

Presenter 4Name : Suwastiko Puji Y N UBorn : Samarinda, 08 January 1995Graduate : SMK Kesehatan SamarindaExplan : Blood vague

FecesSampel for examination of feces should be derived from spontaneous defecation, may also feces sample taken from the rectum with a gloved finger. Can be used for examination of feces while, rarely in need of 24 -hour feces for a particular examination..

Examination of fecesMacroscopic examinationMicroscopic examination Chemical Examination

Macroscopic examinationVisible to the naked eye, includes consistency, color, blood, mucus. The presence of blood and mucus indicates infection should be treated promptly, the infection because of an amoeba or bacteria shigella.

Microscopic examination (only visible through a microscope: leukocytes, erythrocytes, epithelial, starch, eggs, worms and amoebae). The presence of amoeba indicates infection of the gastrointestinal tract of the amoeba, and indicates the presence of worm eggs; patients should be given medicine of the parasitic infection.

Chemical ExaminationTo determine the presence of blood Samar, urobilin, Urobilinogen, bilirubin in feces / feces

The important examination of feces is in the parasite and worm eggs. Equally important in certain circumstances is a test for occult blood.

Sampling fecesis a method to take a feces specimen; it is a complete examination and culture examination: the type of food and peristalsis affect the shape, quantity and consistency.

Indications ExaminationThe presence of diarrhea and constipationJaundiceThe presence of digestive disordersThe presence of mucus in the fecesSuspicion of gastrointestinal diseaseThe presence of blood in feces

Terms of collecting feces• The place should be clean, watertight, free

from urine, examined 30-40 minutes since issued. When the postponed examination on the cupboard shelf ice.

• Patients were prohibited from Barium swallow, Bismuth, and Oil in the 5 days prior to the examination.

• Taken from the most likely to give abnormality.• Most good of spontaneous defecation or Rectal

touches• Patients constipation

feces container feces container is preferably made of glass or other material that can’t penetrate the plastic. If the hard feces consistency, dos layered cardboard paraffin may also be used. Containers must be mouthed wide.

Analysis macroscopic of feces

ColorSmellConsistencyMucusBloodParasit

Color of Feces

Stool color What it may mean Possible dietary causes

Green

Food may be moving through the large intestine too quickly, such as due to diarrhea. As a result, bile doesn't have time to break down completely.

Green leafy vegetables, green food coloring, such as in flavored drink mixes or ice pops, iron supplements.

Light-colored, white or clay-colored

A lack of bile in stool. This may indicate a bile duct obstruction.

Certain medications, such as large doses of bismuth subsalicylate (Kaopectate, Pepto-Bismol) and other anti-diarrheal drugs.

Yellow, greasy, foul-smelling

Excess fat in the stool, such as due to a malabsorption disorder, for example, celiac disease.

Sometimes the protein gluten, such as in breads and cereals. But see a doctor for evaluation.

BlackBleeding in the upper gastrointestinal tract, such as the stomach.

Iron supplements, bismuth subsalicylate (Kaopectate, Pepto-Bismol), black licorice.

Bright red

Bleeding in the lower intestinal tract, such as the large intestine or rectum, often from hemorrhoids.

Red food coloring, beets, cranberries, tomato juice or soup, red gelatin or drink mixes.

SmellNormal smell feces caused by in dole, scatol and butyric acid. The smell was a stench of decay occurs when the intestinal contents, which are proteins that are not digested and Destroy by germs. Reaction feces into such decay leachate.

ConsistencyNormal feces to have a rather soft with. At the diarrhea becomes very soft consistency or liquid, while the opposite on hard fecess constipation in carbon hydrate fermentation in the gut produce soft fecess and mixed gases (CO2).

MucusThe presence of mucus means of stimulation or intestinal inflammation ding - ding. If it was just mucus in the feces can be on the outside, it may be irritable bowel localization great: when mixed with feces likely small intestine. In dysentery, intussusception and ileocilitis may be mucus in the feces without. If mucus contain pus leukocytes occurs.

BloodConsider what it is fresh blood (pink), brown or black, and whether mixed diffuse or just on the outside of feces only. The more proximal bleeding, the blood mingled with the color was Black feces and more. A large amount of blood may be caused by ulcers, varies in the esophagus or hemorrhoid.

Analysis microscopic of feces

No Type examination The objective examination

1. Parasite examination (taken fresh

feces on the existing blood or

mucus)

To see where the parasite (eggs) from worms

and amoebae

2. The rest of the food Look at the process of digestion

Impaired proteolysis (there ismuscle fibers

or striped)

Absorption disorders (ex : fats, proteins,

etc.)

3 Celluler Epithelial cells : mucosal irritation

Leococytes: intestinal inflammatory

process

Erythrocytes: intestinal bleeding

Making Preparationa small amount of feces or material will be examined placed above the glass object, when very solid feces can be added a little water then covered with glass deck, for two or more preparations.The preparation should be thin, so that the elements can be clearly seen and known; though so it will always be found the elements that have broken so that identification is no longer possible.

To search for protozoa is often used as a 1-2% solution of eosin feces diluent or Lugol's solution also 1-2 %. In addition 10 % acetate acid solution is used to see more clearly leukocytes, whereas to see other elements 0.9 % saline solution that should be used for routine examination.

Examination • Epithelial CellsSome of the epithelial cells, which are derived from

the distal bowel wall, can be found in the normal state. If epithelial cells derived from the more proximal part, the cells were partially or completely broken. The number of epithelial cells multiplies when there is stimulation or inflammation of the intestinal wall.

• MacrophagesLarge nucleated cells have the phagocytosis;

plasma is often seen in other cells (leucocyte, erythrocytes) or other objects. In preparations of native cells that resemble amoeba; difference is that these cells can’t move.

Next...• LeukocytesMore clearly seen if the feces is mixed with a few

drops of 10 % acetate acid solution. If only seen a few in the entire preparation, no meaning. In dysentery bacillary, colitis and inflammatory ulcerous others, the numbers become large.

• ErythrocytesOnly seen if the lesion has localization colon, rectum,

or anus. This opinion is always abnormal.• The crystalsIn general, not much meaning. Whatever may be

seen in normal feces crystals triplee phosphate, calcium oxalate and fatty acids? As abnormalities may be found Chaco - Leyden crystal and hematoidin.

• Leftover foodAlmost all can be found as well, not an absence, but

that in certain circumstances the amount attributed to something that abnormal waste food was mostly derived from the leaves of food and some foods of animal origin, such as muscle fibers, fiber elastic, etc. other.

For further isentifikasi feces emulsion mixed with lugol solution: starch (Amylum) imperfect digest grains appear as blue or red. Saturated solution of sudan sudan III or IV in 70% alcohol is also used: neutral fat into tiny droplets of red or orange

Next...

• Yeast CellsSpecial glastocystis hominis is not uncommon to

come by. The importance of knowing the structure is lest amoebic cysts.

• eggs and larvae of wormAscaris lumbricoides, Necator americanus,

Enterobius vermicularis. Trichiusus trichiura, Estrongyloides strcoralis, and others; well which includes the genus cestodas and trematodas probably be

Next...

Direct fecal film for microscopic examination of protozoa, eggs,

and larvae.Making smear:•Place a drop of saline on one half of a microscope slide, and a drop of iodine solution on the other half.•With an applicator stick, select a small sample of feces, carefully avoiding non-fecal elements.•Stir the feces into the drop of saline, making an even suspension. Remove coarse fibers, seeds, sand etc., from the fecal emulsion.•With the same applicator stick, transfer a comparable amount of feces to the drop of iodine solution. Stir and screen out coarse material.•Cover each drop of fecal emulsion with a cover glass.

Examine both preparations microscopically.

The smears should first be examined methodically under low power. Helminthes eggs can be detected and usually identified under the low power magnifications, but high power magnifications may be necessary in some cases. After looking through the preparations under low power scan a portion of the slide under high power and search for small protozoa that have been missed under low power.

Picture of Analysis Microscopic

Blood VagueTests on blood vague important to know the existence of small bleeding that cannot be macroscopically expressed or microscopy. Many of the test procedures used all have limitations there are very sensitive no less sensitive and always nonspecific. The most commonly used guaiac test which has a small false reaction.

ProcedureMake small smear with one drop of feces on the paper - filter paper further given by 1 drop guaiac solution , 1 drop of glacial acetat acid and 1 drop of hydrogen peroxide, a positive test within 30 seconds when it arises blue or dark green, or other colors when incurred arising after 30 seconds is expressed negative reactions.

The endThanks for your attention

By group 5