====Urine Examintion (Routine & Microscopic) by manual method====

**Physical Examination**
- see for the following physical characteristics;
   *Volume
   *Color
   *Appearance
   *Sediment formation- allow the urine to stand for some times and see at the bottom for sediment formation
   *Odor
   *Reaction and ph– place a drop of urine on a blue litmus paper and not down the reaction( Red colour/ no colour change) 
   *Specific gravity-  1)Fill the container ¾ full of urine, 2) Float the urinometer in the urine & rotate it carefully and note the specific gravity reading from the scale
 
**Chemical Examination By Multistix Reagent Strips**
  *Take fresh, well mixed and uncentrifuged urine.
  *Dip the test areas of the strip in the urine.
  *Remove excess of the urine by tapping the edge of the strip against the container.
  *Compare the test areas closely with corresponding colour charts on the bottle at the time specified (60 Sec) in good light.
  *Note the result.


**Chemical Examination by Manual method**
__**Protein(Heat test):**__
  *Take 10ml of urine in a test tube
  *Boil the upper portion of the urine
  *If turbidity develops, add 2 drops of glacial acetic acid if the turbidity is due to phosphate,it will be cleared
  *Reboil the specimen.
__Interpretation__
  *No Turbidity- Protein absent
  *Presence of turbidity-Protein is present
  *Grade the result according to the degree of  Turbididy as +, ++, +++, ++++ .

__**Glucose(Benedict’s qualitative Test)**__
  *Pipette out 5ml of Benedict’s reagent in a test tube.
  *Add 8 drops of urine
  *Heat on the flame till boiling
  *Cool under tap water
__Interpretation__
^Colour^Conclusion^Amtapprox x mg/dl^
|Blue|Absent|-|
|Green|+|250-500|
|Yellow|++|500-750|
|Orange|+++|1000-1500|
|Red|++++|>1500|

__**Ketones (Rothera’s test)**__
  *Take 5ml of urine in a test tube
  *Add 1gm of Rothera’s powder mixture and mix well.
  *Layer 2ml of conc. ammonium hydroxide on urine gently by allowing it to flow down the side of the inclined test tube.
  *Observe for pink-purple ring at the interface.
__Interpretation:__
  *No Purple ring:-Ketones bodies Absent
  *Appearance of Purple Ring:-Ketones bodies present


__**Bile salts (Hay’s sulfur flower test)**__
  *Take about 10 ml urine in a beaker. 
  *Sprinkle dry sulfur powder on the surface of urine. 
  *Observe the sulfurs particles, whether it sinks to bottom or it remains floating on the surface
__Interpretation__
  *Sulfur particle sink to the bottom:-Bile salts present.
  *Sulfur particle remain floating:- Bile salts absent.

__**Bile pigments and Urobilinogen**__
  *Take 3-4 ml urine in centrifuged test tube by pipette.
  *Add equal amount of 10gm/dl barium chloride, mix well.
  *Centrifuge at 1,500 RPM for 10 minutes (Or filter by using Whatman no. 1 filter paper.)
  *Place supernatant in another test tube for urobilinogen test.
  *Add 1-2 drops of Fouchet’s reagent to the sediment (or to the precipitate on a filter paper).
  *Add about .5 ml of Ehrlich reagent to the supernatant.
__Interpretation__
  *Sediment: - No colour change- Bile pigments absent
  *Colour change to green- Bile pigments present.
  *Supernatant: -Pale pink colour- Urobilinogen present- normal.
                 Cherry red colour-Urobilinogen present- increase
                 
                 
__**Benzidine test**__
  *Make saturated solution of  benzidine in glacial acetic acid.
  *Mix 1 ml of this solution  with 1 ml of hydrogen peroxide in a test tube.
  *Add 2 ml of urine.
  *If green or blue color develops within 5 minutes, the test is positive for blood in urine.

**Processimg for Microscopic Examination**
  *Mixed the urine & pour into a test tubes.
  *Centrifuge it for 5 mins at 2500 RPM.
  *Discard the supernatant completely & resuspend the depositby shaking the tubes.
  *Place 1 drop of depositon glass slide &cover it with cover slip.
  *Mark the slide with identificationnumber&observeit 1stunder low power in subdued light (partially closing iris diaphragm & condenser is downward.
  *Note the contents of various fields.