3. What is Coombs reagent? Describe with the aid of diagrams the diagnostic tests in which this reagent is used.              
              
Coombs reagent (also known as Coombs antiglobulin or antihuman globulin) is used in both the direct Coombs test and the indirect Coombs test. Coombs reagent is antihuman globulin. It is made by injecting human globulin into animals, which produce polyclonal antibodies specific for human immunoglobulins and human complement system factors.More specific Coombs reagents or monoclonal antibodies can be used. Coombs test is used to detect the presence of ‘incomplete’ Rh antibodies i.e. IgG antibodies capable of sensitising RBCs but incapable of causing agglutination of RBCs (hemagglutination). Coombs test was introduced by Coombs and colleagues in 1945. The direct Coombs test, also known as direct antiglobulin test (DAT) uses antibodies directed against human proteins (primarily immunoglobulin G [IgG] and complement [C3]) to detect whether these proteins are attached to the surface of RBCs.   This involves the addition of Coombs serum directly to a patient’s washed RBCs. he occurrence of agglutination means that the patient’s RBCs have been sensitized in vivo by the antibody.

Direct Coombs testing is vital for diagnosing autoimmune hemolytic anemias such as;

·        Hemolytic transfusion reaction

·       Haemolytic disease of the newborn

Knowing your diabetes ABCs will help you manage your blood glucose, blood pressure, and cholesterol.

Stopping smoking, if you smoke will also help you manage your diabetes.

Working toward your ABC goals can help lower your chances of having a heart attack, stroke, or other diabetes problems.

A for the A1C test
The A1C test shows your average blood glucose level over the past 3 months. The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be.

B for Blood pressure
The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask what your goal should be.

C for Cholesterol
You have two kinds of cholesterol in your blood: LDL and HDL. LDL or “bad” cholesterol can build up and clog your blood vessels.
Too much bad cholesterol can cause a heart attack or stroke.

HDL or “good” cholesterol helps remove the “bad” cholesterol from your blood vessels. Ask your health care team what your cholesterol numbers should be.
If you are over 40 years of age, you may need to take a statin drug for heart health.

S for Stop smoking
Not smoking is especially important for people with diabetes because both smoking and diabetes narrow blood vessels.
Blood vessel narrowing makes your heart work harder.

E-cigarettes aren’t a safe option either. If you quit smoking you will lower your risk for heart attack, stroke, nerve disease, kidney disease, diabetic eye disease, and amputation.

Your cholesterol and blood pressure levels may improve, your blood circulation will improve you may have an easier time being physically active. If you smoke or use other tobacco products, stop.

Ask for help so you don’t have to do it alone.

Keeping your A1C, blood pressure, and cholesterol levels close to your goals and stopping smoking may help prevent the long-term harmful effects of diabetes.

These health problems include heart disease, stroke, kidney disease, nerve damage, and eye disease. You can keep track of your ABCs with a diabetes care record. Take it with you on your health care visits. Talk about your goals and how you are doing, and whether you need to make any changes in your diabetes care plan.