Common Specialities
Common Issues
Common Treatments


Citrate Test

Citrate Test

also known as: Citrate Excretion, Urine

Citrate is the first intermediate of the citric acid cycle and tricarboxylic acid (TCA) cycle. It also plays an important role in fatty acid synthesis which takes place in the cytoplasm. The movement is assisted by two enzymes, citrate-condensing enzyme, which catalyzes the condensation of the acetyl unit with oxaloacetate in the mitochondria, and citrate-cleavage enzyme (citrate lyase), which catalyzes the release of the acetyl radical in the cytoplasm of the cell. The citrate test detects the ability of an organism to use citrate as the sole source of carbon and energy. The medium contains citrate as the sole carbon source and inorganic ammonium salts (NH4H2PO4) as the sole source of nitrogen.

1.Dissolve above salts in deionized water.
2.Adjust pH to 6.9.
3.Add agar and Bromothymol blue.
4.Gently heat, with mixing, to boiling until agar is dissolved.
5.Dispense 4.0 to 5.0 ml into 16-mm tubes.
6.Autoclave at 121 degree C under 15 psi pressure for 15 minutes.
7.Cool in slanted position (long slant, shallow butt).
8.Tubes should be stored in a refrigerator to ensure a shelf life of 6 to 8 weeks.
9.The uninoculated medium will be a deep forest green due to the pH of the sample and the bromothymol blue.

Citrate utilization test is often part of a battery of tests used to identify gram-negative pathogens of Enterobacteriaceae family and environmental isolates. For instance, test kits such as the API-20E and Enterotube II include citrate utilization medium as one of the diagnostic tests. If the results are positive growth on the medium even without colour change will be considered as positive. A colour change in the medium would be observed if the test organism produces acid or alkali during its growth. The usual colour change observed is from green (neutral) to blue (alkaline). If the results are negative no growth is observed.

1.Inoculate Simmons citrate agar lightly on the slant by touching the tip of a needle to a colony that is 18 to 24 hours old.
2.Incubate at 35 degree C to 37 degree C for 18 to 24 hours. Some organisms may require up to 7 days of incubation due to their limited rate of growth on citrate medium.
3.Observe the development of blue colour as it changes from green colour along the slant which is denoted as alkalinization.

Urine (random), acidified or frozen
10 mL
Use random urine transport tube or urine Monovette® with pH stabilizer (LabCorp N° 56015). Monovette® instructions accompany units..
Average price range of the test is between Rs.1800 to Rs.1800 depending on the factors of city, quality and availablity.
Lybrate Gaurantee
Lybrate Gaurantee

Popular Questions & Answers

My wife is 42 year old. She is suffering thyroid knot at right side. What type of medicine she should take. My nearest doctor suggest aloevera juice take and rub jelly on neck.

MBBS, CCEBDM, Diploma in Diabetology
Endocrinologist, Hubli-Dharwad
Mr. lybrate-user, Thanks for the query. First thing to be done is to do a Thyroid Function test, check the hormone levels and come back with the results. The swelling could be due to hypothyroidism or due to hyper activity. Plus there is a need to get ultra sonography of the gland should be done. Please do not rub any juice on the gland. It may do more harm than any good. The thyroid swellings occur because of some internal functional problems. Which can be detected only by proper testing. Hence you may have to go to an endocrinologist near by for getting these things done. Thanks.
1 person found this helpful

Doctor has diagnosed polycystic ovaries and has prescribed cor 3 tablet is it useful for polycystic ovaries treatment? Please help am worried and also trying for 2nd pregnancy.

Doctor of Medicine
General Physician, Surat
Doctor has diagnosed polycystic ovaries and has prescribed cor 3 tablet is it useful for polycystic ovaries treatment...
Polycestic ovaries may not need any treatment unless it is highly indicated, but most of the time hormone is tried, no specific treatment is there, of course you can try for pregnancy.
1 person found this helpful

I am with pcod, I drink lot of water but after drinking within half an hour I urge to urinate during day but night after sleep it won't disturb me so whether it is a problem or not?

I am with pcod, I drink lot of water but after drinking within half an hour I urge to urinate during day but night af...
It's good you take water but try to run n walk on regular basis around 4 km. It will help to solve your problem of pcod n urination.
1 person found this helpful

Popular Health Tips

How Your Respiratory System Gets Affected Under Anesthesia?

FIAGES, FMAS, MS - General Surgery, MBBS
General Surgeon, Bangalore
How Your Respiratory System Gets Affected Under Anesthesia?

Adverse respiratory events (AREs) are leading causes of post-operative morbidity and mortality. Anesthesia is the use of medicine to prevent or reduce the feeling of pain or sensation during surgery or other painful procedures (such as getting stitches). Giving as an injection or through inhaled gases or vapours, different types of anesthesia affect the nervous system in various ways by blocking nerve impulses and, therefore, pain.

Anesthesia can help control your breathing, blood pressure, blood flow, and heart rate. It may be used to:

  1. Relax you,
  2. Block pain,
  3. Make you sleepy or forgetful,
  4. Make you unconscious for your surgery.

Adverse Respiratory Events (ARE)
Adverse outcomes of such events are fatal and lead to Death & Brain Damage. Three mechanisms of injury are reported to account for highest adverse respiratory events:
Inadequate Ventilation: Insufficient Gas Exchange can produce the adverse outcome. Esophageal Intubation: Incubation between the two sides of the esophagus inadvertently.
Difficult tracheal intubation: Tracheal Intubation is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway. It is performed facilitate ventilation of lungs in severely ill, anesthetized patients.

Other’s are as listed below:

  • Airway Obstruction
  • Inadequate inspired oxygen delivery
  • Aspiration
  • Endobronchial Intubation
  • Premature Extubation

Residual neuromuscular blockade is an important postoperative complication associated to the use of neuromuscular blocking drugs and is commonly observed in the post-anesthesia care unit (PACU) after non-depolarizing neuromuscular blocking agents (NMBAs) are administered intra-operatively. Incomplete neuromuscular recovery can be minimized with acceleromyography monitoring. The risk of adverse respiratory events during early recovery from anesthesia can be reduced by intra-operative acceleromyography use.

Reintubation is a serious adverse respiratory event and the consequences include increased cardiac and respiratory complications, prolonged length of stay at the PACU, intensive care unit (ICU) and hospital, prolonged mechanical ventilator support, higher costs, and increased mortality. Overweight and obesity have also been identified as risk factors for postoperative respiratory complications. Most adverse respiratory events are considered preventable with improved monitoring such as:

  • Pulse Oximetry
  • Capnometry
  • Combination of Both

Closed observation of the clinical factors and appropriate monitoring by well trained people are factors necessary to prevent adverse outcome. If you wish to discuss about any specific problem, you can consult a General Surgeon.

1836 people found this helpful

Know The Ayurvedic Approach To Reversing Diabetes!!

Graduate of Ayurvedic Medicine and Surgery (GAMS)
Ayurveda, Delhi
Know The Ayurvedic Approach To Reversing Diabetes!!

Glucose is the primary ingredient within the body which is turned into an energy source. This is what we use when we move, walk or make the slightest movements. To metabolize glucose into energy, your body needs insulin, which is a hormone produced within the pancreas. However, if the body doesn't react to the insulin or the pancreas is unable to produce enough, glucose cannot be converted into energy and thus results in type 2 diabetes.

Symptoms of type 2 diabetes

  1. Sudden or gradual weight loss despite increased hunger - Many people complain that they feel hungry and eat more, but despite this, tend to lose weight. This occurs as the body cannot metabolize glucose and uses energy reserves from fat or muscles leading to weight loss.
  2. Frequent infections and slow healing - If you are afflicted with Type 2 diabetes, then it might affect your immune system and you may be prone to infections. Also, any cuts or bruises on your body will take much longer to heal than normal.
  3. Irritability and fatigue - Another common symptom of type 2 diabetes along with the other symptoms mentioned here is quick irritability and fatigue. This is because most of the body is deprived of sugar and thus lacks the energy needed to function normally. 
  4. Constant thirst and increased urination - If you feel constantly thirsty despite drinking ample water and urinating frequently, this may be a tell tale sign of type 2 diabetes.
  5. Skin darkening in folds and creases of the body - Also known as acanthosis nigricans; this is a darkening of the skin where it also becomes velvety to the touch. It usually develops in the folds on skin in areas such as the neck and armpits and is a direct result of insulin resistance.

Causes of Type 2 diabetes

Some of the most common causes of Type 2 diabetes could be:

  1. Being overweight
  2. Lack of physical activity
  3. Genetic predisposition or family history 
  4. If you are more than 45 years of age
  5. Hormonal problems such as Polycystic ovarian syndrome

Reverse Diabetes

There three major factors that can help you prevent and reverse pre- and type II diabetes: proper diet and appropriate nutritional and herbal supplementation, exercise, and weight management.

  1. Diet: Proper diet is critical for both preventing and treating pre-and type II diabetes. One of the most important dietary precautions you can take is to eliminate all refined sugars and sugar products from your diet. Also reduce or eliminate your intake of alcohol and caffeine; avoid fast, processed "junk" foods and soda, altogether; and eat protein snacks between meals.
  2. Eating According to the Glycemic Index: Another important dietary tip is eat meals that contains an abundance of low-glycemic (low-sugar) foods. By doing so you can significantly improve your body's ability to maintain low insulin and blood sugar levels. Low-glycemic foods include raw, organic leafy green vegetables, fruits that contain pits, sweet potatoes, yams, organic whole-grain breads and cereals, most legumes and nuts, skim and buttermilk, poultry, white fish, shellfish, and lean cuts of beef and veal.
  3. Nutritional and Herbal Supplements: In addition to a healthy diet, many people at risk for or who already have pre- or type II diabetes will also benefit from various nutritional and herbal supplements.
  4. Exercise: Regular exercise should be part of every diabetic's daily routine. Exercise in combination with a weight loss program has been proven to reduce the odds of developing diabetes by 58 percent among people who are at risk for the disease. If you wish to discuss about any specific problem, you can consult an Ayurveda.
4512 people found this helpful

Pain killers and Heart Attack Risks!

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
Pain killers and Heart Attack Risks!


  •  Doctors have found the use of pain relievers to treat respiratory infections like cold flu may increase the risk of heart attack.
  • For the study, researchers analyzed insurance claims from taiwan's national health insurance program from 2005 to 2011 with data from roughly 10, 000 patients who were hospitalized for a heart attack.
  • The purpose of the study was to assess whether cardiac risk factors from an acute respiratory infection and the use of non-steroidal anti-inflammatory, pain relievers combine to further increase the risk of heart attack.
1 person found this helpful

Myths And Facts About Diabetes!

MBBS, CCEBDM, Diploma in Diabetology
Endocrinologist, Hubli-Dharwad
Myths And Facts About Diabetes!

 1) Diabetes is curable :

Diabetes is  mainly due deficiency of Insulin (hormone produced by Beta cells of pancreas), plus resistance to action of insulin, overweightor obesity  and inactivity. Therefore, to treat diabetes we need drugs that initiate insulin secretion, reduce insulin resistance. In some cases  insulin itself. Plus dietary control and regular exercise to maintain normal weight or reduce excess weight. Hence it can only be effectively controlled. Cure is not possible.

2) Eating Sugar or Sweets causes Diabetes :

It is incorrect to say that eating sweets and / or sugar causes diabetes. Basically excess food intake will lead to excess production of glucose. That puts excess load on insulin producing cells in pancreas due glucotoxicity. Also due to central obesity  the fat around internal organs causes lipotoxicity affecting the beta cells. Therefore, excess food intake in general and weight gain  are the reasons for diabetes.

3) Jaggery is better or safe in diabetes :

Jaggery and sugar both are essentially same. Both contain sucrose, as they are prepared from sugar cane juice. Hence eating either of these will increase blood glucose considerably. In jaggery there are some vitamins and a few antioxidants. But both are bad for a diabetic person.

4) Rice should not be eaten in diabetes :

Not really true. Because in south India this is the major or at times only main food. Rice has a high glycemic index so gets converted to glucose rapidly. So polished rice is not good. Brown rice is better. Quantity should be regulated. All other cereals  also are converted  glucose after digestion. 

5)Allopathic Medications Damage Kidneys, so go for either Ayurvedic or Homeopathic Drugs :

In fact diabetes itself affects kidney, particularly the filtering membrane of glomerulurous  (a filtering unit in the kidney).   Even when diabetes fairly well controlled, kidney does get affected. The drugs used to treat diabetes  help in overcoming kidney damage. Therefore it is wrong to think that modern drugs cause kidney damage. In fact some of the other drugs contain heavy metals (Bhasmas), which can be harmful to the kidney.

6) Sugar intake is essential for body :

Some people keep asking that eating sugar is very necessary for getting energy for the body tissues. This is not at all true.  Because all the cereals like rice, jowar, wheat, ragi, bajra and other millets, contain starch as the main ingredient. Hence intake of each of these foods  provides glucose after digestion. So there is no separate need for taking sugar.

Few things to be remembered and practiced are :

  • Always use whole grain flour, as it contains a good amount of biber content for making chapati or roti.
  • Consume more of green leafy vegetables and salads with every meal.
  • Consider fruits and green leafy vegetables as part of regular snacks
  • Take small meals on more number of occasion to avoid glucose surge.
  • Avoid Maida and foods made from it. It is probably worst kind of food that one can consume.
  • Form healthy food habits.
4 people found this helpful

Pain - Homeopathic Treatment for It!

Homeopath, Chennai
Pain - Homeopathic Treatment for It!

Pain is a feeling of distress that is caused by intense damaging stimuli. It is one of the most common reasons that compels the patient to consult a physician and take painkillers. In the long run, painkillers have adverse effects on our body. While most of the times, the cause of the pain is diagnosed, there are cases in which the cause remains undiagnosed. Homeopathy is a system of medicine that is based on symptoms and has no side effects and thus, it is most effective in the treatment of both muscle and joint pains.

Here we give you a list of common homeopathic pain medications that are prescribed to give relief to patients and the circumstances under which they can be used.

  1. Bryonia- It is given when there is a hot swollen joint, pain from overuse of body part or injury. The slightest movement aggravates the pain and is relieved of the pressure on the affected part.
  2. Causticum - It is recommended for muscle spasm, stiff neck and pain. The character of the pain is sharp and tearing and is caused by cold dry weather. The patient is relieved by the warmth.
  3. Arnica Montana - Arnica is suggested when a patient has sore, bruised feeling all over the body. The patient is very sensitive to the pain and everything on which he rests seems very hard. Arnica is a top remedy in case of injury from falling, sprain and bruise.
  4. Rhus Toxicodendron- A first choice of remedy in case of rheumatism and back pain. The right side of the body is especially affected. The patient experiences stiffness and aching pain that aggravates during the rainy season, in the morning, on exposure to cold and also by rest. Pain is relieved by moving the affected parts and by warmth.
  5. Cuprum Metallicum- It is given in cases of muscle twitching or severe muscle spasm. The patient feels better when the painful area is massaged.
  6. Magnesia Phosphorica - This is the best medicine for all types of pain, especially when the pain is in the right side of the body. The pain is aggravated by cold and movement and is relieved by heat and rest in the general. This is suggested to relieved lower abdomen pain during menstruation.
  7. Pulsatilla- This is an excellent remedy for rheumatic pains that shifts from one joint to another. Homeopathic medicine is suggested after a thorough understanding of patient symptoms and the medication differs from patient to patient. So it is better to consult a homeopathic physician to select a suitable medicine to get relieved from pain.
3313 people found this helpful