Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
White blood cell count (WBC) is the number of white blood cells in a volume
of blood. Normal range varies
slightly between laboratories but is generally between 4,300 and 10,800 cells
per cubic millimeter (cmm). This can also be referred to as the leukocyte count
and can be expressed in international units as 4.3 to 10.8 x 109 cells per
liter.
White blood cell (WBC) differential count. White blood count is comprised
of several different types that are differentiated, or distinguished, based on
their size and shape. The cells in a differential count are
granulocytes,
lymphocytes,
monocytes,
eosinophils, and
basophils.
A machine generated percentage of the different types of
white blood cells is called the automated WBC differential. These components
can also be counted under the microscope on a glass slide by a trained laboratory technician or a
doctor and referred to as the manual WBC differential.
Red cell count (RBC) signifies the number of red blood cells in a volume of
blood. Normal range varies slightly between laboratories but is generally
between 4.2 to 5.9 million cells/cmm. This can also be referred to as the
erythrocyte count and can be expressed in international units as 4.2 to 5.9 x
1012 cells per liter.
Red blood cells are the most common cell type in blood
and people have millions of them in their blood circulation. They are smaller than white blood
cells, but larger than platelets.
Hemoglobin (Hb). This is the amount of hemoglobin in a
volume of blood. Hemoglobin is the protein molecule within red blood cells that
carries oxygen
and gives blood its red color. Normal range for hemoglobin is different between
the sexes and is approximately 13 to 18 grams per deciliter for men and 12 to 16
for women (international units 8.1 to 11.2 millimoles/liter for men, 7.4 to 9.9
for women).
Hematocrit (Hct). This is the ratio of the volume of
red cells to the
volume of whole blood. Normal range for hematocrit is different between the
sexes and is approximately 45% to 52% for men and 37% to 48% for women. This is
usually measured by spinning down a sample of blood in a test tube, which causes
the red blood cells to pack at the bottom of the tube.
Mean corpuscular volume (MCV) is the average volume of a red blood cell.
This is a calculated value derived from the hematocrit and red cell count.
Normal range may fall between 80 to 100 femtoliters (a fraction of one millionth
of a liter).
Mean Corpuscular Hemoglobin (MCH) is the average amount of hemoglobin in
the average red cell. This is a calculated value derived from the measurement of
hemoglobin and the red cell count. Normal range is 27 to 32 picograms.
Mean Corpuscular Hemoglobin Concentration (MCHC) is the average
concentration of hemoglobin in a given volume of red cells. This is a calculated
volume derived from the hemoglobin measurement and the hematocrit. Normal range
is 32% to 36%.
Red Cell Distribution Width (RDW) is a measurement of the
variability of red cell size and shape. Higher numbers indicate greater variation in size. Normal
range is 11 to 15.
Platelet count. The number of platelets in a specified volume of blood.
Platelets are
not complete cells, but actually fragments of
cytoplasm (part of a cell without
its nucleus or the body of a cell) from a cell found in the
bone marrow called a
megakaryocyte.
Platelets play a vital role in blood clotting. Normal range
varies slightly between laboratories but is in the range of 150,000 to 400,000/ cmm (150
to 400 x 109/liter).
Mean Platelet Volume (MPV). The average size of platelets in a volume of
blood.
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment,
Liver disease can be cause by a variety of things including infection (hepatitis), diseases such as gallstones, high cholesterol or triglycerides, blood
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an
Dizziness is a symptom that is often applies to a variety of sensations including lightheadedness and vertigo. Causes of dizziness include low blood pressure,
Anemia is the condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying
Leukemia is a type of cancer of the blood cells in which the growth and development of the blood cells are abnormal. Strictly speaking, leukemia should
Inflammation of the inner lining of the colon is referred to as colitis. Symptoms of the inflammation of the colon lining include diarrhea, pain, and blood
Ascites, the accumulation of fluid in the abdominal cavity is most commonly caused by cirrhosis of the liver. Some of the other causes of ascites include
Fibromyalgia, formerly
known as fibrositis, causes chronic pain, stiffness, and
tenderness of muscles, tendons, and joints without detectable inflammation.
Fainting, also referred to as blacking out, syncope, or temporary loss of consciousness has many causes. Often a person will have signs or symptoms prior
Polycythemia (elevated red blood cell count) causes are either primary (aquired or genetic mutations) or secondary (diseases, conditions, high altitude).
The spleen enlarges if it is asked to do excessive work in filtering or manufacturing blood cells, if there is abnormal blood flow to it, or if it is invaded
Pernicious anemia is a blood disorder in which the body does not make enough red blood cells due to a lack of vitamin B12 in the blood. Pernicious anemia
Multiple myeloma is a form of cancer that develops in plasma cells, the white blood cells that make antibodies. Symptoms include bone pain, weakness, extreme
Thrombocytopenia refers to a decreased number of platelets in the blood. There are many causes of thrombocytopenia such as decreased platelet production
Hydronephrosis is a condition in which the kidney swells, due to a backup of urine. Hydronephrosis generally occurs with another disease.Symptoms of hydronephrosis
Rhabdomyolysis is a rapid deterioration and destruction of skeletal muscle. Some of the causes of rhabdomyolysis include severe burns, muscle trauma, coma,
Celiac disease is a result of an immune reaction to gluten, a protein found in wheat or related grains and present in many foods that we eat. Celiac disease
Osteomyelitis is an infection of the bone. Potential causes include injections around the bone, fractures that puncture the skin, recent surgeries, and
Gastritis is an inflammation of the stomach lining. Causes of gastritis include drinking too much alcohol, medications such as NSAIDs, ibuprofen, aspirin,
Hodgkin's disease is a cancer of the lymphatic system with symptoms that include unexplained, recurring fevers, unexplained weight loss, itchy skin, and
Neutropenia is a marked decrease in the number of neutrophils, neutrophils being a type of white blood cell (specifically a form of granulocyte) filled
Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least three months, two years in a row. Causes of chronic bronchitis
Leprosy (Hansen's disease) is a disfiguring disease caused by infection with Mycobacterium leprae bacteria. The disease is spread from person to person