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The valence of the microorganisms could be determined by pressing evenly on the cover slip with a pointed object like the tip of a pen. When pink blood cells grow to be infested with the higher valence progress types of the first parasite, their urge to merge pulls the RBCs together. Copulation between high valence microorganisms on adjoining RBC membranes account for the rouleau formations. The presence of huge rouleau can be detrimental to patients affected by occlusive vascular diseases because it causes impairment of blood movement in the small vessels that can compromise the crimson blood cells’ capacity to trade carbon dioxide and oxygen gases. This may cause higher blood strain so as to increase the availability of blood and oxygen to the tissue. Peripheral blood smears display rouleau when factors that enhance ESR (erythrocyte sedimentation Gluco Extend price and offers) are present. Anemia, by increasing the ratio of RBCs to plasma, increases rouleau formation Gluco Extend price and offers accelerates sedimentation.

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