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CLINICAL INFORMATION :
HDFC BIOCHEMISTRY
CREATININE, SERUM
CREATININE 0.81 Low 0.90 - 1.30 mg/dL
METHOD : SPECTROPHOTOMETRY, ALKALINE PICRATE KINETIC JAFFE'S
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DIAGNOSTIC REPORT
CLINICAL INFORMATION :
Interpretation(s)
LIVER FUNCTION PROFILE, SERUM-
LIVER FUNCTION PROFILE
Bilirubin is a yellowish pigment found in bile and is a breakdown product of normal heme catabolism. Bilirubin is excreted in bile and urine, and elevated levels may give
yellow discoloration in jaundice.Elevated levels results from increased bilirubin production (eg, hemolysis and ineffective erythropoiesis), decreased bilirubin excretion (eg,
obstruction and hepatitis), and abnormal bilirubin metabolism (eg, hereditary and neonatal jaundice). Conjugated (direct) bilirubin is elevated more than unconjugated
(indirect) bilirubin in Viral hepatitis, Drug reactions, Alcoholic liver disease Conjugated (direct) bilirubin is also elevated more than unconjugated (indirect) bilirubin when
there is some kind of blockage of the bile ducts like in Gallstones getting into the bile ducts, tumors &Scarring of the bile ducts. Increased unconjugated (indirect) bilirubin
may be a result of Hemolytic or pernicious anemia, Transfusion reaction & a common metabolic condition termed Gilbert syndrome, due to low levels of the enzyme that
attaches sugar molecules to bilirubin.
AST is an enzyme found in various parts of the body. AST is found in the liver, heart, skeletal muscle, kidneys, brain, and red blood cells, and it is commonly measured
clinically as a marker for liver health. AST levels increase during chronic viral hepatitis, blockage of the bile duct, cirrhosis of the liver,liver cancer,kidney failure,hemolytic
anemia,pancreatitis,hemochromatosis. AST levels may also increase after a heart attack or strenuous activity.ALT test measures the amount of this enzyme in the blood.ALT
is found mainly in the liver, but also in smaller amounts in the kidneys,heart,muscles, and pancreas.It is commonly measured as a part of a diagnostic evaluation of
hepatocellular injury, to determine liver health.AST levels increase during acute hepatitis,sometimes due to a viral infection,ischemia to the liver,chronic hepatitis,obstruction
of bile ducts,cirrhosis.
ALP is a protein found in almost all body tissues.Tissues with higher amounts of ALP include the liver,bile ducts and bone.Elevated ALP levels are seen in Biliary obstruction,
Osteoblastic bone tumors, osteomalacia, hepatitis, Hyperparathyroidism, Leukemia, Lymphoma, Paget's disease,Rickets,Sarcoidosis etc. Lower-than-normal ALP levels seen
in Hypophosphatasia,Malnutrition,Protein deficiency,Wilson's disease.GGT is an enzyme found in cell membranes of many tissues mainly in the liver,kidney and pancreas.It is
also found in other tissues including intestine,spleen,heart, brain and seminal vesicles.The highest concentration is in the kidney,but the liver is considered the source of
normal enzyme activity.Serum GGT has been widely used as an index of liver dysfunction.Elevated serum GGT activity can be found in diseases of the liver,biliary system and
pancreas.Conditions that increase serum GGT are obstructive liver disease,high alcohol consumption and use of enzyme-inducing drugs etc.Serum total protein,also known as
total protein,is a biochemical test for measuring the total amount of protein in serum.Protein in the plasma is made up of albumin and globulin.Higher-than-normal levels may
be due to:Chronic inflammation or infection,including HIV and hepatitis B or C,Multiple myeloma,Waldenstrom's disease.Lower-than-normal levels may be due to:
Agammaglobulinemia,Bleeding (hemorrhage),Burns,Glomerulonephritis,Liver disease, Malabsorption,Malnutrition,Nephrotic syndrome,Protein-losing enteropathy etc.Human
serum albumin is the most abundant protein in human blood plasma.It is produced in the liver.Albumin constitutes about half of the blood serum protein.Low blood albumin
levels (hypoalbuminemia) can be caused by:Liver disease like cirrhosis of the liver, nephrotic syndrome,protein-losing enteropathy,Burns,hemodilution,increased vascular
permeability or decreased lymphatic clearance,malnutrition and wasting etc
CREATININE, SERUM-
Higher than normal level may be due to:
•Blockage in the urinary tract
•Kidney problems, such as kidney damage or failure, infection, or reduced blood flow
•Loss of body fluid (dehydration)
•Muscle problems, such as breakdown of muscle fibers
•Problems during pregnancy, such as seizures (eclampsia)), or high blood pressure caused by pregnancy (preeclampsia)
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DIAGNOSTIC REPORT
CLINICAL INFORMATION :
HAEMATOLOGY
BLOOD COUNTS
HEMOGLOBIN 15.3 13.0 - 17.0 g/dL
METHOD : CYANMETHEMOGLOBIN METHOD
EOSINOPHILS 5 1-6 %
METHOD : ACV TECHNOLOGY
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DIAGNOSTIC REPORT
CLINICAL INFORMATION :
LYMPHOCYTES 48 High 20 - 40 %
METHOD : ACV TECHNOLOGY
MONOCYTES 2 2 - 10 %
METHOD : ACV TECHNOLOGY
BASOPHILS 0 0-2 %
METHOD : ACV TECHNOLOGY
WBC
WITHIN NORMAL LIMITS.
Interpretation(s)
BLOOD COUNTS-
The cell morphology is well preserved for 24hrs. However after 24-48 hrs a progressive increase in MCV and HCT is observed leading to a decrease in MCHC. A direct smear is
recommended for an accurate differential count and for examination of RBC morphology.
RBC AND PLATELET INDICES-
The cell morphology is well preserved for 24hrs. However after 24-48 hrs a progressive increase in MCV and HCT is observed leading to a decrease in MCHC. A direct smear is
recommended for an accurate differential count and for examination of RBC morphology.
BIO CHEMISTRY
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DIAGNOSTIC REPORT
CLINICAL INFORMATION :
CHOLESTEROL, SERUM
Interpretation(s)
GLUCOSE, FASTING, PLASMA-
ADA 2012 guidelines for adults as follows:
Pre-diabetics: 100 - 125 mg/dL
Diabetic: > or = 126 mg/dL
Glycation is nonenzymatic addition of sugar residue to amino groups of proteins. HbA1C is formed by the condensation of glucose with n-terminal valine
residue of each beta chain of hb a to form an unstable schif base. It is the major fraction, constituting approximately 80% of HbA1.
Formation of glycated hemoglobin (GHb) is essentially irreversible and the concentration in the blood depends on both the lifespan of the red blood cells (RBC)
(120 days) and the blood glucose concentration. The GHB concentration represents the integrated values for glucose aver the period of 6 to 8 weeks. GHb
values are free of day to day glucose fluctuations and are unaffected by recent exercise or food ingestion. Concentration of plasma glucose concentration in
GHb depends on the time interval, with more recent values providing a larger contribution than earlier values.
The interpretation of GHb depends on RBC having a normal life span. Patients with hemolytic disease or other conditions with shortened RBC survival exhibit a
substantial reduction of GHb. High GHb have been reported in iron deficiency anemia .
GHb has been firmly established as an index of long term blood glucose concentrations and as a measure of the risk for the development of complications in
patients with diabetes mellitus. The absolute risk of retinopathy and nephropathy are directly proportional to the mean of HbA1C.
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DIAGNOSTIC REPORT
CLINICAL INFORMATION :
HIV 4TH GEN ASSAY (P24AG + HIV AB) NON REACTIVE NON REACTIVE
METHOD : IMMUNOBLOT METHOD
Interpretation(s)
HEPATITIS B SURFACE ANTIGEN, SERUM-
Hepatitis B is caused by infection with HBV, a enveloped DNA agent that is classified as hepadnavirus.This test detects the presence of viral surface antigen (HbsAg) in serum
sample and is indicative of an active HBV infection, either acute or chronic.
Test Utility:
HbsAg is the first serologic marker appearing in the serum 6-16 weeks following hepatitis B viral infection. In typical HBV infection, HBsAg will be detected 2-4 weeks before
the liver enzyme levels (ALT) become abnormal and 3-5 weeks before patient develops jaundice.In acute cases HbsAg usually disappears 1-2 months after the onset of
symptoms.Persistence of HbsAg for more than 6 months indicates development of either a chronic carrier state or chronic liver disease.The presence of HbsAg is frequently
associated with infectivity. HbsAg when accompanied by Hepatitis Be antigen and/or hepatitis B viral DNA almost always indicates infectivity.
Limitations:
- For diagnostic purposes, results should be used in conjunction with patient history and other hepatitis markers for diagnosis of acute or chronic infection. If the antibody
results are inconsistent with clinical evidence, additional testing is suggested to confirm the result.
- HBsAg detection will only indicate the presence of surface antigens in the serum and should not be used as the sole criteria for diagnosis, staging or monitoring of HBV
infection This test may be negative during ""window period"" i.e. after disappearance of anti-HBs.
- The current assay being a highly sensitive test , may yield a small percentage of false positive reports. Hence all HbsAg positive specimens should be confirmed with an
assay based upon Neutralisation of Human anti Hepatitis B Surface antibody.
HIV 4TH GEN ASSAY (P24AG + HIV AB), SERUM-
Acquired immunodeficiency syndrome (AIDS) is caused by 2 types of human immunodeficiency viruses, collectively designated HIV. HIV is transmitted by sexual contact,
exposure to blood or blood products, and prenatal infection of a fetus or perinatal infection of a newborn.
Phylogenetic analysis classifies HIV-1 into groups M (major), N (non-M, non-O), and O (outlier).HIV-2 is similar to HIV-1 in its structural morphology, genomic organization,
cell tropism, in vitro cytopathogenicity, transmission routes, and ability to cause AIDS. However, HIV-2 is less pathogenic than HIV-1.HIV-2 infections have a longer latency
period with slower progression to disease, lower viral titers, and lower rates of vertical and horizontal transmission. HIV-2 is endemic to West Africa but HIV-2 infections, at a
low frequency compared to HIV-1, have been identified in the USA, Europe, Asia, and other regions of Africa. India predominantly has HIV-1M subtype C.
Test Util
ity;
The test used is the 4th generation assay that detects HIV 1 P24 antigen and HIV 1/ 2 antibodies. This leads to improved sensitivity and, therefore, a shorter diagnostic
window as compared to 3rd generation anti-HIV assays.
If HIV reactive result is obtained, confirmation of HIV antibody status is done using 2 more antibody tests (as per NACO guidelines-Strategy III algorithm). If indicated HIV
serostatus may be confirmed by repeating antibody test on fresh specimen or HIV-1 Western Blot (Immunoblot) Assay (SRL test code #3012) and HIV DNA detector (SRL
test code #9885B).
In case of HIV reactive by one method and non reactive by other two methods, results need to be correlated with the clinical history of the patient. As per NACO guidelines,
result may be interpreted as “ Negat i
ve”for low risk individuals and “
Indet ermi nate”in case of high risk individuals.
For tests reported/interpreted as ‘ Indet er
mi nate,testing should be repeated on a second fresh specimen after 14-28 days. In case the serological results continue to be
indeterminate, HIV Western blot /PCR is recommended.
Limitations:
•Antibody tests may give false negative results during the window period, an interval of 3 weeks to 6 months between the time of HIV infection and the production of
measurable antibodies to HIV seroconversion. Most people develop detectable antibodies approximately 30 days after infection, although some seroconvert later. The vast
majority of people (97%) have detectable antibodies by three months after HIV i nf
ect i
on;a 6-month window is extremely rare with modern antibody testing
•False negative results can occur in patients with X-linked agammaglobulinemia. False positive results can occur in autoimmune disorders, alcoholic hepatitis , multiple
pregnancies.
- Early antiretroviral therapy during the window period may alter antibody responses. This does not apply to individuals undergoing treatment with post-exposure prophylaxis
(PEP).
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DIAGNOSTIC REPORT
CLINICAL INFORMATION :
•A positive HIV result in an infant <18 months of age may not reflect the infant's HIV infection status.HIV antibodies persist in the sera of infants upto 18 months of age, due
to transplacentally acquired maternal antibodies. HIV PCR testing is recommended in this age group for diagnosis.
•The presence of HIV antigen or antibodies to HIV is not a diagnosis of AIDS.
•For diagnostic purposes, the results should always be assessed in conjunction with the pat ient’smedical history, clinical examination and other findings.
CLINICAL PATH
URINALYSIS
APPEARANCE CLEAR
METHOD : MANUAL
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DIAGNOSTIC REPORT
CLINICAL INFORMATION :
Comments
Interpretation(s)
URINALYSIS-Routine urine analysis assists in screening and diagnosis of various metabolic, urological, kidney and liver disorders
Protein: Elevated proteins can be an early sign of kidney disease. Urinary protein excretion can also be temporarily elevated by strenuous exercise, orthostatic proteinuria,
dehydration, urinary tract infections and acute illness with fever
Glucose: Uncontrolled diabetes mellitus can lead to presence of glucose in urine. Other causes include pregnancy, hormonal disturbances, liver disease and certain
medications.
Ketones: Uncontrolled diabetes mellitus can lead to presence of ketones in urine. Ketones can also be seen in starvation, frequent vomiting, pregnancy and strenuous
exercise.
Blood: Occult blood can occur in urine as intact erythrocytes or haemoglobin, which can occur in various urological, nephrological and bleeding disorders.
Leukocytes: An increase in leukocytes is an indication of inflammation in urinary tract or kidneys. Most common cause is bacterial urinary tract infection.
Nitrite: Many bacteria give positive results when their number is high. Nitrite concentration during infection increases with length of time the urine specimen is retained in
bladder prior to collection.
pH: The kidneys play an important role in maintaining acid base balance of the body. Conditions of the body producing acidosis/ alkalosis or ingestion of certain type of food
can affect the pH of urine.
Specific gravity: Specific gravity gives an indication of how concentrated the urine is. Increased specific gravity is seen in conditions like dehydration, glycosuria and
proteinuria while decreased specific gravity is seen in excessive fluid intake, renal failure and diabetes insipidus.
Bilirubin: In certain liver diseases such as biliary obstruction or hepatitis, bilirubin gets excreted in urine.
Urobilinogen: Positive results are seen in liver diseases like hepatitis and cirrhosis and in cases of hemolytic anemia
**End Of Report**
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DIAGNOSTIC REPORT
CLINICAL INFORMATION :
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Gall eal*h3
Everything about health
Result: NEGATIVE
Note:
Signa
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