Report Geeti Paul

PO No :PO4010181534-958
Name : Ms.GEETI PAUL :

Age/Gender : 79/Female Registration Date : 11-Jul-22 12:30 PM
Patient ID : KOL67439 Collection Date : 11/Jul/2022 07:34AM
Barcode ID / Order ID : A8245114 / 5090829 Sample Receive Date : 11/Jul/2022 02:59PM
Referred By : Dr. Report Status : Final Report
Sample Type : WHOLE BLOOD-EDTA Report Date : 11/Jul/2022 05:09PM
HAEMATOLOGY
GOOD HEALTH GOLD PACKAGE
Test Name Result Unit Bio. Ref. Range Method
Glycosylated Hemoglobin (HbA1c) 6.1 % 4-5.6 HPLC

Estimated average glucose (eAG) 128.37 mg/dL Calculated
Comment:
Interpretation:
HbA1c%
≤5.6 Normal
5.7-6.4 At Risk For Diabetes
≥6.5 Diabetes
Adapted from American Diabetes Association.
Comments:-
A 3 to 6 monthly monitoring is recommended in diabetics. People with diabetes should get the test done more often if their blood sugar stays
too high or if their healthcare provider makes any change in the treatment plan. HbA1c concentration represent the integrated values for
blood glucose over the preceding 8-12 weeks and is not affected by daily glucose fluctuation, exercise & recent food intake.
Please note, Glycemic goal should be individualized based on duration of diabetes, age/life expectancy, comorbid conditions, known CVD or
advanced microvascular complications, hypoglycemia unawareness, and individual patient considerations.
Factors that interfere with HbA1c Measurement: Hemoglobin variants, elevated fetal hemoglobin (HbF) and chemically modified
derivatives of hemoglobin (e.g. carbamylated Hb in patients with renal failure) can affect the accuracy of HbA1c measurements.
Factors that affect interpretation of HbA1c Measurement: Any condition that shortens erythrocyte survival or decrease mean
erythrocyte age (e. g., recovery from acute blood loss, hemolytic anemia, HbSS, HbCC, and HbSC) will falsely lower HbA1c test results
regardless of the assay method used. Iron deficiency anemia is associated with higher HbA1c.
Note: Presence of Hemoglobin variants and/or conditions that affect red cell turnover must be considered, particularly when the HbA1c result
does not correlate with the patient's blood glucose levels.
• HPLC - High performance liquid chromatography
Page 1 of 18
PO No :PO4010181534-958
Sample Type : Whole Blood-EDTA Report Date : 11/Jul/2022 03:48PM
HAEMATOLOGY
Complete Blood Count

Hemoglobin 10.8 g/dL 13.0-17.0 Cyanide-free SLS-
Hemoglobin
RBC 3.68 10^6/cu.mm 3.8-4.8 Impedance variation
Measure
HCT 34.0 % 40 - 50 Derived from - Impedance
MCV 92.2 fl 83 - 101 Derived from - Impedance
MCH 29.2 pg 27 - 32 Derived from - Impedance
MCHC 31.7 g/dL 31.5 - 34.5 Derived from - Impedance
RDW-CV 17.6 % 11.5-14 Derived from - Impedance
Total Leucocyte Count 7.12 10^3/µI 4 - 10 Impedance and
Absorbency/Microscopy
Differential Leucocyte Count
Neutrophils 58.8 % 40-80 Impedance and
Lymphocytes 32.3 % 20-40 Impedance and
Monocytes 5.4 % 2-10 Impedance and
Eosinophils 3.2 % 1-6 Impedance and
Basophils 0.3 0-2 Impedance/Calculated
Absolute Leucocyte Count
Absolute Neutrophil Count 4.19 10^3/µI 2-7 Impedance and
Absorbency/Calculated
Absolute Lymphocyte Count 2.3 10^3/µI 1-3 Impedance and
Absolute Monocyte Count 0.38 10^3/µI 0.2-1 Impedance and
Page 2 of 18
PO No :PO4010181534-958
Sample Type : Whole Blood-EDTA Report Date : 11/Jul/2022 03:48PM
HAEMATOLOGY
Absolute Eosinophil Count 0.23 10^3/µI 0.02-0.5 Impedance and

Absolute Basophil Count 0.02 10^3/µI 0-0.1
Platelet Count 168 10^3/µI 150-410 Impedance/Microscopy
MPV 12.3 fl 6.5 - 12 Derived from Impedance
PDW 30 fL 11-20 Derived from Impedance
Comment:
As per the recommendation of International council for Standardization in Hematology, the differential leucocyte counts
are additionally being reported as absolute numbers of each cell in per unit volume of blood.
Test conducted on EDTA whole blood.
Page 3 of 18
PO No :PO4010181534-958
Sample Type : FLUORIDE PLASMA Report Date : 11/Jul/2022 04:15PM
BIOCHEMISTRY
Glucose - Fasting 104 mg/dL 70.0-100.0 Hexokinase
Fasting Plasma Glucose 2 hr plasma Glucose Diagnosis

(mg/dL) (mg/dL)
99 or below 139 or below Normal
100 to 125 140 to 199 Pre-Diabetes (IGT)
126 or above 200 or above Diabetes
Reference : American Diabetes Association
Comment:
American Diabetes associations reference range,
Normal <100 mg/dl

Impaired Fasting 100-125 mg/dl
Diabetes >=126 mg/dl
Comment: Random glucose in plasma measures the glucose levels regardless of the last meal intake.
Page 4 of 18
PO No :PO4010181534-958
Sample Type : Serum Report Date : 11/Jul/2022 06:12PM
BIOCHEMISTRY
Lipid Profile
Cholesterol - Total 199 mg/dL Low (desirable): < 200 Enzymatic
mg/dL
Moderate (borderline)
200–239 mg/dL
High: = 240 mg/dL
Triglycerides 152 mg/dL Normal: < 150, GPO, Trinder without
Borderline: 150 - 199, serum blank
High:200 - 499, Very
High >=500
Cholesterol - HDL 36 mg/dL Low (undesirable, high Elimination/catalase
risk): < 40 mg/dL
High (desirable, low risk):
>= 60 mg/dL
Cholesterol - LDL 132 mg/dL Desirable: <100 Elimination/catalase
Above desirable: 100 -
129
Borderline high : 130 -
159
High : 160 - 189
Very high : >=190
Cholesterol- VLDL 30 mg/dL 10-30 Calculated
Cholesterol : HDL Cholesterol 5.5 Ratio Calculated
LDL / HDL Cholesterol Ratio 3.66 Ratio Calculated
Non HDL Cholesterol 163 mg/dL Desirable:< 130, Calculated
Above Desirable:130 -
159, Borderline High:160
- 189, High:190 - 219,
Very High: >= 220
Page 5 of 18
PO No :PO4010181534-958
BIOCHEMISTRY
Comment:
Measurements in the same patient can show physiological & analytical variations. Three serial samples 1 week apart
are recommended for Total Cholesterol, Triglycerides, HDL & LDL Cholesterol.
Lipid Association of India (LAI) recommends screening of all adults above the age of 20 years for Atherosclerotic
Cardiovascular Disease (ASCVD) risk factors, especially lipid profile. This should be done earlier if there is a family
history of premature heart disease, dyslipidemia, obesity, or other risk factors.
The LAI recommends LDL-C as the primary target and non-HDL-C as a co-primary target, for lipid-lowering therapy.
Non-HDL Cholesterol comprises the cholesterol carried by all atherogenic particles, including LDL, IDL, VLDL & VLDL
remnants, Chylomicron remnants and Lp(a).
Apo B measurement is recommended in high-risk subjects after LDL-C and non-HDL-C goals have been achieved.
Additional testing for Apolipoprotein B, hsCRP, Lp(a ) and LP-PLA2 should be considered among patients with
moderate risk for ASCVD for risk refinement.
Updated 2020 risk stratification approach recommended by the Lipid Association of India
Risk Factors/Markers
Moderate-risk
Major ASCVD Risk Factors Other High risk features nonconventional risk
factors
1. Age ≥45 years in males and 1. Diabetes with 0-1 other major ASCVD Risk factors and no 1. Coronary calcium score
≥55 years in females evidence of target organ damage 100-299
2. Family history of premature
2. CKD Stage 3B or 4 2. Increased carotid IMT
ASCVD
3. Current cigarette smoking and 3. Familial hypercholesterolemia (other than familial 3. Lipoprotein (a) 20-49
tobacco use homozygous hypercholesterolemia mg/dL
4. High blood pressure 4. Extreme of a single risk factor 4. Impaired Fasting Glucose*
5. Increased waist
5. Low HDL-C 5. Coronary calcium score ≥300
circumference**
6. Apolipoprotein B ≥110
6. Non-stenotic carotid plaque
mg/dL
7. Lipoprotein (a) ≥50 mg/dL 7. hsCRP ≥2 mg/L***
Risk groups
Low risk Moderate risk High risk Very High risk Extremely High risk
Page 6 of 18
PO No :PO4010181534-958
BIOCHEMISTRY
2 Major
≥3 major ASCVD
ASCVD risk Pre-existing ASCVD Category A Category B
risk factor
factors
0-1 major
Low risk group 2 major ASCVD risk
ASCVD risk Diabetes ≥2 other CAD ≥1 feature of very high risk
≥1 moderate- factor with ≥1
factor and major risk factors or group or recurrent ACS (within
risk moderate-risk
Lifetime CVD evidence of target one year) despite LDL-C ≤50
nonconventional nonconventional risk
risk <30% organ damage mg/dL or polyvascular disease
risk factors factors
Lifetime CVD ≥1 other high risk Familial homozygous
risk ≥30% features Hypercholesterolemia
* A fasting blood sugar level from 100 to 125 mg/dl. It should be confirmed by repeat testing; **Waist circumference is to be
measured at the superior border of the iliac crest just after expiration. Increased waist circumference is defined as >90 cm
in men and >80 cm in women. If increased waist circumference is the only risk factor, it should again be measured after 6
months after initiating heart-healthy lifestyle measures; ***On two occasions at least 2 weeks apart. For reclassifying moderate
risk group only.
Newer treatment goals and statin initiation thresholds based on the risk categories proposed by LAI in 2020
Risk groups Treatment Goals Consider Drug Therapy
LDL-C (mg/dL) Non-HDL (mg/dL) LDL-C (mg/dL) Non-HDL (mg/dL)
Extreme Risk Group Category A <50 (Optional goal ≤30) <80 (Optional goal ≤60) ≥50 ≥80
Extreme Risk Group Category B ≤30 ≤60 >30 >60
Very High Risk <50 <80 ≥50 ≥80
High Risk <70 <100 ≥70 ≥100
Moderate Risk <100 ≥100 ≥130
Low risk <100 ≥130* ≥160*
*After an adequate non-pharmacological intervention for at least 3 months
Page 7 of 18
PO No :PO4010181534-958
BIOCHEMISTRY
Liver Function Test

Bilirubin-Total 0.30 mg/dL 0.2 – 1.1 Vanadate oxidation
Bilirubin-Direct 0.10 mg/dL 0.0-0.3 Vanadate oxidation
Bilirubin-Indirect 0.20 mg/dL 0.1 - 1.0 Calculated
Protein, Total 6.90 g/dL 5.7–8.2 Biuret
Albumin 4.15 g/dL 3.4-4.8 BCG Dye Binding
Globulin 2.8 g/dl 1.8-3.6 Calculated
A/G Ratio 1.5 Ratio Calculated
Aspartate Transaminase (SGOT) 26 U/L <34 U/L Modified IFCC
Alanine Transaminase (SGPT) 20 U/L 10-49 Modified IFCC
SGOT/SGPT 1.30 Ratio Calculated
Alkaline Phosphatase 132 U/L 46-116 IFCC Standardization
Gamma Glutamyltransferase (GGT) 21 U/L <38 Modified IFCC
Comment:
LFTS are based upon measurements of substances released from damaged hepatic cells into the blood that gives idea of the Existence,
Extent and Type of Liver damage.
- Acute Hepatocellular damage: ALT & AST levels are sensitive index of hepatocellular damage
- Obstruction to the biliary tract,Cholestasis and blockage of bile flow:
1) Serum Total Bilirubin concentration 2) Serum Alkaline Phosphatase (ALP) activity 3) Gamma Glutamyl Transpeptidase (GGTP) 4) 5`-
Nucleotidase
- Chronic liver disease: Serum Albumin concentration
Bilirubin results from the enzymatic breakdown of heme. Jaundice is a yellowish discoloration of the skin and mucous membranes caused by
hyperbilirubinemia.
Pre-hepatic or hemolytic jaundice - Abnormal red cells, antibodies,drugs and toxins,Hemoglobinopathies, Gilbert’s syndrome, Crigler-Najjar
syndrome
Hepatic or Hepatocellular jaundice-Viral hepatitis,toxic hepatitis, intrahepatic cholestasis
Post-hepatic jaundice -Extrahepatic cholestasis, gallstones, tumors of the bile duct, carcinoma of pancreas
In viral hepatitis and other forms of liver disease associated with acute hepatic necrosis, serum AST and ALT concentrations are elevated
even before the clinical signs and symptoms of disease appear. ALT is the more liver-specific enzyme and elevations of ALT activity persist
longer than AST activity. Peak values of aminotransferase activity occur between the seventh and twelfth days. Activities then gradually
decrease, reaching normal activities by the third to fifth week. Peak activities bear no relationship to prognosis and may fall with worsening of
the patient's condition.
Aminotransferase activities observed in cirrhosis vary with the status of the cirrhotic process and range from the upper reference limit to four
to five times higher, with an AST/ALT ratio greater than 1. The ratio's elevation can reflect the grade of fibrosis in these patients. Slight or
moderate elevations of both AST and ALT activities have been observed after administration of various medications and chronic hepatic injury
such as (1) hemochromatosis, (2) Wilson disease, (3) autoimmune hepatitis, (4) primary biliary cirrhosis, (5) sclerosing cholangitis, and (6)
a1-antitrypsin deficiency. AST activity also is increased in acute myocardial infarction, progressive muscular dystrophy and dermatomyositis,
Page 8 of 18
PO No :PO4010181534-958
BIOCHEMISTRY
reaching concentrations up to eight times the upper reference limit.Slight to moderate AST elevations are noted in hemolytic disease.
GGT is a sensitive indicator of the presence of hepatobiliary disease, being elevated in most subjects with liver disease regardless of cause.
Increased concentrations of the enzyme are also found in serum of subjects receiving anticonvulsant drugs, such as phenytoin and
phenobarbital.
Page 9 of 18
PO No :PO4010181534-958
BIOCHEMISTRY
Kidney Function Test.

Blood Urea Nitrogen 15 mg/dL 9.0-21.0 Urease with GLDH
Urea 32.10 mg/dL 19.26-49.22 Calculated
Creatinine 0.87 mg/dL 0.5-1.1 Alkaline picrate-kinetic
Creatinine is a more specific and sensitive indicator of renal disease than Blood Urea Nitrogen.
Uses:
To diagnose renal insufficiency;

Adjusting dosage of renally excreted medications.
Monitoring renal transplant recipients.
Serum creatinine levels are a proxy for reduced skeletal muscle mass.
Serum creatinine measurement is used in estimating the Glomerular Filtration Rate (GFR) for people with Chronic Kidney
disease (CKD) and those with risk factors for CKD (Diabetes Mellitus, hypertension, cardiovascular disease, and family
history of kidney disease).
Increased In: Blockage in the urinary tract, Pre- and postrenal azotemia, Impaired kidney function, Loss of body fluid
(dehydration), Muscle diseases such as gigantism, acromegaly.
Decreased In: Pregnancy, certain drugs (e.g., cimetidine, trimethoprim), Myasthenia Gravis, Muscular dystrophy.
Uric Acid 7.1 mg/dL 3.1-7.8 Uricase/Peroxidase

Sodium 143 mEq/L 132.0-146.0 Indirect ISE
Potassium 4.4 mEq/L 3.5-5.5 Indirect ISE
Comment:
Hyperkalemia (increased serum potassium): Kidney disease, drugs like NSAIDS, ACE inhibitors and, potassium,sparing
diuretics, diabetes and Addison’s disease.
Hypokalemia (decreased serum potassium): Severe diarrhoea, extensive sweating, severe eating disorders, diureticdrugs and
renal disease.
Page 10 of 18
PO No :PO4010181534-958
BIOCHEMISTRY
Chloride 106.0 mEq/L 99 - 109 Indirect ISE

BUN/Creatinine Ratio 17.2 Ratio Calculated
Comment:
Renal function tests help to screen the individual for renal disease and to determine the extent or progression of renal disease. These tests also aid in determining drug dosage for
drugs excreted through the kidneys. The clinical syndrome resulting from decreased renal function and azotemia is called uremia
Renal azotemia: glomerular nephritis and chronic pyelonephritis.Prerenal azotemia: severe dehydration, hemorrhagic shock and excessive protein intake. Post renal azotemia:
urethral stones or tumors and prostatic obstructions
Measurement of urea in dialysis fluids is widely used in assessing the adequacy of renal replacement therapy.
In these prerenal situations, the plasma creatinine concentration may be normal.In obstructive post renal conditions, both plasma creatinine and urea concentrations will be
increased, although there is often a greater increase in plasma urea than creatinine because of the increased back diffusion.These considerations give rise to the principal clinical
utility of plasma urea, which lies in its measurement in conjunction with that of plasma creatinine and subsequent calculation of the urea nitrogen/creatinine ratio. This ratio has
been used as a crude discriminator between prerenal and postrenal azotemia. Significantly lower ratios usually denote (1) acute tubular necrosis, (2) low protein intake, (3)
starvation, or (4) severe liver disease (decreased urea synthesis). So even though blood urea is not an excellent marker of renal dysfunction as it rises quite late in the
dysfunction and its rise is also not exclusive to kidney dysfunction, but for practical purposes serum urea level is still one of the most ordered test and forms an important part
of the kidney function test.
Long-term follow-up of asymptomatic hyperuricemic patients is undertaken because many are at risk for kidney disease that may develop as a result of hyperuricemia and
hyperuricuria; few of these patients ever develop the clinical syndrome of gout.. It is also used in the diagnosis and monitoring of pregnancy-induced hypertension (pre-
eclamptic toxemia). Concentrations in excess of 6.0 mg/dL at 32 weeks gestation have been noted to be associated with a high perinatal mortality rate.
Page 11 of 18
PO No :PO4010181534-958
Immunology
Thyroid Profile
T3, Total 0.94 ng/mL 0.60 - 1.81 CLIA
Comment:
Below mentioned are the guidelines for pregnancy related reference ranges for total T3.
Pregnancy Reference ranges total T3 (ng/mL)

1st trimester 0.81-1.90
2nd trimester 1.00-2.60
1.00-2.60
3rd trimester
Total T3 and T4 circulate in plasma almost entirely bound to transport proteins, mainly thyroxine-binding globulin (TBG). It
is the unbound or free hormones which diffuse into tissues and exert diverse metabolic actions.
T3 concentrations are altered by physiological or pathological changes in thyroxine binding protein capacity. For example,
factors such as estrogen, glucocorticoid or androgen therapy, pregnancy, oral contraceptives, nephrotic syndrome, and
genetic influences can cause substantial changes in TBG levels.
Clinically, T3 blood levels better define hyperthyroidism and are especially valuable in following the course of therapy for
this disorder.
The T3 level is also a good indicator of the ability of the thyroid to respond to both stimulatory and suppressive tests.
Total T3 Increased Levels: Pregnancy, Graves disease, T3 thyrotoxicosis, TSH dependent Hyperthyroidism
Total T3 Decreased Levels: Non-thyroidal illness, Hypothyroidism,Nutritional deficiency, Systemic illness
For diagnostic purposes, results should be used in conjunction with other data; e.g., symptoms, results of other thyroid
tests, clinical impressions, etc.
TSH T3 T4 Interpretation
High Normal Normal Subclinical Hypothyroidism
Low Normal Normal Subclinical Hyperthyroidism
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PO No :PO4010181534-958
Immunology
High High High Secondary Hyperthyroidism

Low High/Normal High/Normal Hyperthyroidism
Non thyroidal illness / Secondary
Low Low Low Hypothyroidism
T4, Total 8.1 µg/dl 5.0 - 10.7 CLIA
Comment:
Below mentioned are the guidelines for pregnancy related reference ranges for total T4.
Pregnancy Reference Ranges (μg/dl)
1st trimester 7.33-14.8
2nd trimester 7.93-16.1
3rd trimester 6.95-15.7
Total T3 and T4 circulate in plasma almost entirely bound to transport proteins, mainly
thyroxine-binding globulin (TBG). It is the unbound or free hormones which diffuse into
tissues and exert diverse metabolic actions.
T4 concentrations are altered by physiological or pathological changes in thyroxine binding
globulin (TBG) capacity . For example, factors such as estrogen, glucocorticoid or androgen
therapy, pregnancy, oral contraceptives, nephrotic syndrome, and genetic influences can
cause substantial changes in TBG levels.
Increased Levels: Hyperthyroidism, Increased TBG, Familial dysalbuminemic
hyperthyroxinemia, Increased Transthyretin, Estrogen therapy, Pregnancy
Decreased Levels:Primary hypothyroidism, Pituitary TSH deficiency, Hypothalamic TRH
deficiency, Non thyroidal illness.
Serum T4 levels in neonates and infants are higher than values in the normal adult, due to
the increased concentration of TBG in neonate serum.
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PO No :PO4010181534-958
Immunology
Consequently, while T4 concentrations give good indications of thyroid status in many cases,
compensatory changes in T4 levels can also occur and T4 levels alone may give a false
impression of thyroid function.
For diagnostic purposes, results should be used in conjunction with other data; e.g.,
symptoms, results of other thyroid tests, clinical impressions, etc
Various drugs can lead to interference in test results.
Low High/Normal High/Normal Hyperthyroidism
Non thyroidal illness /
Secondary
Low Low Low Hypothyroidism
Thyroid Stimulating Hormone - Ultra 4.852 uIU/ml 0.55 - 4.78 CLIA

Sensitive
Comment:
Reference ranges for TSH (μIU/ml) [As per American thyroid
Pregnancy
Association]
1st
0.1-2.5
trimester
2nd
0.2-3.0
trimester
3rd
0.3-3.0
trimester
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PO No :PO4010181534-958
Immunology
TSH levels are subject to circadian variation, reaching peak levels between 2 - 4.a.m. and at a minimum between 6-10 pm .
The variation is of the order of 50%, hence time of the day has influence on the measured serum TSH concentrations.
TSH is secreted in a dual fashion: Intermittent pulses constitute 60-70% of total amount, background continuous secretion is 30-
40%.These pulses occur regularly every 1-3 hrs.
TSH is a very sensitive and specific parameter for assessing thyroid function and is particularly suitable for early detection or
exclusion of disorders in the central regulating circuit between the hypothalamus, pituitary and thyroid.
Changes in thyroid status are typically associated with concordant changes in T3, T4 and TSH levels.
For the diagnosis of hypothyroidism and hyperthyroidism, sole dependence on TSH should not be done and assay needs to be
interpreted with the clinical condition & other investigations.
Serum TSH level changes significantly in response to even minor changes in thyroid hormones.
Transient increase in TSH level or an abnormal TSH levels can be seen in various nonthyroidal diseases.
Unexpectedly abnormal or discordant thyroid test values may be seen with some rare, but clinically significantconditions such as
central hypothyroidism, TSH-secreting pituitary tumors, thyroid hormone resistance, or thepresence of heterophilic antibodies
(HAMA) or thyroid hormone autoantibodies.
Low High / Normal High/Normal Hyperthyroidism
Non thyroidal illness / Secondary
Low Low Low
Hypothyroidism
Comment:
Thyroid dysfunction is common in the general population and Laboratory tests are essential for the accurate diagnosis and cost-effective monitoring of thyroid dysfunction.
TSH is now firmly established as the first-line thyroid function test to assess thyroid status for most clinical conditions. Interpretation of the results of thyroid function tests is
Page 15 of 18
PO No :PO4010181534-958
Immunology
facilitated by an understanding of thyroid hormone physiology, especially the normal inverse relationship between free T4 and TSH concentrations.Changes in thyroid status are
normally associated with concordant changes in T3,T4 and TSH concentrations (e.g. raised T4 and T3 with suppressed TSH in thyrotoxicosis; low T4 and T3 with elevated
TSH in hypothyroidism). An abnormal TSH requires further investigation, including measurement of free T4 . In most clinical situations involving discordant FT4 and TSH
results, the TSH test usually yields the most diagnostically reliable result, provided that the patient is not receiving medications that directly inhibit TSH secretion, and there are
no conditions affecting the pituitary-thyroid axis.. Using TSH as a single criterion has been shown to accurately classify the thyroid state of a patient in over 95% of
cases. Non-thyroidal illness (NTI), pituitary disease and various drugs can all affect the axis and cause discrepancies between TSH levels, thyroid hormone levels and the clinical
state. Measurement of the TSH level is indicated for patients with symptoms suggestive of thyroid dysfunction, reduced bone mineral density, dyslipidaemia, depression, or
atrial fibrillation.
Total T4 measures the total amount of thyroxine circulating in the bloodstream. Indications:Used to make diagnosis of underactive or overactive thyroid when TSH is
abnormal • Used with TSH for monitoring patients with Graves’ disease • Newborn screening test for hypothyroidism • Fairly accurate in patients with no protein abnormalities
and not pregnant Free T4 measures the available, unbound amount of thyroxine in the bloodstream.
Free T4 is critical for evaluating patients with hypothalamic-pituitary disease. It is also useful for evaluating the response to levothyroxine in cases of poor compliance and in
the first months of treating patients with chronic, severe hypothyroidism.
The total T3 test measures the total amount of triiodothyronine circulating in the bloodstream. Free T3 measures the free, unbound levels of the hormone triiodothyronine
available for use by the body.Total T3 measurements, however, should be performedIn patients suspected of having T3 thyrotoxicosis and in patients taking drugs that inhibit
the peripheral conversion of T4 to T3 (such as dexamethasone, propranolol, propylthiouracil, amiodarone, and iodine-containing contrast media)
Maternal hypothyroidism causes adverse effects on fetal psychomotor development, highlighting the significance of evaluating thyroid function during pregnancy.Tests should
be performed pre-pregnancy or in the first trimester with TSH tests that can detect mild thyroid failure. During pregnancy, the total levels of T3 and T4 are high because of
increased TBG, and free T4 levels may slightly increase during the first trimester but will subsequently decline in the second and third trimesters.
In addition to the pre-analytical factors, potential analytical factors that interfere with the thyroid function tests assays such as heterophilic antibodies and autoantibodies, may
lead to discordant thyroid function test results. The optimal use of thyroid function tests should be patient-specific and depends on the patient’s specific thyroid disease, the
stage of the disease and co-existing medical conditions. Results should be interpreted in the appropriate clinical context of the individual patient with good communication
between clinicians and the requesting test laboratory.
Page 16 of 18
PO No :PO4010181534-958
Sample Type : Urine Report Date : 11/Jul/2022 04:15PM
CLINICAL PATHOLOGY
Urine Routine & Microscopy

Colour PALE YELLOW Pale Yellow Manual
Appearance HAZY Clear Manual
Specific gravity 1.010 1.005 - 1.030 pKa change
Ph 6.0 5.0 - 8.5 Double Indicator
Glucose NEGATIVE Negative GOD-POD
Protein NEGATIVE Negative Protein Error Principle
Ketones NEGATIVE Negative Nitroprusside
Blood NEGATIVE Negative Peroxidase
Bilirubin NEGATIVE Negative Diazonium
Urobilinogen NORMAL Normal Ehrlich
Leucocyte Esterase 1+ Negative Pyrrole
Nitrite NEGATIVE Negative Sulbhanilamide Diazo
Pus cells 10-12 /hpf 0-5 Microscopy
Red Blood Cells NIL /hpf few Microscopy
Epithelial cells 4-6 /hpf Few Microscopy
Casts NIL Nil Microscopy
Crystals NIL Nil Microscopy
Yeast NIL Nil Microscopy
Bacteria NIL Nil Microscopy
Comment:
Note:Pre-test condition to be observed while submitting the sample-first void, mid stream urine, collected in a clean, dry, sterile
container is recommended for routine urine analysis, avoid contamination with any discharge from vaginal, urethra, perineum, as
applicable, avoid prolonged transit time & undue exposure to sunlight.
Page 17 of 18
PO No :PO4010181534-958
Sample Type : Urine Report Date : 11/Jul/2022 04:15PM
CLINICAL PATHOLOGY
During interpretation, points to be considered are Negative nitrite test does not exclude the urinary tract infections. Trace
proteinuria can be seen with many physiological conditions like prolonged recumbency, exercise, high protein diet. False positive
reactions for bile pigments, proteins, glucose and nitrites can be caused by peroxidase like activity by disinfectants, therapeutic
dyes, ascorbic acid and certain drugs.
*** End Of Report ***
Page 18 of 18
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PO No :PO4010181534-958

Name : Ms.GEETI PAUL :

Glycosylated Hemoglobin (HbA1c) 6.1 % 4-5.6 HPLC

Adapted from American Diabetes Association.

• HPLC - High performance liquid chromatography

Complete Blood Count

Absolute Eosinophil Count 0.23 10^3/µI 0.02-0.5 Impedance and

Glucose - Fasting 104 mg/dL 70.0-100.0 Hexokinase

Fasting Plasma Glucose 2 hr plasma Glucose Diagnosis

Reference : American Diabetes Association

Normal <100 mg/dl

Liver Function Test

Kidney Function Test.

To diagnose renal insufficiency;

Uric Acid 7.1 mg/dL 3.1-7.8 Uricase/Peroxidase

Chloride 106.0 mEq/L 99 - 109 Indirect ISE

Pregnancy Reference ranges total T3 (ng/mL)

High High High Secondary Hyperthyroidism

T4, Total 8.1 µg/dl 5.0 - 10.7 CLIA

Thyroid Stimulating Hormone - Ultra 4.852 uIU/ml 0.55 - 4.78 CLIA

Urine Routine & Microscopy

*** End Of Report ***

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* End Of Report *