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Test Information

1. Biochemistry
In addition to all biochemical IVD Tests, LFT, RFT, Cardiac Markers, TFT will be conducted.

2. Hematology
This Department covers CBC, ESR and Coagulation Tests.

3. Immunology/Serology
Apart from routine serology tests Tumor Markers, Fertility Hormones, Auto Immune Disease markers, Bone Markers, Infectious Disease markers and Special tests for Diabetes are included in this department.

4. Microbiology
Klab microbiology department covers Aerobic/Anaerobic Bacteriological Culture/Sensitivity along with Fungal Culture facility.

5. Clinical Pathology
In this department we are providing services like Urine & Stool Analysis, Rapid tests of different kind and microscopic examination.

6. Cytology
In this department specimens like Cervical smears, body fluids, Swabs, Sputum etc. are analyzed. FNAC and Bone marrow samples are not collected at Klab but analysis services will be provided.

Cardiac Markers : ( other than CK-NAK , CK-MB)
Analysis Method (ECLIA): TAT 4 Hours: Sample Serum in Red Cap Vacuette
What is being tested

Troponin I & Troponin T
Troponins are a type of proteins found in skeletal and heart (also referred to as cardiac) muscle fibres. The three different types of troponin are troponin C (TnC), troponin T (TnT) and troponin I (TnI). Together, these three proteins regulate muscle contraction. The heart troponins which are called TnI and TnT, are not normally present in the blood. When there is damage to heart muscle, TnI and TnT are released into the blood. The more damage there is, the greater the release of TnT and TnT into the blood, and the higher the blood level when it is tested.
When a patient has a heart attack, levels of cardiac troponin can increase in the blood within 3 or 4 hours after the attack and may remain high for 10 to 14 days.

THYROID FUNCTION PROFILE
Analysis Method (ECLIA): TAT 4 Hours: Sample Serum in Red Cap Vacuette
What is being tested

Free T3:
The test measures the amount of free triiodothyronine, or FT3, in blood.
T3 is one of two major hormones produced by the thyroid gland (the other hormone is called thyroxine, or T4). The thyroid gland is found in the neck, in front of the windpipe. T3 makes up less than 10% of what we call thyroid hormone, while T4 makes up the rest. T3, however, is about four times as strong as T4, and is thought to cause most, if not all, the effects of thyroid hormones.
Many of your body’s cells can turn T4 into T3; T4 may be mainly a “reservoir” used to make T3 available.
Thyroid hormones help regulate the body’s metabolism (how the body functions).
About 99.7% of T3 in blood is attached to a protein , and the rest is unattached (free). Blood tests can measure either the total (both bound and unattached) or free T3 hormone in the blood. These tests are called TT3 (total T3), and FT3 (free T3) respectively.

FT4
This test measures free thyroxine, or FT4, in your blood. Thyroxine is one of two major hormone produced by the thyroid gland (the other is called triiodothyronine. Within the blood, most thyroid hormones are attached to a protein, but it is the hormones that are free from these proteins that are able to affect body functions. This is therefore why we measure the ‘free’ thyroixine in your blood sample. The thyroid gland is found in the neck, in front of the windpipe.
Thyroxine (T4) makes up nearly all of what we call thyroid hormone, while triiodothyronine (T3) makes up less than 10%. Thyroid hormones help regulate the body’s metabolism (that is, how the body functions).
Most T4 in blood is attached to a protein ; less than 1% is unattached. The blood test can measure either the total (both bound and unattached, TT4) or free (unattached, FT4) T4 hormone in your blood.
Scientists believe that free hormone is responsible for all the effects of thyroid hormone.

TSH
The test measures the amount of thyroid-stimulating hormone (TSH) in your blood, which is an indicator of thyroid disease TSH is made by the pituitary gland, a tiny organ located below the brain and behind the sinus cavities. It is part of the body’s feed back system to maintain stable amounts of the thyroid hormones thyroxine (T4) and triiodothyronine (T3) in the blood.

Thyroid hormones help control the rate at which the body uses energy. When concentrations decrease in the blood, the hypothalamus (an organ in the brain) releases thyrotropin releasing hormone (TRH). This stimulates the release of TSH by the pituitary gland. The TSH in turn stimulates the production and release of T4 and T3 by the thyroid gland, a small butterfly-shaped gland that lies in the neck flat against the windpipe. When all three organs are functioning normally, thyroid hormone concentrations in the blood remain constant.

Anti-TPO
Thyroid peroxidase (TPO) is an enzyme needed to produce thyroid hormones. The TPO enzyme helps the reaction which adds iodine to thyroglobulin, a protein necessary to producing the thyroid hormones. TPO function is stimulated by TSH. TSH is released by the pituitary in response to the body’s need for more thyroid hormones, which are major hormones necessary for the body cells metabolism. Anti-TPO antibodies target the TPO enzymes slowing or stopping this necessary activity.
Significance: Having anti-TPO antibodies does not necessarily mean one has thyroid disease. It can also indicate a chronic inflammatory disease, like rheumatoid arthritis, is present. People with Addison’s disease (low adrenal gland hormones), celiac disease (gluten intolerance) or alopecia areata (an autoimmune reaction which causes baldness) can also have anti-TPO antibodies. However, from 5 to 50 percent of people with these conditions can also have a concurrent autoimmune thyroid disorder.
BONE MARKER
Analysis Method (ECLIA): TAT 4 Hours: Sample Serum in Red Cap Vacuette
What is being tested

PTH
Parathyroid hormone (PTH) helps the body maintain stable levels of calcium in the blood. It is part of a ‘feedback loop’ that includes calcium, PTH, vitamin D, and to some extent phosphate and magnesium. Conditions and diseases that disrupt this feedback loop can cause inappropriate elevations or decreases in calcium and PTH levels and lead to symptoms of hypercalcaemia (raised blood levels of calcium) or hypocalcaemia (low blood levels of calcium).
PTH is produced by four parathyroid glands that are located in the neck beside the thyroid gland. Normally, these glands secrete PTH into the bloodstream in response to low blood calcium levels. Parathyroid hormone then works in three ways to help raise blood calcium levels back to normal. It takes calcium from the body’s bone, stimulates the activation of vitamin D in the kidney (which in turn increases the absorption of calcium from the intestines), and suppresses the excretion of calcium in the urine (while encouraging excretion of phosphate). As calcium levels begin to increase in the blood, PTH normally decreases.
Parathyroid hormone itself is composed of 84 amino acids (sometimes called PTH (1-84)). Once it is released from the parathyroid gland into the blood stream, it has a very short life-span; levels fall by half in less than 5 minutes. The fall is caused primarily by the breakdown of PTH to smaller fragments.
Anemia Scanner
Analysis Method (ECLIA): TAT 4 Hours: Sample Serum in Red Cap Vacuette
What is being tested
Ferritin
Ferritin is a Protein that stores iron for later use by your body. The amount of ferritin in your blood stored reflects the amount of iron stored.
Iron is mainly stored in ferritin, but also in another protein called haemosiderin. Ferritin and haemosiderin are present mostly in the liver, but also in the bone marrow, spleen, and muscles. Small amounts of ferritin also circulate in the blood. In healthy people, most iron is stored in ferritin (an estimated 70% in men and 80% in women) and smaller amounts are stored in haemosiderin.

Folate, Vitamin B12
These tests measure the concentration of folate and vitamin B12 in the serum (liquid portion of the blood). The amount of folate inside the red blood cell (RBC) may also be measured – it will normally be at a higher concentration inside the cell than in the serum.
Both B12 and folate are necessary for normal red cell formation, tissue and cellular repair, and DNA synthesis. B12 is also important for nerve health, while folate is necessary for cell division such as is seen in a fetus during pregnancy. A deficiency in either B12 or folate can lead to macrocytic anaemia, where red cells are reduced but macrocytic (abnormally large). Specifically a bone marrow test may show megaloblastic anaemia, where immature red cells called megaloblasts may be seen.
B12 deficiency can also result in varying degrees of neuropathy, nerve damage that can cause tingling and numbness in the patient’s hands and feet. In severe B12 deficiency, a more serious nerve damage may occur known as subacute combined degeneration of the cord or SACD, where severe weakness and incoordination may occur. Subtle deterioration in eyesight and mental ability may occur. Folate deficiency in early pregnancy can cause neural tube defects such as spina bifida in a growing fetus.
There are a variety of causes of B12 and/or folate deficiencies. They include:
Insufficient intake
Malabsorption
Increased loss
Increased need

Diabetes (Other than F/PP/R- Sugar & HbA1c)
Analysis Method (ECLIA): TAT 4 Hours: Sample Serum in Red Cap Vacuette
What is being tested
Rheumatoid Arthritis ( Other than RF, PTH, and other related test)
Analysis Method (ECLIA): TAT 4 Hours: Sample Serum in Red Cap Vacuette
What is being tested
Anti-CCP
The cyclic citrullinated peptide antibody (CCP) test is a relatively new assay that detects the presence of anti-citrulline antibodies in the blood. Citrulline is an unusual amino acid (protein building block), which is created when the amino acid arginine is altered. There is speculation that conversion of arginine to citrulline resulting in “citrullinated” proteins in the lining of joints, may be the target of anti-CCP antibodies in RA, which may contribute to inflammatory process in RA.
CCP antibodies are much more specific for diagnosis of RA, meaning that if present they are more likely to indicate the presence of RA.
CCP is not recommended as a screening test. Like RF, it is best used for patients whose clinical signs suggest RA or who have already been diagnosed with undifferentiated arthritis. CCP is best used in patients with suggestive features of RA, whose RF is negative. CCP is now also being used in specialist early arthritis clinics to identify patients with RA early.

TUMOR MARKERS
Analysis Method (ECLIA) : TAT 4 Hours : Sample Serum in RED CAP Vacuette
WHAT IS BEING TESTED
CEA
CEA is a protein that is normally not detected in the blood of a healthy person. When certain types of cancer are present, CEA may be produced by the cancer cells. CEA may then be detected in blood, but it will not indicate which kind of cancer is present. CEA is often used to monitor patients with cancers of the gastrointestinal (GI) tract such as colorectal cancer. It may be raised in other cancers, such as ovarian and breast cancers, but can also be raised in benign conditions such as liver disease and inflammatory bowel disease (Crohns disease or ulcerative colitis).

AFP
AFP is a protein that is normally produced by the developing fetus. However, it can also be produced by certain tumours and disease of the liver. Raised levels of AFP are found in the majority of patients with a type of liver cancer called hepatocellular carcinoma and also in some patients with cancer of the testis.

PSA
Blood is being tested for the level of PSA it contains. PSA is a protein produced mainly by cells in the prostate gland and can be a useful indicator of prostate cancer. This protein can be found in all males; however, men whose levels are increased may have an infection of the prostate gland (prostatitis), prostate enlargement or prostate cancer. In blood, PSA is present both as free PSA and as complexed PSA bound to other blood proteins. The free PSA test measures the percentage of the total PSA that is not bound to proteins in the patient’s blood.

B-hCG
hCG is a protein produced in the placenta of a pregnant woman. A pregnancy test is a specific blood or urine test that can detect hCG and confirm pregnancy. This hormone can be detected 10 days after a missed menstrual period, the time period when the fertilised egg is implanted in the woman’s uterus. With some methods, hCG can be detected even earlier, at one week after conception.
During the early weeks of pregnancy, hCG is important in maintaining function of the corpus luteum (the mass of cells that forms from a mature egg). Production of hCG increases steadily during the first trimester (8 – 10 weeks), peaking around the 10th week after the last menstrual cycle. Levels then fall slowly during the remainder of the pregnancy. hCG is no longer detectable within a few weeks after delivery. hCG is also produced by some germ cell tumours and increased levels are seen in trophoblastic disease

CA 125
CA 125 is a protein often found on the surface of ovarian cancer cells and in some normal tissues. It is used as a marker for ovarian cancer. However, CA 125 levels may also be high in other types of non-cancerous conditions, including menstruation, preganacy, and pelvic inflammatory disease.

CA 15-3
Cancer antigen 15-3 (CA 15-3) is a normal product of breast cells. Concentrations of CA 15-3 in the blood are often increased in breast cancer. CA 15-3 does not cause cancer; rather, it is a protein that is shed by the tumour cells, making it useful as a marker to follow the course of the cancer.
CA 15-3 is rarely elevated in women with localised breast cancer but is increased in about 75% of those with breast cancer that has metastasized (spread to other organs). CA 15-3 also may be elevated in healthy people and in individuals with other cancers, or diseases, such as bowel cancer, lung cancer, cirrhosis, hepatitis, and benign (not malignant) breast disease.

CA19-9
Cancer antigen 19-9 (CA 19-9) is a protein that exists on the surface of certain cells. CA 19-9 does not cause cancer; rather, it is a protein that is produced by the tumour cells, making it useful as a tumor marker to follow the course of the cancer.
CA 19-9 is elevated in most patients with advanced pancreatic cancer, but it may also be elevated in other cancers and diseases such a bowel cancer, lung cancer and gall bladder cancer, as well as in benign diseases such as gall stones,pancreatitis, cystic fibrosis, and liver disease. Because elevated levels of CA 19-9 are seen in many diseases, elevated level do not necessary mean the presence of pancreatic cancer. Very small amounts of CA19-9 may also be found in healthy patients.

CREATININE PLUS
Roche Enzymatic Creatinine Assay
The Roche Creatinine Plus enzymatic creatinine assay, for use with cobas or MODULAR Analytics analysers, offers a specific and accurate alternative to the less specific Jaffé method, ensuring clinically more reliable results in the management of patients with chronic kidney disease (CKD)1. Users at GSTS (Guys, St Thomas’, Serco) Pathology, London and the University Hospital, Coventry, amongst others, have found that the assay provides a more accurate assessment of renal function

Pancreatic Amylase and Lipase ( For Pancreatitis)
Amylase :
The pancreatic enzyme responsible for digesting carbohydrates, is the most common blood test for acute pancreatitis. It increases from 2 to 12 hours after the beginning of symptoms and peaks at 12 to 72 hours. It may rise to 5 to 10 times the normal level and will usually return to normal within a week. Amylase also may be monitored in patients with chronic pancreatitis; it will often be moderately elevated until the cells that produce it are destroyed, at which point blood levels may be decreased. It should be noted that amylase is an enzyme that has different forms called isoenzymes: P-amylase refers to that made by the pancreas and S-amylase refers to the form made by the salivary glands. Normally, a total amylase is requested. Sometimes, the isoenzymes are requested to distinguish pancreatic and non-pancreatic causes of increased amylase.

Lipase :
It is the pancreatic enzyme that, along with bile from the liver, digests fats. Its level increases in the blood within 4 to 8 hours of the beginning of an acute attack and peaks at 24 hours. Lipase is both more sensitive and specific than amylase for the diagnosis of acute pancreatitis. However, there are other sources of lipase in the digestive tract. For some assay that detect non-pancreatic lipase, milder elevations may occur with non-pancreatic disorders. In patients with pancreatitis, lipase may rise to several times its normal level and remains elevated longer than amylase. As cells are destroyed with chronic pancreatitis and as lipase production drops to less than 10% of the normal level, steatorrhea (fatty, foul-smelling stools) will form. As chronic pancreatitis progresses, amylase and lipase may be normal or decreased even during acute attacks.

We can add information on fertility hormones highlighting AMH and SFT
Another title Infectious markers: Add HIV Combi (?4th generation), HBsAg and HCV