comparative study between different positions of government

Collection & Processing Date : 14/01/2015 16:15 Reporting Date : 14/01/2015 22:08 AALHADLab No : 1720Name : Dr.D.M.Singh Sex : Male Age : 64 Yrs

Dr. K.Anwar

Location : SRL DIAG.- ANWAR PATHOLOGY LAB

COMPLETE BLOOD COUNTTest Result UnitsReference Range

SAMPLE : WHOLE BLOODDONE ON : FULLY AUTOMATED CELL COUNTER (SYSMEX)

HAEMOGLOBIN, SLS 14.6 13.5 - 18.0 gms/dlRBC Count (Electrical Impedence) 4.78 4.7 - 6.0 milln/ulHaematocrit (P.C.V.),Pulse Ht.Detection 47.8 42 - 52 %Mean Corpuscular Vol(MCV) (Calculated) 100.0 78 - 100 fLMean Corpuscular Hb.(MCH) (Calculated) 30.5 27 - 31 pg.Mean Corp.Hb.Con. (MCHC) (Calculated) 30.5 32 - 36 g/dl.

WBC COUNT (Flowcytometry) 7,100 4000 - 10000 /cu.mm.DIFFERENTIAL COUNTNeutrophils 68 40 - 80 percentLymphocytes 24 20 - 40 percentEosinophils 02 1 - 6 percentMonocytes 06 2 - 10 percentBasophils 00 < 1 - 2 percent

PLATELET COUNT (Electrical Impedence) 2,96,000 150000-400000 /cu.mmPlatelets ON Smear Adequate

RDW-CV 13.5 11.5 - 14.0 percentPERIPHERAL SMEAR : Within Normal Limits


Dr. K.Anwar


COMPLETE BLOOD COUNT

NEWER PARAMETERS IN HAEMATOLOGY

IMMATURE PLATELET FRACTION:- 1.IPF can be used to predict platelet recovery in dengue patients having thrombocytopenia. A single value of >10% is indicative of platelet recovery within 24-48 hrs. If IPF value raises the next day i.e. Day 2, the platelet count may be expected to rise within 24 - 48 hours. 2.Immature platelet fraction (IPF) is an index of thrombopoiesis and can help determine the mechanism of thrombocytopenia. An increased IPF in the presence of thrombocytopenia is indicative of platelet destruction or consumption. (ITP, TTP,and DIC patients though ITP and TTP patients in remission have normal IPFresults.** Patients with regenerating marrows also have high IPF. A decreased/low normal IPF in the presence of thrombocytopenia is indicative of decreased marrow production. Patients with decreased production, including those undergoing cytotoxic chemotherapy, have IPF in the low or low normal range. 3.IPF is an indirect measure to better evaluate the necessity or timing of platelet transfusion. 4.IPF can be used to distinguish between thrombocytopenia due to bone marrow failure, where bleeding is more likely to occur,and thrombocytopenia due to peripheral destruction, where bleeding episodes are less common at any particular platelet count unless infection is present. 5.IPF reflects the severity of platelet destruction.There is a significant inverse correlation of platelet count with IPF;the lower the platelet count the higher the IPF. RETICULOCYTE PRODUCTION INDEX:- *RPI = Corrected Reticulocyte Count/Reticulocyte Maturation Time in days. *RPI should be used only for adult anaemic patients. *RPI > 2 = Increase Hematopoiesis *RPI < 2 = Reduced Hematopoiesis IMMATURE RETICULOCYTE FRACTION (IRF):- IRF gives an idea about the immature erythrocytes which contain the most RNA. In many clinical situations the IRFincreases before the total reticulocyte count and can be used to monitor BM response.

RETICULOCYTE Hb EQUIVALENT (Ret He):- Ret He provides an indirect measure of functional iron over the last 3 - 4 days. Ret He is reduced in patient withFunctional Iron Deficiency (FID). FID occurs when Advised Iron Studies. is not delivered for erythropoiesis (eg.Chronic renal dialysis, chronic inflammation, cancer patients).


Dr. K.Anwar


LIPID PROFILE

SAMPLE TYPE : SERUM

TEST OBSERVED VALUE REFERENCE RANGE

CHOLESTEROL * 302.0 mg/dl (CHOD - PAP) DESIRABLE : < 200 BORDERLINE HIGH: 200 - 239 HIGH : > 240

TRIGLYCERIDES 162.0 mg/dl

(GPO - PAP)


Dr. K.Anwar


BIOCHEMISTRY TESTTest Result UnitsReference Range

S.G.P.T. (IFCC U.V. Kinetic) 18 10 - 40 IU/L

S.CREATININE (Jaffe Kinetic) 0.9 0.9 - 1.4 mg/dl

S.URIC ACID (Uricase Enzymatic) 3.3 Low 4.0 - 8.6 mg/dl

CALCIUM (NM-BAPTA) 9.4 8.1 - 10.4 mg/dl

G.G.T.P. (SZAZ Method) 23.0 8 - 78 U/L

ALKALINE PHOSPHATASE (IFCC) 104 40 - 129 IU/L


Dr. K.Anwar


THYROID FUNCTION TESTS

Sample : Serum.

Method : FULLY AUTOMATED CHEMILUMINESCENCE SYSTEM.

Test Observed Values Reference Range & Units

T3 100.30 ng/dl Euthyroid : 70 to 204 ng/dl. Hypothyroid : < 70.0 ng/dl. Hyperthyroid : > 204.0 ng/dl.

T4 6.40 ug/dl Euthyroid : 4.2 to 11.8 ug/dl. Hypothyroid : < 4.2 ug/dl. Hyperthyroid : > 11.8 ug/dl.

TSH ( ULTRASENSITIVE ) 1.390 uIU/mlThird generation assay Euthyroid : 0.2 to 5.7 uIU/ml. Thyroid Stimulation Hypothyroid : > 5.7 uIU/ml Hormone. Hyperthyroid : < 0.2 uIU/ml.


Dr. K.Anwar


25-HYDROXY VITAMIN D (VITAMIN D3+D2) Sample : Serum. Method : FULLY AUTOMATED CMIA METHOD.

Test Observed Value Biological Reference Interval25-HYDROXY, Vitamin D 19.60 ng/ml Deficiency : Below 10 ng/ml Insufficiency : 10 - 30 ng/ml Sufficiency : 30 - 100 ng/ml Toxicity : Above 100 ng/ml 1. Vitamin D is a fat soluble vitamin & exists in two main forms as cholecalciferol (vitamin D3) which is synthesized in skin from 7-dehydrocholesterol in response to sunlight exposure & Ergocalciferol (vitamin D2) present mainly in dietary sources. Both cholecalciferol & Ergocalciferol are converted to 25 (OH) vitamin D in liver. Testing for 25 (OH) vitamin D is recommended as it is the best indicator of vitamin D nutritional status as obtained from sunlight exposure & dietary intake. 2. 25 OH Vitamin D is the best indicator of Vitamin D nutritional status, it is used as an aid in assessment of Vitamin D sufficiency in adults.

3. 25 OH Vitamin D deficiency is seen in secondary hyperparathyroidism. 4. Decreased levels of 25 OH Vitamin D can lead to Osteomalacia, reduced bone mass & thus increase the risk of bone fractures.

5. Decreased 25 OH Vitamin D levels are also associated with low bone mineral density & also seen in nutritional rickets. 6. Decreased levels of 25 OH Vitamin D are also associated with increased cardiovascular risk, low immunity & chronic renal failure.

7. Elevated levels are associated with Vitamin D intoxication. Please note change in Normal Ranges.


Dr. K.Anwar


GLYCOSYLATED HEMOGLOBIN (HbA1c)

Method : FULLY AUTOMATED D-10 ANALYZER (HPLC)

Note : The hemoglobin A1c program for the D-10 analyzer has been certified by the national glycohemoglobin standardization program.

GLYCOSYLATED HEMOGLOBIN 5.7 %

HbA1c Degree Of Glucose Control ---------- --------------------------------------------------

>8 % Action suggested >6.5 % Diabetic level 5.7 - 6.4 % Pre Diabetic level

Reference : ADA Diabetes Guidelines:2013

INFORMATION :

Glycosylated hemoglobin accumulates within the red blood cells & exists in this form throughout the lifespan of redcells. Thus a single HbA1c value taken every 2 to 3 months serves over those months.The measurement of HbA1chas been used as an index of metabolic control of diabetes during the preceding 2 to 3 months providing physicianwith an objective look at patients diabetes control. HbA1c is not affected by factors like intake of carbohydrates,timing of anti-diabetes drugs, daily activities.

Please note change in format.

MEAN PLASMA GLUCOSE 116.9 mg/dl

1) MPG (Mean Plasma Glucose) converts percentage HbA1c to md/dl, to compare blood glucose levels.

2) MPG gives an evaluation of blood glucose levels for the last couple of months.

3) MPG is calculated as MPG (mg/dl) = 28.7 * HbA1c - 46.7


Dr. K.Anwar


GLYCOSYLATED HEMOGLOBIN (HbA1c)

Remark : HbA1c Estimation can get affected due to :

(I) Shortened Erythrocyte survival : Any condition that shortens erythrocyte survival or decreases mean erythrocyteage (e.g. recovery from acute blood loss,hemolytic anemia) will falsely lower HbA1c test results.Fructosamine isrecommended in these patients which indicates diabetes control over 15 days

(II) Vitamin C & E are reported to falsely lower test results.(possibly by inhibiting glycation of hemoglobin.)

(III)Iron deficiency anemia is reported to increase test results.Hypertrig lyceridemia,uremia,hyperbilirubinemia,chronicalcoholism,chronic ingestion of salicylates & opiates addiction are reported to interfere with some assaymethods,falsely increasing results.

(IV) Interference of hemoglobinopathies in HbA1c estimation : a) Homozygous hemoglobinopathy is detected, Fructosamine is recommended for testing of HbA1c. b) Heterozygous state detected (D10/Varient II Turbo is corrected for HbS & HbC trait.) c) HbF > 25%, an alternate paltform (Boronate affinity chromatography) is recommended for testing of HbA1c.

Hemoglobin eletrophoresis (HPLC method) is recommended for detecting hemoglobinopathy.

COMPLETE BLOOD COUNTCOMPLETE BLOOD COUNTNEWER PARAMETERS IN HAEMATOLOGYLIPID PROFILEBIOCHEMISTRY TESTTHYROID FUNCTION TESTS25-HYDROXY VITAMIN D (VITAMIN D3+D2)GLYCOSYLATED HEMOGLOBIN (HbA1c)GLYCOSYLATED HEMOGLOBIN (HbA1c)

comparative study between different positions of government

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