Po4009507960 540
Po4009507960 540
Po4009507960 540
HAEMATOLOGY
MONSOON HEALTH SCREENING
Test Name Result Unit Bio. Ref. Interval Method
Comment:
Interpretation: HbA1c%
≤5.6 Normal
5.7-6.4 At Risk For Diabetes
≥6.5 Diabetes
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.
Page 1 of 14
PO No :PO4009507960-540
HAEMATOLOGY
MONSOON HEALTH SCREENING
Test Name Result Unit Bio. Ref. Interval Method
Page 2 of 14
PO No :PO4009507960-540
HAEMATOLOGY
MONSOON HEALTH SCREENING
Test Name Result Unit Bio. Ref. Interval Method
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.
Page 3 of 14
PO No :PO4009507960-540
BIOCHEMISTRY
MONSOON HEALTH SCREENING
Test Name Result Unit Bio. Ref. Interval Method
Glucose - Fasting
Glucose - Fasting 82 mg/dL 70-100 Hexokinase/G-6-PDH
Comment:
Impaired glucose tolerance (IGT) fasting, means a person has an increased risk of developing type 2 diabetes but does not
have it yet. A level of 126 mg/dL or above, confirmed by repeating the test on another day, means a person has diabetes.
IGT (2 hrs Post meal ), means a person has an increased risk of developing type 2 diabetes but does not have it yet. A 2-hour
glucose level of 200 mg/dL or above, confirmed by repeating the test on another day, means a person has diabetes
Page 4 of 14
PO No :PO4009507960-540
BIOCHEMISTRY
MONSOON HEALTH SCREENING
Test Name Result Unit Bio. Ref. Interval Method
Lipid Profile
Cholesterol - Total 174 mg/dL Low (desirable): < 200 Enzymatic
mg/dL
Moderate (borderline)
200–239 mg/dL
High: >/= 240 mg/dL
Triglycerides 101 mg/dL Normal: < 150, GPO, Trinder without
Borderline: 150 - 199, serum blank
High:200 - 499, Very
High >=500
Cholesterol - HDL 38 mg/dL Low (undesirable, high Elimination/catalase
risk): < 40 mg/dL
High (desirable, low risk):
>= 60 mg/dL
Cholesterol - LDL 116 mg/dL Desirable: <100 Calculated
Above desirable: 100 -
129
Borderline high : 130 -
159
High : 160 - 189
Very high : >=190
Cholesterol- VLDL 20 mg/dL <30 Calculated
Cholesterol : HDL Cholesterol 4.6 Ratio Desirable : 3.5-4.5 Calculated
High Risk : >5
LDL : HDL Cholesterol 3.04 Ratio Desirable : 2.5-3.0 Calculated
High risk : >3.5
Non HDL Cholesterol 136 mg/dl Desirable:< 130, Calculated
Above Desirable:130 -
159,
Borderline High:160 -
189,
High:190 - 219,
Very High: >= 220
Page 5 of 14
PO No :PO4009507960-540
BIOCHEMISTRY
MONSOON HEALTH SCREENING
Test Name Result Unit Bio. Ref. Interval Method
Comment:
Indians are at a high risk of developing atherosclerotic cardiovascular disease (ASCVD); at a much earlier age; more
severe in nature and have high mortality.
Major risk factors have been found to be dyslipidemia (abnormal lipid profile), smoking, sedentary lifestyle, obesity,
hypertension and diabetes. Dyslipidemia is most important and found to be very high in Indians (79%); hence control of
dyslipidemia is the key healthcare target.
LDL-Cholesterol (LDL-C) contributes most significantly to atherosclerosis and is the primary target of treatment.
Triglyceride (TG) rich lipoprotein remnants also play a major role in CVD. Indians have higher triglyceride levels and lower
HDL-C (good cholesterol) combined with increased proportion of small dense LDL-C; this pattern is called atherogenic
dyslipidemia and is associated with diabetes, metabolic syndrome and insulin resistance.
Non-HDL-Cholesterol (Non-HDLC) measures all atherogenic lipoproteins (LDL-C, VLDL, Lp(a), Apo-B). Monitoring of Non-
HDLC is the co-primary target and is especially important in patients with elevated TG (e.g. diabetics, obese persons,
metabolic syndrome) and those on statin therapy.
Lipid Association of India (LAI) recommendations (2020) -
Screening of all Indians above the age of 20 years for CVD risk factors esp. lipid profile.
Risk factors known to promote atherosclerosis include: Age- male ≥45 years, female ≥55 years; Family h/o
premature CAD (male <55 years, female <65 years), Smoking/tobacco use, Systemic hypertension, Low HDL (males
<40 mg/dl and females <50 mg/dl.
Fasting lipid profile is not mandatory. Both fasting and non-fasting lipid profiles are important for managing Indian
patients with dyslipidemia. Non-HDLC should be calculated in every subject.
Newer treatment goals have been laid down based on different risk categories (According to LAI algorithm). LAI
recommends LCD-C as primary target and Non-HDL as co-primary treatment target.
Lifestyle modifications are integral for management and prevention of dyslipidemia.
In low risk patients, consider therapy after an initial non-pharmacological intervention for at least 3 months.
Additional testing for Apolipoprotein B, hsCRP, Lp(a ) should be considered among patients with moderate risk for
ASCVD for risk refinement
Note: Reference Interval as per National Cholesterol Education Program (NCEP) ATP-III Report.
Page 6 of 14
PO No :PO4009507960-540
BIOCHEMISTRY
MONSOON HEALTH SCREENING
Test Name Result Unit Bio. Ref. Interval Method
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, reaching
concentrations up to eight times the upper reference limit.Slight to moderate AST elevations are noted in hemolytic disease.
Page 7 of 14
PO No :PO4009507960-540
BIOCHEMISTRY
MONSOON HEALTH SCREENING
Test Name Result Unit Bio. Ref. Interval Method
•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 8 of 14
PO No :PO4009507960-540
BIOCHEMISTRY
MONSOON HEALTH SCREENING
Test Name Result Unit Bio. Ref. Interval Method
Comment:
BUN is directly related to protein intake and nitrogen metabolism and inversely related to the rate of excretion of urea.Blood
urea nitrogen (BUN) levels reflect the balance between the production and excretion of urea. Increased levels are seen in renal
failure (acute or chronic), urinary tract obstruction, dehydration, shock, burns, CHF, GI bleeding, nephrotoxic drugs. Decreased
levels are seen in hepatic failure, nephrotic syndrome, cachexia (low-protein and high-carbohydrate diets).
Urea is a non-proteinous nitrogen compound formed in the liver from ammonia as an end product of protein metabolism. Urea
diffuses freely into extracellular and intracellular fluid and is ultimately excreted by the kidneys. Increased levels are found in
acute renal failure, chronic glomerulonephritis, congestive heart failure, decreased renal perfusion, diabetes, excessive protein
ingestion, gastrointestinal (GI) bleeding, hyperalimentation, hypovolemia, ketoacidosis, muscle wasting from starvation,
neoplasms, pyelonephritis, shock, urinary tract obstruction, nephrotoxic drugs. Decreased levels are seen in inadequate dietary
protein, low-protein/high-carbohydrate diet, malabsorption syndromes, pregnancy, severe liver disease, certain drugs.
Creatinine is catabolic product of creatinine phosphate, which is excreted by filtration through the glomerulus and by tubular
secretion. Creatinine clearance is an acceptable clinical measure of glomerular filtration rate (GFR). Increased levels are seen in
acute/chronic renal failure, urinary tract obstruction, hypothyroidism, nephrotoxic drugs, shock, dehydration, congestive heart
failure, diabetes. Decreased levels are found in muscular dystrophy.
BUN/Creatinine ratio (normally 12:1–20:1) is decreased in acute tubular necrosis, advanced liver disease, low protein intake,
and following hemodialysis. BUN/Creatinine ratio is increased in dehydration, GI bleeding, and increased catabolism.
Uric acid levels show diurnal variation. The level is usually higher in the morning and lower in the evening. Increased levels are
seen in starvation, strenuous exercise, malnutrition, or lead poisoning, gout, renal disorders, increased breakdown of body cells
in some cancers (including leukemia, lymphoma, and multiple myeloma) or cancer treatments, hemolytic anemia, sickle cell
anemia, or heart failure, pre-eclampsia, liver disease (cirrhosis), obesity, psoriasis, hypothyroidism, low blood levels of
parathyroid hormone (PTH), certain drugs, foods that are very high in purines - such as organ meats, red meats, some seafood
and beer. Decreased levels are seen in liver disease, Wilson's disease, Syndrome of inappropriate antidiuretic hormone (SIADH),
certain drugs.
Page 9 of 14
PO No :PO4009507960-540
Immunology
MONSOON HEALTH SCREENING
Test Name Result Unit Bio. Ref. Interval Method
Comment:
Immunoglobulin E (IgE) is the most important trigger molecule for allergic information.
As IgE is a mediator of allergic response, quantitative measurement can provide useful information for differential
diagnosis of atopic and non-atopic disease.
The level of IgE is low during the first year of life, gradually increases with age and reaches adult level after 10 years.
Uses
Increased Levels:
Atopic/Non-atopic allergy, Hyper IgE syndrome, Parasitic infections, IgE Myeloma, Bronchopulmonary Aspergillosis,
Immunodeficiency states & Autoimmune diseases, Hodgkin’s disease,etc.
Decreased Levels:
Note:
Normal levels of IgE does not eliminate the possibility of allergic diseases
No close correlation has been demonstrated between severity of allergic reaction and IgE levels.
Page 10 of 14
PO No :PO4009507960-540
Immunology
MONSOON HEALTH SCREENING
Test Name Result Unit Bio. Ref. Interval Method
Thyroid Profile
T3, Total 1.08 ng/mL 0.60 - 1.81 CLIA
T4, Total 9.4 µg/dl 4.5 - 12.6 CLIA
Thyroid Stimulating Hormone - Ultra 1.874 uIU/ml 0.55 - 4.78 CLIA
Sensitive
Comment:
Below mentioned are the guidelines for pregnancy related reference ranges for TSH, total T3 & Total T4.
Pregnancy
TSH (μIU/mL) (as per
American Thyroid Total T3 (ng/mL) Total T4(μg/dL)
Association )
1st trimester 0.1-2.5 0.81-1.90 7.33-14.8
2nd trimester 0.2-3.0 1.00-2.60 7.93-16.1
3rd trimester 0.3-3.0 1.00-2.60 6.95-15.7
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.
Total T3 & T4 concentrations are altered by physiological or pathological changes in thyroxine binding globulin (TBG)
capacity .
The determination of free T3 & free T4 has the advantage of being independent of changes in the concentrations and
binding properties of the binding proteins.
Changes in thyroid status are typically associated with concordant changes in T3, T4 and TSH levels.
Unexpectedly abnormal or discordant thyroid test values may be seen with some rare, but clinically significant conditions
such as central hypothyroidism, TSH-secreting pituitary tumors, thyroid hormone resistance, or the presence of
heterophilic antibodies (HAMA) or thyroid hormone autoantibodies.
For diagnostic purposes, results should be used in conjunction with other data.
TSH T3 T4 Interpretation
Page 11 of 14
PO No :PO4009507960-540
Immunology
MONSOON HEALTH SCREENING
Test Name Result Unit Bio. Ref. Interval Method
Page 12 of 14
PO No :PO4009507960-540
Immunology
MONSOON HEALTH SCREENING
Test Name Result Unit Bio. Ref. Interval Method
Comment:
Vitamin D is a fat-soluble steroid prohormone involved in the intestinal absorption of calcium and the regulation of calcium
homeostasis.
Two forms of vitamin D are biologically relevant - vitamin D3 (Cholecalciferol) and vitamin D2 (Ergocalciferol).
Both vitamins D3 and D2 can be absorbed from food but only an estimated 10-20perc. of vitamin D is supplied through
nutritional intake.
Vitamin D is converted to the active hormone 1,25-(OH)2-vitamin D (Calcitriol) through two hydroxylation reactions. The
first hydroxylation converts vitamin D into 25-OH vitamin D and occurs in the liver. The second hydroxylation converts 25-
OH vitamin D into the biologically active 1,25-(OH)2-vitamin D and occurs in the kidneys as well as in many other cells of
the body.
Most cells express the vitamin D receptor and about 3perc. of the human genome is directly or indirectly regulated by the
vitamin D endocrine system.
The major storage form of vitamin D is 25-OH vitamin D and is present in the blood at up to 1,000 fold higher
concentration compared to the active 1,25-(OH)2-vitamin D. 25-OH vitamin D has a half-life of 2-3 weeks vs. 4 hours for
1,25-(OH)2-vitamin D. Therefore, 25-OH vitamin D is the analyte of choice for determination of the vitamin D status.
Risk factors for vitamin D deficiency include low sun exposure, inadequate intake, decreased absorption, abnormal
metabolism, vitamin D resistance and and liver or kidney diseases.
Vitamin D deficiency is a cause of secondary hyperparathyroidism and diseases resulting in impaired bone metabolism (like
rickets, osteomalacia).
Recently, many chronic diseases such as cancer, high blood pressure, osteoporosis and several autoimmune diseases
have been linked to vitamin D deficiency.
The assay measures both D2 (Ergocalciferol) and D3 (Cholecalciferol) metabolites of vitamin D
Page 13 of 14
PO No :PO4009507960-540
Immunology
MONSOON HEALTH SCREENING
Test Name Result Unit Bio. Ref. Interval Method
Comment:
Vitamin B12 along with folate is essential for DNA synthesis and myelin formation.
Decreased levels a r e s e e n i n a n a e m i a , t e r m p r e g n a n c y , v e g e t a r i a n d i e t , i n t r i n s i c f a c t o r d e f i c i e n c y , p a r t i a l
gastrectomy/ileal damage, celiac disease, oral contraceptive use, parasitic infestation, pancreatic deficiency, treated
epilepsy, smoking, hemodialysis and advanced age.
Increased levels are seen in renal failure, hepatocelluar disorders, myeloproliferative disorders and at times with excess
supplementation of vitamins pills.
Page 14 of 14
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