All Tests

AIDS is caused by human immnodeficiency virus (HIV). HIV kills or damages the body's immune system cells.
There are two types of HIV. Type I and Type II. Type I is more common in India.

AIDS is generally caused by unprotected sex with an infected partner. It may also spread through the use of infected syringes of HIV infected people and blood transfusions.

The first sign of AIDS is influenza (flu) like symptoms or may be swollen glands, but at times, symptoms might not appear. Symptoms may appear after two or three months. Generally, blood test is done to confirm the diagnosis. There is no cure, but there are many medicines to fight/ control HIV infection

Asthma is a chronic disease characterized by recurrent attacks of breathlessness and wheezing. During an asthma attack, the lining of the bronchial tubes (airways) swells, causing the airways to narrow, turn more sensitive to irritants in the environment, and thus reducing the flow of air into and out of the lungs. The causes of asthma are not completely understood.

However, risk factors for developing asthma include inhaling asthma “triggers”, such as allergens (some common to all and some individualized), tobacco smoke and chemical irritants. Several patients with asthma may also have allergic rhinitis which is characterized by sneezing and “runny” nose. It can start at any age. About half of all people with asthma tend to have their first symptoms by the age of ten years, and many children with asthma have had their first asthma attack before the age of six. Asthma cannot be cured, but appropriate management can control the disorder and enable people to enjoy a good quality of life.

This article explains the basics of an allergic reaction. Learn what happens when your immune system goes on high alert.

Who Gets Allergies?

Anyone can get them, at any age. You could develop them as a child, or you might not have any symptoms until you’re an adult.

What Causes an Allergic Reaction?

While your problem may seem to start in the nose or the eyes, allergies actually come from an immune system run wild.

An albumin blood test measures the amount of albumin in your blood. Albumin is a protein made by your liver. Albumin helps keep fluid in your bloodstream so it doesn't leak into other tissues. It is also carries various substances throughout your body, including hormones, vitamins, and enzymes. Low albumin levels can indicate a problem with your liver or kidneys.

Other names: ALB

An alkaline phosphatase (ALP) test measures the amount of ALP in your blood. ALP is an enzyme found throughout the body, but it is mostly found in the liver, bones, kidneys, and digestive system. When the liver is damaged, ALP may leak into the bloodstream. High levels of ALP can indicate liver disease or bone disorders.

Other names: ALP, ALK, PHOS, Alkp, ALK PHOS

Allergies are a common and chronic condition that involves the body's immune system. Normally, your immune system works to fight off viruses, bacteria, and other infectious agents. When you have an allergy, your immune system treats a harmless substance, like dust or pollen, as a threat. To fight this perceived threat, your immune system makes antibodies called immunoglobulin E (IgE).

Substances that cause an allergic reaction are called allergens. Besides dust and pollen, other common allergens include animal dander, foods, including nuts and shellfish, and certain medicines, such as penicillin. Allergy symptoms can range from sneezing and a stuffy nose to a life-threatening complication called anaphylactic shock. Allergy blood tests measure the amount of IgE antibodies in the blood. A small amount of IgE antibodies is normal. A larger amount of IgE may mean you have an allergy.

Other names: IgE allergy test, Quantitative IgE, Immunoglobulin E, Total IgE, Specific IgE

Alpha-fetoprotein (AFP) is a protein produced in the liver of a developing fetus. During a baby's development, some AFP passes through the placenta and into the mother's blood. An AFP test measures the level of AFP in pregnant women during the second trimester of pregnancy. Too much or too little AFP in a mother's blood may be sign of a birth defect or other condition. These include:

• A neural tube defect, a serious condition that causes abnormal development of a developing baby's brain and/or spine
• Down syndrome, a genetic disorder that causes intellectual disabilities and developmental delays
• Twins or multiple births, because more than one baby is producing AFP
• Miscalculation of due date, because AFP levels change during pregnancy

Other names: AFP Maternal; Maternal Serum AFP; msAFP screen

ALT, which stands for alanine transaminase, is an enzyme found mostly in the liver. When liver cells are damaged, they release ALT into the bloodstream. An ALT test measures the amount of ALT in the blood. High levels of ALT in the blood can indicate a liver problem, even before you have signs of liver disease, such as jaundice, a condition that causes your skin and eyes to turn yellow. An ALT blood test may be helpful in early detection of liver disease.

Other names: Alanine Transaminase (ALT), SGPT, Serum Glutamic-Pyruvic Transaminase, GPT

An amylase test measures the amount of amylase in your blood or urine. Amylase is an enzyme, or special protein, that helps you digest food. Most of your amylase is made in the pancreas and salivary glands. A small amount of amylase in your blood and urine is normal. A larger or smaller amount may mean that you have a disorder of the pancreas, an infection, alcoholism, or another medical condition.

Other names: Amy test, serum amylase, urine amylase

An anion gap blood test is a way to check the levels of acid in your blood. The test is based on the results of another blood test called an electrolyte panel. Electrolytes are electrically charged mineralsthat help control the balance of chemicals in your body called acids and bases. Some of these minerals have a positive electric charge. Others have a negative electric charge. The anion gap is a measurement of the difference-or gap-between the negatively charged and positively charged electrolytes. If the anion gap is either too high or too low, it may be a sign of a disorder in your lungs, kidneys, or other organ systems.

Other names: Serum anion gap

Alcoholism, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in mental or physical health problems. It was previously divided into two types: alcohol abuse and alcohol dependence. In a medical context, alcoholism is said to exist when two or more of the following conditions is present: a person drinks large amounts over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use.Risky situations include drinking and driving or having unsafe sex among others.Alcohol use can affect all parts of the body but particularly affects the brain, heart, liver, pancreas, and immune system.This can result in mental illness, Wernicke–Korsakoff syndrome, an irregular heart beat, liver failure, and an increase in the risk of cancer, among other diseases Drinking during pregnancy can cause damage to the baby resulting in fetal alcohol spectrum disorders. Generally women are more sensitive to alcohol's harmful physical and mental effects than men

Bloat is any abnormal gas swelling, or increase in diameter of the abdominal area. As a symptom, the patient feels a full and tight abdomen, which may cause abdominal pain and is sometimes accompanied by increased stomach growling, or more seriously, the total lack of it.

Pains that are due to bloating will feel sharp and cause the stomach to cramp. These pains may occur anywhere in the body and can change locations quickly.They are so painful that they are sometimes mistaken for heart pains when they develop on the upper left side of the chest. Pains on the right side are often confused with problems in the appendix or the gallbladder.

Gastroesophageal reflux disease (GERD), also known as acid reflux, is a long-term condition where stomach contents come back up into the esophagus resulting in either symptoms or complications.Symptoms include the taste of acid in the back of the mouth, heartburn, bad breath, chest pain, vomiting, breathing problems, and wearing away of the teeth. Complications include esophagitis, esophageal strictures, and Barrett's esophagus.

Risk factors include obesity, pregnancy, smoking, hiatus hernia, and taking certain medicines. Medications involved include antihistamines, calcium channel blockers, antidepressants, and sleeping medication. It is due to poor closure of the lower esophageal sphincter (the junction between the stomach and the esophagus).Diagnosis among those who do not improve with simpler measures may involve gastroscopy, upper GI series, esophageal pH monitoring, or esophageal manometry.

Arthritis includes more than 100 diseases and conditions that affect joints, the tissues that surround the joint, and other connective tissue. Symptoms vary depending on the specific form of the disease, but typically include pain and stiffness in and around one or more joints.  Some rheumatic conditions can also involve the immune system and various internal organs of the body.

Autism spectrum disorder (ASD) is a developmental disability  that can cause significant social, communication and behavioral challenges. There is often nothing about how people with ASD look that sets them apart from other people, but people with ASD may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less.

Acne, also known as acne vulgaris, is a long-term skin disease that occurs when hair follicles are clogged with dead skin cells and oil from the skin. It is characterized by blackheads or whiteheads, pimples, oily skin, and possible scarring. It primarily affects areas of the skin with a relatively high number of oil glands, including the face, upper part of the chest, and back. The resulting appearance can lead to anxiety, reduced self-esteem and, in extreme cases, depression or thoughts of suicide.

Genetics is thought to be the primary cause of acne in 80% of cases. The role of diet and cigarette smoking is unclear, and neither cleanliness nor exposure to sunlight appear to play a part. During puberty, in both sexes, acne is often brought on by an increase in hormones such as testosterone. A frequent factor is excessive growth of the bacterium Propionibacterium acnes, which is normally present on the skin.

Acupressure [from Latin acus "needle" (see acuity) + pressure (n.)] is an alternative medicine technique similar in principle to acupuncture. It is based on the concept of life energy which flows through "meridians" in the body. In treatment, physical pressure is applied to acupuncture points with the aim of clearing blockages in these meridians. Pressure may be applied by hand, by elbow, or with various devices.

Some medical studies have suggested that acupressure may be effective at helping manage nausea and vomiting, for helping lower back pain, tension headaches, stomach ache, among other things, although such studies have been found to have a high likelihood of bias. Like many alternative medicines, it may benefit from a placebo effect.

Acupuncture is a form of alternative medicine in which thin needles are inserted into the body. It is a key component of traditional Chinese medicine. TCM theory and practice are not based upon scientific knowledge, and acupuncture is a pseudoscience. There is a diverse range of acupuncture theories based on different philosophies, and techniques vary depending on the country. The method used in TCM is likely the most widespread in the United States. It is most often used for pain relief, though it is also used for a wide range of other conditions. Acupuncture is generally used only in combination with other forms of treatment.

A relatively new term, “adrenal fatigue” was proposed as a new condition in 1998 by Dr. James L. Wilson, a naturopath and chiropractor. His assumption was that an overstimulation of the adrenal glands (or “adrenals”) by chronic stress over time could lead to an inconsistent level of cortisol (the stress hormone) in the bloodstream, sometimes far more than normal and at other times, far too low. In addition to this overload or improper cortisol level, people with adrenal fatigue often don’t have enough DHEA, the “parent hormone” responsible for the creation of many necessary hormones in the body.

Unlike other endocrine disorders that are caused by physical damage to parts of the adrenal glands, hypoadrenia is seen by many in the natural health world as a “middle ground” syndrome with simple and easy-to-implement solutions. Currently, no official diagnosis exists for adrenal fatigue and people are either considered to have normal endocrine function or total endocrine failure, like that seen in Cushing’s syndrome or adrenal insufficiency/Addison’s disease. 

Alcoholism, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in mental or physical health problems. It was previously divided into two types: alcohol abuse and alcohol dependence. In a medical context, alcoholism is said to exist when two or more of the following conditions is present: a person drinks large amounts over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use.

Alzheimer's disease is a progressive disease that destroys memory and other important mental functions. At first, someone with Alzheimer's disease may notice mild confusion and difficulty remembering. Eventually, people with the disease may even forget important people in their lives and undergo dramatic personality changes.

Alzheimer's disease is the most common cause of dementia — a group of brain disorders that cause the loss of intellectual and social skills. In Alzheimer's disease, the brain cells degenerate and die, causing a steady decline in memory and mental function.

Current Alzheimer's disease medications and management strategies may temporarily improve symptoms. This can sometimes help people with Alzheimer's disease maximize function and maintain independence for a little while longer. But because there's no cure for Alzheimer's disease, it's important to seek supportive services and tap into your support network as early as possible.

Amenorrhoea is the absence of a menstrual period in a woman of reproductive age. Physiological states of amenorrhoea are seen, most commonly, during pregnancy and lactation (breastfeeding), the latter also forming the basis of a form of contraception known as the lactational amenorrhoea method. Outside the reproductive years, there is absence of menses during childhood and after menopause.

Amenorrhoea is a symptom with many potential causes. Primary amenorrhoea (menstrual cycles never starting) may be caused by developmental problems, such as the congenital absence of the uterus or failure of the ovary to receive or maintain egg cells. Also, delay in pubertal development will lead to primary amenorrhoea. It is defined as an absence of secondary sexual characteristics by age 14 with no menarche or normal secondary sexual characteristics but no menarche by 16 years of age. Secondary amenorrhoea (menstrual cycles ceasing) is often caused by hormonal disturbances from the hypothalamus and the pituitary gland, from premature menopause or intrauterine scar formation. It is defined as the absence of menses for three months in a woman with previously normal menstruation or nine months for women with a history of oligomenorrhoea.

Pruritus ani is the irritation of the skin at the exit of the rectum, known as the anus, causing the desire to scratch. The intensity of anal itching increases from moisture, pressure, and rubbing caused by clothing and sitting. At worst, anal itching causes intolerable discomfort that often is accompanied by burning and soreness. It is estimated that up to 5% of the population of the United States experiences this type of discomfort daily

Anemia is a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood, or a lowered ability of the blood to carry oxygen.[5] When anemia comes on slowly, the symptoms are often vague and may include feeling tired, weakness, shortness of breath or a poor ability to exercise.[1] Anemia that comes on quickly often has greater symptoms, which may include confusion, feeling like one is going to pass out, loss of consciousness, or increased thirst. Anemia must be significant before a person becomes noticeably pale. Additional symptoms may occur depending on the underlying cause

Anorexia nervosa, often referred to simply as anorexia, is an eating disorder characterized by low weight, fear of gaining weight, and a strong desire to be thin, resulting in food restriction. Many people with anorexia see themselves as overweight even though they are in fact underweight. If asked they usually deny they have a problem with low weight. Often they weigh themselves frequently, eat only small amounts, and only eat certain foods. Some will exercise excessively, force themselves to vomit, or use laxatives to produce weight loss. Complications may include osteoporosis, infertility and heart damage, among others. Women will often stop having menstrual periods.

Anxiety is an emotion characterized by an unpleasant state of inner turmoil, often accompanied by nervous behavior, such as pacing back and forth, somatic complaints, and rumination. It is the subjectively unpleasant feelings of dread over anticipated events, such as the feeling of imminent death. Anxiety is not the same as fear, which is a response to a real or perceived immediate threat, whereas anxiety is the expectation of future threat.[3] Anxiety is a feeling of uneasiness and worry, usually generalized and unfocused as an overreaction to a situation that is only subjectively seen as menacing. It is often accompanied by muscular tension,[3] restlessness, fatigue and problems in concentration. Anxiety can be appropriate, but when experienced regularly the individual may suffer from an anxiety disorder.

Aplastic anemia is a rare disease in which the bone marrow and the hematopoietic stem cells that reside there are damaged. This causes a deficiency of all three blood cell types (pancytopenia): red blood cells (anemia), white blood cells (leukopenia), and platelets (thrombocytopenia). Aplastic refers to inability of the stem cells to generate mature blood cells.

It is most prevalent in people in their teens and twenties, but is also common among the elderly. It can be caused by heredity, immune disease, or exposure to chemicals, drugs, or radiation. However, in about half the cases, the cause is unknown.

Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a ruptured appendix include widespread, painful inflammation of the inner lining of the abdominal wall and sepsis.

Appendicitis is caused by a blockage of the hollow portion of the appendix. This is most commonly due to a calcified "stone" made of feces. Inflamed lymphoid tissue from a viral infection, parasites, gallstone, or tumors may also cause the blockage. This blockage leads to increased pressures in the appendix, decreased blood flow to the tissues of the appendix, and bacterial growth inside the appendix causing inflammation. The combination of inflammation, reduced blood flow to the appendix and distention of the appendix causes tissue injury and tissue death.[12] If this process is left untreated, the appendix may burst, releasing bacteria into the abdominal cavity, leading to increased complications.

An armpit lump usually refers to the enlargement of at least one of the lymph nodes under your arm. Lymph nodes are small, oval-shaped glands that are located throughout the body. They play an important role in your body’s immune system. The lump may feel small. In other cases, it may be extremely noticeable. Armpit lumps may be caused by cysts, infection, or irritation due to shaving or antiperspirant use. However, these lumps may also indicate a serious underlying health condition. 

Aromatherapy uses plant materials and aromatic plant oils, including essential oils, and other aroma compounds for improving psychological or physical well-being. It can be offered as a complementary therapy or, more controversially, as a form of alternative medicine. Complementary therapy can be offered alongside standard treatment, with alternative medicine offered instead of conventional, evidence-based treatments.

Aromatherapists, who specialize in the practice of aromatherapy, utilize blends of therapeutic essential oils that can be issued through topical application, massage, inhalation or water immersion to stimulate a desired response.

Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In some types other organs are also affected. Onset can be gradual or sudden.

There are over 100 types of arthritis. The most common forms are osteoarthritis (degenerative joint disease) and rheumatoid arthritis. Osteoarthritis usually occurs with age and affects the fingers, knees, and hips. Rheumatoid arthritis is an autoimmune disorder that often affects the hands and feet.

An autoimmune disease is a condition arising from an abnormal immune response to a normal body part. There are at least 80 types of autoimmune diseases. Nearly any body part can be involved. Common symptoms include low grade fever and feeling tired. Often symptoms come and go.

The cause is generally unknown. Some autoimmune diseases such as lupus run in families, and certain cases may be triggered by infections or other environmental factors. Some common diseases that are generally considered autoimmune include celiac disease, diabetes mellitus type 1, Graves' disease, inflammatory bowel disease, multiple sclerosis, psoriasis, rheumatoid arthritis, and systemic lupus erythematosus. The diagnosis can be difficult to determine.

Ayurveda is a system of medicine with historical roots in the Indian subcontinent. Globalized and modernized practices derived from Ayurveda traditions are a type of complementary or alternative medicine. In countries beyond India, Ayurveda therapies and practices have been integrated in general wellness applications and in some cases in medical use.

The main classical Ayurveda texts begin with accounts of the transmission of medical knowledge from the Gods to sages, and then to human physicians. In Sushruta Samhita (Sushruta's Compendium), Sushruta wrote that Dhanvantari, Hindu god of Ayurveda, incarnated himself as a king of Varanasi and taught medicine to a group of physicians, including Sushruta. Ayurveda therapies have varied and evolved over more than two millennia. Therapies are typically based on complex herbal compounds, minerals and metal substances (perhaps under the influence of early Indian alchemy or rasa shastra). Ancient Ayurveda texts also taught surgical techniques, including rhinoplasty, kidney stone extractions, sutures, and the extraction of foreign objects.

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders. ADHD is a broad term, and the condition can vary from person to person. There are an estimated 6.4 million diagnosed children in the United States, according to the Centers for Disease Control and Prevention.This condition is sometimes called attention deficit disorder (ADD), but this is an outdated term. The term was once used to refer to someone who had trouble focusing but was not hyperactive. The American Psychiatric Association released the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in May 2013. The DSM-5 changed the criteria to diagnose someone with ADHD.

Only 6.3% of the population has A Negative blood. Because your blood is rare, it is important to maintain sufficient supplies for our community and local patients. Your regular and frequent blood donations are especially valued, and many in our area will be given a fighting chance at life because of your generous gift. 1 in 16 people have A- blood (approximately 6.3% of the population).

As an AB blood donor, you have a unique opportunity to enhance your generous “gift of life”. People with AB Negative (.6% of the population) and AB Positive (3.4%) are potential universal plasma donors.  You may not know, but there is a special need for AB Plasma.In addition to being the most rare blood type, AB Plasma is universal and can be used for all patients regardless of their blood type. Plasma is used to treat clotting disorders, burn, and shock victims. Your plasma donation is especially important to maintaining sufficient supplies for our community, and with regular and frequent plasma donations you’ll be helping hundreds of patients in our area. Almost anyone who is a whole blood donor can donate plasma. You are eligible if you are at least 17 years old, weigh at least 110 pounds and are in generally good health.  You can donate plasma every 28 days.

As an A Positive donor you are incredibly important to maintaining the blood supply in our community. A Positive is the second most common blood type and therefore just as many patients need this blood type.

Annually, more than 120,000 units of blood, platelets and plasma are required to meet the needs of the hospitals we serve, and your blood type is crucial to maintaining an adequate supply.  We are grateful to you for so willingly giving the “gift of life”, and through your continued commitment, we are able to maintain our heritage of service to those in need. 1 in 3 people have A+ blood (approximately 35.7% of the population).

Amyotrophic lateral sclerosis (ALS) is a rare group of neurological diseases that mainly involve the nerve cells (neurons) responsible for controlling voluntary muscle movement. Voluntary muscles produce movements like chewing, walking, breathing and talking. The disease is progressive, meaning the symptoms get worse over time. Currently, there is no cure for ALS and no effective treatment to halt, or reverse, the progression of the disease.

ALS belongs to a wider group of disorders known as motor neuron diseases, which are caused by gradual deterioration (degeneration) and death of motor neurons. Motor neurons are nerve cells that extend from the brain to the spinal cord and to muscles throughout the body. These motor neurons initiate and provide vital communication links between the brain and the voluntary muscles.

Messages from motor neurons in the brain (called upper motor neurons) are transmitted to motor neurons in the spinal cord and to motor nuclei of brain (called lower motor neurons) and from the spinal cord and motor nuclei of brain to a particular muscle or muscles.

In ALS, both the upper motor neurons and the lower motor neurons degenerate or die, and stop sending messages to the muscles. Unable to function, the muscles gradually weaken, start to twitch (called fasciculations), and waste away (atrophy). Eventually, the brain loses its ability to initiate and control voluntary movements.

Early symptoms of ALS usually include muscle weakness or stiffness. Gradually all muscles under voluntary control are affected, and individuals lose their strength and the ability to speak, eat, move, and even breathe.

Most people with ALS die from respiratory failure, usually within 3 to 5 years from when the symptoms first appear. However, about 10 percent of people with ALS survive for 10 or more years.

RINGWORM OVERVIEW

Despite its name, ringworm is not caused by a worm. Ringworm is actually an infection caused by a fungus. It is called ringworm because it can cause a ring-shaped, red, itchy rash on the skin. Ringworm is also called tinea.

There are several different types of ringworm infections, which are named from the body-part that is affected:

●Tinea capitis affects the top of the head, or scalp, and is found mostly in children

●Tinea pedis affects the feet, and is also called "athlete's foot"

●Tinea cruris affects the groin, and is also called "jock itch"

●Tinea faciei affects the face

●Tinea barbae affects the beard area

●Tinea manuum affects the hands

●Tinea corporis is the catch-all term for tinea infections on other body surfaces

You can catch ringworm from someone else who is infected, or even from an infected dog or cat. You can also catch it from objects, such as a shower stall, locker room floor, or pool area that has the fungus. Plus, you can spread ringworm from one body part (such as your feet) to another (such as your groin or hand).

If you have ringworm, your healthcare provider may be able to diagnose it just by looking at your rash. In some cases, s/he will take some scrapings of the rash and look at it under a microscope to check for the fungus. Rarely, a healthcare provider may need to send scrapings from the rash for a fungal culture (a test used to identify fungus by growing it in a microbiology laboratory).

This article will discuss the symptoms and treatment of each type of ringworm infection. More detailed information about tinea is available by subscription  Fungal nail infections are also discussed separately. 

Athlete's foot (tinea pedis) is a fungal infection that usually begins between the toes. It commonly occurs in people whose feet have become very sweaty while confined within tightfitting shoes.Signs and symptoms of athlete's foot include a scaly rash that usually causes itching, stinging and burning. Athlete's foot is contagious and can be spread via contaminated floors, towels or clothing.Athlete's foot is closely related to other fungal infections such as ringworm and jock itch. It can be treated with over-the-counter antifungal medications, but the infection often recurs. Prescription medications also are available.

Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and often continues into adulthood. ADHD includes a combination of persistent problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior.

Children with ADHD also may struggle with low self-esteem, troubled relationships and poor performance in school. Symptoms sometimes lessen with age. However, some people never completely outgrow their ADHD symptoms. But they can learn strategies to be successful.

While treatment won't cure ADHD, it can help a great deal with symptoms. Treatment typically involves medications and behavioral interventions. Early diagnosis and treatment can make a big difference in outcom

An actinic keratosis (ak-TIN-ik ker-uh-TOE-sis) is a rough, scaly patch on your skin that develops from years of exposure to the sun. It's most commonly found on your face, lips, ears, back of your hands, forearms, scalp or neck.

Also known as a solar keratosis, an actinic keratosis enlarges slowly and usually causes no signs or symptoms other than a patch or small spot on your skin. These patches take years to develop, usually first appearing in people over 40.

A small percentage of actinic keratosis lesions can eventually become skin cancer. You can reduce your risk of actinic keratoses by minimizing your sun exposure and protecting your skin from ultraviolet (UV) rays.

Anaphylaxis is a rapidly developing and serious allergic reaction that can affect multiple body systems at the same time. Severe anaphylactic reactions can be fatal. Anaphylaxis is often triggered by substances that are injected or ingested and thereby gain access into the bloodstream. This can result in a reaction involving the skin, lungs, nose, throat, and gastrointestinal tract.

Ankylosing spondylitis is a form of chronic inflammation of the spine and the sacroiliac joints. The sacroiliac joints are located at the base of the low back where the sacrum (the bone directly above the tailbone) meets the iliac bones (bones on either side of the upper buttocks) of the pelvis. Chronic inflammation in these areas causes pain and stiffness in and around the spine, including the neck, middle back, lower back, and buttocks. Over time, chronic inflammation of the spine (spondylitis) can lead to a complete cementing together (fusion) of the vertebrae, a process referred to as ankylosis. Ankylosis causes loss of mobility of the spine.

The Achilles tendon attaches your calf muscles to your heel bone, or calcaneus. You use this tendon to jump, walk, run, and stand on the balls of your feet. Continuous, intense physical activity, such as running and jumping, can cause painful inflammation of the Achilles tendon, known as Achilles tendonitis (or tendinitis).

There are two types of Achilles tendonitis: insertional Achilles tendinitis and noninsertional Achilles tendonitis. Insertional Achilles tendonitis affects the lower portion of your tendon where it attaches to your heel bone. Noninsertional Achilles tendonitis involves fibers in the middle portion of the tendon and tends to affect younger people who are active.

Simple home treatments can help Achilles tendonitis. However, if home treatment doesn’t work, it’s important to see a doctor. If your tendonitis gets worse, your tendon can tear. You may need medication or surgery to ease the pain.

Are you worried about your mental sharpness? Or maybe that of a loved one’s?

Mild forgetfulness can be a normal part of aging. If you have trouble remembering someone's name but it comes to you later, that's not a serious memory problem.

But if memory problems are seriously affecting your daily life, they could be early signs of Alzheimer's disease. While the number of symptoms you have and how strong they are vary, it’s important to identify the early signs. You need to ask yourself some tough questions.

Imagine that you're exercising. You're working up a sweat, you're breathing hard, your heart is thumping, blood is coursing through your vessels to deliver oxygen to the muscles to keep you moving, and you sustain the activity for more than just a few minutes. That's aerobic exercise (also known as "cardio" in gym lingo), which is any activity that you can sustain for more than just a few minutes while your heart, lungs, and muscles work overtime. In this article, I'll discuss the mechanisms of aerobic exercise: oxygen transport and consumption, the role of the heart and the muscles, the proven benefits of aerobic exercise, how much you need to do to reap the benefits, and more.

White blood cells are an important part of your body’s immune system. They’re vital to protecting you from invading bacteria, viruses, and parasites. Your bone marrow produces all five of the different kinds of white blood cells in the body.

Each white blood cell lives anywhere from several hours to several days in the blood stream. An eosinophil is a type of white blood cell. Eosinophils are stored in tissues throughout the body, surviving for up to several weeks. The bone marrow continually replenishes the body’s white blood cell supply.

The number and type of each white blood cell in your body can give doctors a better understanding of your health. Elevated levels of white blood cells in your blood can be an indicator that you have an illness or infection. Elevated levels often mean your body is sending more and more white blood cells to fight off infections.

An eosinophil count is a blood test that measures the quantity of eosinophils in your body. Abnormal eosinophil levels are often discovered as part of a routine complete blood count (CBC) test.

Ongoing research continues to uncover an expanding list of roles performed by eosinophils. It appears now that nearly every system of the body relies on eosinophils in some way. Two important functions are within your immune system. Eosinophils destroy invading germs like viruses, bacteria, or parasites such as hookworms. They also have a role in the inflammatory response, especially if an allergy is involved.

Inflammation is neither good nor bad. It helps isolate and control the immune response at the site of an infection, but a side effect is tissue damage around it. Allergies are immune responses that often involve chronic inflammation. Eosinophils play a significant role in the inflammation related to allergies, eczema, and asthma.

Most of the time blood is drawn from a vein on the inside of the elbow or the back of the hand. The site is cleaned with an antiseptic. The health care provider wraps an elastic band around your upper arm to make the vein swell with blood.

Next, the provider gently inserts a needle into the vein. The blood collects into an airtight tube attached to the needle. The elastic band is removed from your arm. The needle is then removed and the site is covered to stop bleeding.

In infants or young children, a sharp tool called a lancet may be used to prick the skin. The blood collects in a small glass tube, or onto a slide or test strip. A bandage is put on the spot to stop bleeding.

In the lab, the blood is placed on a microscope slide. A stain is added to the sample. This causes eosinophils to show up as orange-red granules. The technician then counts how many eosinophils are present per 100 cells. The percentage of eosinophils is multiplied by the white blood cell count to give the absolute eosinophil count.

When ketones accumulate in the blood, the body enters ketosis. For some people, ketosis is normal. Low-carbohydrate diets can induce this state. This is sometimes called nutritional ketosis.

If you have type 1 diabetes, you may be at risk for diabetic ketoacidosis (DKA), which is a life-threatening complication in which your blood becomes too acidic. It can lead to a diabetic coma or death.

Contact your doctor immediately if you have diabetes and have a moderate or high reading for ketones. Some newer blood glucose meters will test blood ketone levels. Otherwise, you can use urine ketone strips to measure your urine ketone level. DKA can develop within 24 hours and can lead to life-threatening conditions if left untreated.

Prostatic acid phosphatase (PAP) is an enzyme that is found in the prostate gland and semen of men. If the prostate isn’t working properly, then PAP is released into the blood. PAP determination in conjunction with PSA measurements is useful in assessing the prognosis of prostate cancer.1,2 Measurement of two markers allows identification of prostate cancer patients who have an elevation of PAP but not of PSA, and thus help monitoring the course of disease and response to treatment.

Adrenocorticotropic hormone (ACTH) is a hormone produced in the anterior, or front, pituitary gland in the brain. The function of ACTH is to regulate levels of the steroid hormone cortisol, which released from the adrenal gland.

ACTH is also known as:

adrenocorticotropic hormone

serum adrenocorticotropic hormone

highly-sensitive ACTH

corticotropin

cosyntropin, which is a drug form of ACTH

An ACTH test measures the levels of both ACTH and cortisol in the blood and helps your doctor detect diseases that are associated with too much or too little cortisol in the body. Possible causes of these diseases include:

Your pituitary gland is a pea-sized gland located at the base of your brain. It produces many types of hormones, including the adrenocorticotropic hormone (ACTH).

ACTH stimulates the adrenal glands, which sit atop the kidneys, to release two hormones: cortisol and adrenaline (also known as epinephrine). These hormones help you respond to stress in a healthy way and support your immune system. Cortisol is a steroid hormone that affects many different systems in the body, including your:

circulatory system

immune system

nervous system

bone metabolism

metabolism of nutrients such as carbohydrates, fats, and protein

Adrenaline, or epinephrine, is a hormone responsible for maintaining normal nervous system and circulatory function. This hormone, along with another hormone called norepinephrine, are responsible for your protective fight-or-flight response when you face a stressful situation.

Your healthcare provider might have you take an ACTH (cosyntropin) test if they suspect your adrenal glands aren’t functioning properly. This test requires you to receive an injection of cosyntropin, a synthetic portion of ACTH. You will also have two blood samples drawn — one before the injection and one after the injection. These samples measure the level of cortisol in your blood.

This ACTH stimulation test measures how your adrenal glands react to the ACTH in your blood. It does this by measuring your body’s cortisol levels. It’s important not to confuse this test with an ACTH test, which simply measures the ACTH levels in your blood.

Protein C, a part of the natural anticoagulant system, is a vitamin K-dependent protein zymogen (molecular weight=62,000 da) that is synthesized in the liver and circulates at a plasma concentration of approximately 5 mcg/mL. Protein C is activated to activated protein C (APC) via proteolytic cleavage by thrombin bound to thrombomodulin, an endothelial cell surface membrane protein. APC downregulates the procoagulant system by proteolytically inactivating procoagulant factors Va and VIIIa. Protein S, another vitamin K-dependent coagulation protein, catalyzes APC inactivation of factors Va and VIIIa. APC interacts with and proteolyses factors V/Va and VIII/VIIIa at specific APC binding and cleavage sites, respectively. Resistance to activated protein C (APC resistance) is a term used to describe abnormal resistance of human plasma to the anticoagulant effects of human APC. APC resistance is characterized by a reduced anticoagulant response of patient plasma after adding a standard amount of APC. For this assay, the activated partial thromboplastin time clotting test fails to prolong significantly after the addition of APC.

Investing laboratories and new rapid tools to diagnose tuberculosis20140521_105740 Suzanne Zambia

To be able to halt the tuberculosis (TB) epidemic, one of the first and most essential breakthroughs we need to realize is universal access to laboratories that provide quality-assured diagnostic tests for TB. Each year an estimated 3 million people are either not diagnosed or not treated for TB. To be able to identify all persons with TB disease in need of treatment, laboratory facilities and laboratory networks urgently need to be upgraded and expanded in many countries. Laboratory work is also becoming progressively complex, following the increased use of quality-assured diagnostics and the introduction of new laboratory tools.

Countries often lack appropriately qualified technicians and well-trained managers, and laboratory services are facing challenges ranging from poor infrastructure, unreliable basic utilities (water, electricity), to interruptions of essential supplies.

Alpha-fetoprotein (AFP) is a single polypeptide chain glycoprotein with a molecular weight of approximately 70,000 daltons. Synthesis of AFP occurs primarily in the liver and yolk sac of the fetus. It is secreted in fetal serum, reaching a peak at approximately 13 weeks gestation, after which it rapidly declines until about 22 weeks gestation and then gradually declines until term. Transfer of AFP into maternal circulation is accomplished primarily through diffusion across the placenta. Maternal serum AFP levels rise from the normal nonpregnancy level of 0.20 ng/mL to about 250 ng/mL at 32 weeks gestation.

If the fetus has an open neural tube defect, AFP is thought to leak directly into the amniotic fluid causing unexpectedly high concentrations of AFP. Other fetal abnormalities such as omphalocele, gastroschisis, congenital renal disease, and esophageal atresia; and other fetal distress situations such as threatened abortion, prematurity, and fetal demise, may also show AFP elevations. Decreased amniotic fluid AFP values may be seen when gestational age has been overestimated.

Alpha-fetoprotein (AFP) is a protein produced in the liver of a developing fetus. During a baby's development, some AFP passes through the placenta and into the mother's blood. An AFP test measures the level of AFP in pregnant women during the second trimester of pregnancy. Too much or too little AFP in a mother's blood may be sign of a birth defect or other condition. These include:

A neural tube defect, a serious condition that causes abnormal development of a developing baby's brain and/or spine

Down syndrome, a genetic disorder that causes intellectual disabilities and developmental delays

Twins or multiple births, because more than one baby is producing AFP

Miscalculation of due date, because AFP levels change during pregnancy

Alpha-fetoprotein (AFP) is a glycoprotein that is produced in early fetal life by the liver and by a variety of tumors including hepatocellular carcinoma, hepatoblastoma, and nonseminomatous germ cell tumors of the ovary and testis (eg, yolk sac and embryonal carcinoma). Most studies report elevated AFP concentrations in approximately 70% of patients with hepatocellular carcinoma. Elevated AFP concentrations are found in 50% to 70% of patients with nonseminomatous testicular tumors.(1)

AFP is elevated during pregnancy. Persistence of AFP in the mother following birth is a rare hereditary condition.(2) Neonates have markedly elevated AFP levels (>100,000 ng/mL) that rapidly fall to below 100 ng/mL by 150 days and gradually return to normal over their first year.(2)

Concentrations of AFP above the reference range also have been found in serum of patients with benign liver disease (eg, viral hepatitis, cirrhosis), gastrointestinal tract tumors and, along with carcinoembryonic antigen in ataxia telangiectasia.

Your liver’s in charge of making most of the proteins that are in your blood. They are important for good health.

Two of the key ones are:

Albumin. This carries medicines and hormones throughout your body. It also helps with tissue growth and healing.

Globulin. This is a group of proteins. Some of them are made by your liver. Others are made by your immune system. They help fight infection and transport nutrients.

The total serum protein test measures all the proteins in your blood. It can also check the amount of albumin you have compared to globulin, or what’s called your “A/G ratio.”

Your body converts a form of sugar called glucose into energy. This process requires a number of different steps. One important component in the process is an enzyme known as aldolase. Aldolase can be found throughout the body, but concentrations are highest in skeletal muscle and liver.

Although there’s not a direct correlation, high blood aldolase levels can occur if there is damage to your liver or muscles.

An aldosterone (ALD) test measures the amount of ALD in your blood. It’s also called a serum aldosterone test. ALD is a hormone made by the adrenal glands. The adrenal glands are found on top of your kidneys and are responsible for producing several important hormones. ALD affects blood pressure and also regulates sodium (salt) and potassium in your blood, among other functions.

Too much ALD can contribute to high blood pressure and low potassium levels. It’s known as hyperaldosteronism when your body makes too much ALD. Primary hyperaldosteronism could be caused by an adrenal tumor (usually benign, or noncancerous). Meanwhile, secondary hyperaldosteronism could be caused by a variety of conditions. These include:

congestive heart failure

cirrhosis

some kidney diseases (e.g., nephrotic syndrome)

excess potassium

low sodium

toxemia from pregnancy

The skin of the inner forearm is the usual test site for allergy testing using the Skin Prick Test method. One can also take a blood sample for allergy testing and measure Total Immunoglobulin E (IgE) which is the marker antibody for allergy sensitisation. Then there are the Phadiatop inhalant screen, Food Allergy screens and over 450 individual RAST or ImmunoCAP tests available.

We can quantify allergy severity with another cellular marker, this is the Eosinophil cell in the blood stream. Eosinophils are also found in the allergy sufferer’s phlegm, gullet secretions and nasal mucous. Lung function tests are important in asthma diagnosis, and tests include Peak Flow (PF), Forced Expiratory Volume in 1 second (FEV1) and Forced Vital Capacity (FVC). Measurement of Nitric Oxide (NO) in exhaled air is another measure of allergic inflammation and indicates poor control or ineffective treatment

An alpha-fetoprotein (AFP) blood test checks the level of AFP in a pregnant woman's blood. AFP is a substance made in the liver of an unborn baby (fetus). The amount of AFP in the blood of a pregnant woman can help see whether the baby may have such problems as spina bifida and anencephaly. An AFP test can also be done as part of a screening test to find other chromosomal problems, such as Down syndrome (trisomy 21) or Edwards syndrome (trisomy 18). An AFP test can help find an omphalocele, a congenital problem in which some of the baby's intestines stick out through the belly wall.

Normally, low levels of AFP can be found in the blood of a pregnant woman. No AFP (or only a very low level) is generally found in the blood of healthy men or healthy, nonpregnant women.

The level of AFP in the blood is used in a maternal serum triple or quadruple screening test. Generally done between 15 and 20 weeks, these tests check the levels of three or four substances in a pregnant woman's blood. The triple screen checks alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and a type of estrogen (unconjugated estriol, or uE3). The quad screen checks these substances and the level of the hormone inhibin A. The levels of these substances-along with a woman's age and other factors-help the doctor estimate the chance that the baby may have certain problems or birth defects.

To determine whether the presence of circulating desialylated glycoproteins reflect the existence and/or the severity of liver disease, 73 patients were evaluated with liver biopsies, conventional liver function tests, and the measurement of the degree of desialylation of two glycoproteins alpha 1-acid glycoprotein (alpha 1-AGP) and alpha 1-antitrypsin (alpha 1-AT). A combination of two immunological methods, available as routine laboratory tests, was used for the determination of the desialylation of alpha 1-AGP and alpha 1-AT. The severity of liver disease was assessed by a clinical classification depending upon the presence or absence of four complications (jaundice, ascites, hepatic encephalopathy, and weight loss). The presence of serum desialylated alpha 1-AGP did not allow detection of mild liver disease, but asialo alpha 1-AGP (and to a lesser extent of asialo-alpha 1-(AT) correlated with the severity of liver disease. The sensitivity of desialylated alpha 1-AGP in detection of severe liver disease was 65%, and its specificity was 80%.

Alpha-1-antitrypsin (A1A) is the most abundant serum protease inhibitor and inhibits trypsin and elastin, as well as several other proteases. The release of proteolytic enzymes from plasma onto organ surfaces and into tissue spaces results in tissue damage unless inhibitors are present. Congenital deficiency of A1A is associated with the development of emphysema at an unusually early age and with an increased incidence of neonatal hepatitis, usually progressing to cirrhosis.

Alpha-2-macroglobulin is a protease inhibitor and is 1 of the largest plasma proteins. It transports hormones and enzymes, exhibits effector and inhibitor functions in the development of the lymphatic system, and inhibits components of the complement system and hemostasis system.

Increased levels of alpha-2-macroglobulin are found in nephrotic syndrome when other lower molecular weight proteins are lost and alpha-2-macroglobulin is retained because of its large size. In patients with liver cirrhosis and diabetes, the levels are found to be elevated.

Patients with acute pancreatitis exhibit low serum concentrations which correlate with the severity of the disease. In hyperfibrinolytic states, after major surgery, in septicemia and severe hepatic insufficiency, the measured levels of alpha-2-macroglobulin are often low. Acute myocardial infarction patients with low alpha-2-macroglobulin have been reported to have a significantly better prognosis with regard to the >1 year survival time.

Under normal physiologic conditions, the usual daily dietary intake of aluminum (5-10 mg) is completely eliminated. Excretion is accomplished by avid filtration of aluminum from the blood by the glomeruli of the kidney. Patients in renal failure (RF) lose the ability to clear aluminum and are candidates for aluminum toxicity. Many factors increase the incidence of aluminum toxicity in patients in RF:

-Aluminum-laden dialysis water can expose dialysis patients to aluminum.

-Aluminum-laden albumin can expose patients to an aluminum burden they cannot eliminate.

-The dialysis process is not highly effective at eliminating aluminum.

-Aluminum-based phosphate binder gels are administered orally to minimize phosphate accumulation; a small fraction of this aluminum may be absorbed and accumulated.

If it is not removed by renal filtration, aluminum accumulates in the blood where it binds to proteins such as albumin and is rapidly distributed through the body. Aluminum overload leads to accumulation of aluminum at 2 sites: brain and bone. Brain deposition has been implicated as a cause of dialysis dementia. In bone, aluminum replaces calcium at the mineralization front, disrupting normal osteoid formation.

Primary aminoacidopathies are typically autosomal recessive or X-linked inherited disorders resulting from a deficient enzyme or transport protein. Over 30 aminoacidopathies have been described in the literature. Symptoms range from relatively benign to severe and may include, but are not limited to, growth and mental retardation, developmental delay, learning disabilities, seizures, lethargy, coma, vomiting, metabolic acidosis or alkalosis, sudden infant death syndrome (SIDS), osteomalacia, and osteoporosis. Depending on the natural history of the disorder, symptoms may be minimized or prevented by early diagnosis and treatment. Treatment may be based on dietary restrictions and/or supplementation with cofactors (eg, riboflavin or cobalamin) or conjugating agents (eg, carnitine or sodium benzoate)

This test checks the level of ammonia in your blood. The test helps find out why you may have changes in consciousness and also helps diagnose a liver disease called hepatic encephalopathy. This disease affects how your brain works, because of excess toxins, or poisons, in your body.

Your liver may not work properly if you have high levels of ammonia in your blood. Ammonia is a chemical made by bacteria in your intestines and your body's cells while you process protein. Your body treats ammonia as a waste product. It turns it into an amino acid called glutamine and a chemical compound called urea. Your bloodstream moves the urea to your kidneys, where it is eliminated in your urine.

But ammonia will build up in your body if you can't get rid of urea. This can sometimes happen if you have kidney or liver failure. It can also happen if you have a urea cycle disorder, a genetic disorder that means your body is missing one of the enzymes that remove ammonia from the blood. The ammonia blood test is the gold standard for diagnosing urea cycle disorders.

Too much ammonia in your body can cause psychological problems like confusion, tiredness, and possibly coma or death.

A child's reaction to too much ammonia can include seizures, breathing difficulties, and potentially death.

A noninvasive diagnostic test for amebic liver abscess is needed, because amebic and bacterial abscesses appear identical on ultrasound or computer tomography and because it is rarely possible to identify Entamoeba histolytica in stool specimens from patients with amebic liver abscess. Here we report a method of detection in serum of circulating E. histolytica Gal/GalNAc lectin to diagnose amebic liver abscess, which was used in patients from Dhaka, Bangladesh. The TechLab E. histolytica II test (which differentiates the true pathogen E. histolytica from Entamoeba dispar) detected Gal/GalNAc lectin in the sera of 22 of 23 (96%) amebic liver abscess patients tested prior to treatment with the antiamebic drug metronidazole and 0 of 70 (0%) controls. After 1 week of treatment with metronidazole, 9 of 11 (82%) patients became serum lectin antigen negative. The sensitivity of the E. histolytica II antigen detection test for intestinal infection was also evaluated. Antigen detection identified E. histolytica infection in 50 samples from 1,164 asymptomatic preschool children aged 2 to 5 years, including 16 of 16 (100%) culture-positive specimens. PCR analysis of stool specimens was used to confirm that most antigen-positive but culture-negative specimens were true-positive: PCR identified parasite DNA in 27 of 34 (79%) of the antigen-positive, culture-negative stool specimens. Antigen detection was a more sensitive test for infection than antilectin antibodies, which were detected in only 76 of 98 (78%) amebic liver abscess patients and in 26 of 50 (52%) patients with intestinal infection. We conclude that the TechLab E. histolytica II kit is a sensitive means to diagnose hepatic and intestinal amebiasis prior to the institution of metronidazole treatment.

Diagnosis and differential diagnosis of hyperandrogenism (in conjunction with measurements of other sex-steroids). An initial workup in adults might also include total and bioavailable testosterone (TTBS / Testosterone, Total and Bioavailable, Serum) measurements. Depending on results, this may be supplemented with measurements of sex hormone-binding globulin (SHBG / Sex Hormone Binding Globulin [SHBG], Serum) and other androgenic steroids (eg, dehydroepiandrosterone sulfate [DHEA-S]).

Diagnosis of congenital adrenal hyperplasia (CAH), in conjunction with measurement of other androgenic precursors, particularly, 17-alpha-hydroxyprogesterone (OHPG) (OHPG / 17-Hydroxyprogesterone, Serum), 17 alpha-hydroxypregnenolone, DHEA-S (DHES / Dehydroepiandrosterone Sulfate [DHEA-S], Serum), and cortisol (CORT / Cortisol, Serum).

Monitoring CAH treatment, in conjunction with testosterone (TTST / Testosterone, Total, Serum), OHPG (OHPG / 17-Hydroxyprogesterone, Serum), DHEA-S (DHES / Dehydroepiandrosterone Sulfate [DHEA-S], Serum), and DHEA (DHEA_ / Dehydroepiandrosterone [DHEA], Serum).

Diagnosis of premature adrenarche, in conjunction with gonadotropins (FSH / Follicle-Stimulating Hormone [FSH], Serum; LH / Luteinizing Hormone [LH], Serum) and other adrenal and gonadal sex-steroids and their precursors (TTBS / Testosterone, Total and Bioavailable, Serum or TGRP / Testosterone, Total and Free, Serum; EEST / Estradiol, Serum; DHES / Dehydroepiandrosterone Sulfate [DHEA-S], Serum; DHEA_ / Dehydroepiandrosterone [DHEA], Serum; SHBG / Sex Hormone Binding Globulin [SHBG], Serum; OHPG / 17-Hydroxyprogesterone, Serum).

Culture and Sensitivity Anaerobic test is performed on a sample of blood to measure the level of Culture of the pathogenic organism in the blood.It is performed to confirm Infection and also during the treatment and after the treatment of Infection.

Also known as

C/S Anaerobic Blood, C/S Anaerobic, Culture and Sensitivity Anaerobic

The immune system makes an abundance of proteins called antibodies. Antibodies are made by white blood cells (B cells). The antibodies recognize and combat infectious organisms (germs) in the body. Antibodies develop in our immune system to help the body fight infectious organisms. When an antibody recognizes the foreign proteins of an infectious organism, it recruits other proteins and cells to fight off the infection. This cascade of attack is called inflammation.

Sometimes these antibodies make a mistake, identifying normal, naturally-occurring proteins in our bodies as being “foreign” and dangerous. When these antibodies make incorrect calls, identifying a naturally-occurring protein (or self protein) as foreign, they are called autoantibodies. Autoantibodies start the cascade of inflammation, causing the body to attack itself. The antibodies that target “normal” proteins within the nucleus of a cell are called antinuclear antibodies (ANA). Most of us have autoantibodies, but typically in small amounts. The presence of large amount of autoantibodies or ANAs can indicate an autoimmune disease. ANAs could signal the body to begin attacking itself which can lead to autoimmune diseases, including lupus, scleroderma, Sjögren’s syndrome, polymyositis/dermatomyositis, mixed connective tissue disease, drug-induced lupus, and autoimmune hepatitis. A positive ANA can also be seen in juvenile arthritis.

Angiotensin converting enzyme (ACE) participates in the renin cascade in response to hypovolemia. Its peptidase action on the decapeptide angiotensinogen I results in the hydrolysis of a terminal histidyl leucine dipeptide and the formation of the octapeptide angiotensin II, a potent vasoconstrictor that increases blood pressure.

The primary source of ACE is the endothelium of the lung. ACE activity is increased in sarcoidosis, a systemic granulomatous disease that commonly affects the lungs. In sarcoidosis, ACE is thought to be produced by epithelioid cells and macrophages of the granuloma.

Currently, it appears that ACE activity reflects the severity of sarcoidosis: 68% positivity in those with stage I sarcoidosis, 86% in stage II sarcoidosis, and 91% in stage III sarcoidosis. Serum ACE also appears to reflect the activity of the disease; there is a dramatic decrease in enzyme activity in some patients receiving prednisone.

Other conditions such as Gaucher disease, leprosy, untreated hyperthyroidism, psoriasis, premature infants with respiratory distress syndrome, adults with amyloidosis, and histoplasmosis have been associated with increased levels of ACE.

Angiotensin II is the primary regulator of renal aldosterone secretion and a potent vasoconstrictor. It is generated through the renin angiotensin system (RAS): circulating angiotensinogen is cleaved by renin to form angiotensin I, which is then converted to angiotensin II via angiotensin converting enzyme (ACE). The rate-limiting step in the RAS is renin secretion by the renal juxtaglomerular cells, modulated by renal blood flow. Low renal blood flow and low perfusion pressure increases renin secretion, stimulating angiotensin II and aldosterone production with a resulting increase in blood pressure and renal sodium retention. These changes then produce inhibition of renin secretion and complete the feedback control loop.

The antistreptolysin O (ASO) titer test is a blood test that checks for a strep infection. When you come into contact with harmful bacteria, your body produces antibodies to defend itself against these bacteria. Your body produces antibodies specific to the bacteria they fight.

The ASO titer test measures antibodies produced by your body in response to a toxin known as streptolysin O. Streptolysin O is a toxin produced by group A Streptococcus (GAS) bacteria. Your body makes the antistreptolysin O antibodies when you have a strep infection caused by GAS bacteria.

Usually, when you have a strep infection like strep throat, you receive antibiotics that kill the strep bacteria. But some people don’t have any symptoms during a strep infection and may not know they need treatment. When this happens, an untreated infection can lead to future complications. These complications are known as post-streptococcal complications.

The ASO titer test can help your doctor determine if you recently had a strep infection by measuring the presence of antistreptolysin antibodies in your blood.

Anti B Titre test is performed on a sample of blood to measure the level of Anti B Titre in the blood.It is performed to confirm ABO Incompatibility and also during the treatment and after the treatment of ABO Incompatibility.

Also known as

Anti B Titre Tube Agglutination

Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly systemic lupus erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid and psoriatic arthritis, and primary Sjögren's syndrome.

Double-stranded (ds, native) DNA (dsDNA) antibodies of the IgG class are an accepted criterion (American College of Rheumatology) for the diagnosis of systemic lupus erythematosus (SLE).(1-3) dsDNA antibodies are detectable in approximately 85% of patients with untreated SLE, and are rarely detectable in other connective tissue diseases. Weakly-positive results caused by low-avidity antibodies to dsDNA are not specific for SLE and can occur in a variety of diseases.

Testing for IgG antibodies to dsDNA is indicated in patients who have a positive test for antinuclear antibodies (ANA) along with signs and symptoms that are compatible with the diagnosis of SLE. If the ANA test is negative, there is no reason to test for antibodies to dsDNA.(2)

The levels of IgG antibodies to dsDNA in serum are known to fluctuate with disease activity in lupus erythematosus, often increasing prior to an increase in inflammation and decreasing in response to therapy.

Hepatitis A virus (HAV) is endemic throughout the world, occurring most commonly, however, in areas of poor hygiene and low socioeconomic conditions. The virus is transmitted primarily by the fecal-oral route, and it is spread by close person-to-person contact and by food- and water-borne epidemics. Outbreaks frequently occur in overcrowded situations and in high-density institutions and centers, such as prisons and health care or day care centers. Viral spread by parenteral routes (eg, exposure to blood) is possible but rare, because infected individuals are viremic for a short period of time (usually <3 weeks). There is little or no evidence of transplacental transmission from mother to fetus or transmission to newborn during delivery.

Serological diagnosis of acute viral hepatitis A depends on the detection of specific anti-HAV IgM. Its presence in the patient's serum indicates a recent exposure to HAV. HAV-specific IgM antibody level becomes detectable in the blood by 4 weeks after infection, persisting at elevated levels for about 2 months before declining to undetectable levels by 6 months. They rarely persist beyond 12 months after infection.

The test system widely used currently for the determination of anti-HCV permits the detection of anti-HCV IgG alone. The data recently published by T. G. Wreghitt et al. confirm the probability of the presence of anti-HCV of both IgG and IgM classes in sera from hepatitis C patients. Anti-HCV IgM was detected by Ortho test with some modifications using an anti-M conjugate in the last stage of the experiment. Anti-HCV IgG were detected by regular Ortho test. A total of 46 patients with different forms of HCV infection and a control group were examined. According to the preliminary data, 18 patients were positive in the routine anti-HCV Ortho test. Among 18 anti-HCV-positive patients, nine had chronic HCV infection and the other 9 acute HCV infection. The distribution of IgM and IgG anti-HCV in the acute patients was as follows: 4 patients (44.5%) had approximately equal titres of IgG and IgM, 3 (33.5%) had predominantly IgG, 2 (22.2%) mainly IgM. A similar pattern was observed in the group with chronic HCV infection. Thus, 5 subjects (55.6%) showed approximately equal ratio of IgM and IgG anti-HCV, 2 (22.2%) had mostly IgM and the rest 2 mainly IgG. No anti-HCV in the control group was found. The control group consisted of 18 patients with chronic liver diseases without markers of HBV or HDV infection, 3 with HAV infection, 2 with HBV infection and 5 healthy subjects. The specificity of anti-HCV IgM test was confirmed by Chiron Western blot analysis using the same modification.(ABSTRACT TRUNCATED AT 250 WORDS).

Hepatitis E virus (HEV) is the major etiologic agent of enterically transmiited non-A, non-B hepatitis worldwide and has a high case-fatality rate in pregnant women. Both IgM and IgG antibody to HEV (anti-HEV) are produced following infection. The titer of IgM anti-HEV declines rapidly during early convalescence; IgG anti-HEV persists and appears to provide at least short-term protection against disease.

Antineutrophil cytoplasmic antibodies (ANCA) can occur in patients with autoimmune vasculitis including Wegener's granulomatosis (WG), microscopic polyangiitis (MPA), or organ-limited variants thereof such as pauci-immune necrotizing glomerulonephritis.(1) Detection of ANCA is a well-established diagnostic test for the evaluation of patients suspected of having autoimmune vasculitis. ANCA react with enzymes in the cytoplasmic granules of human neutrophils including proteinase 3 (PR3), myeloperoxidase (MPO), elastase, and cathepsin G. Antibodies to PR3 occur in patients with WG (both classical WG and WG with limited end-organ involvement) and produce a characteristic pattern of granular cytoplasmic fluorescence on ethanol-fixed neutrophils called the cANCA pattern. Antibodies to MPO occur predominately in patients with MPA and produce a pattern of perinuclear cytoplasmic fluorescence on ethanol-fixed neutrophils called the pANCA pattern.

An antisperm antibody test looks for special proteins (antibodies) that fight against a man's sperm in blood, vaginal fluids, or semen. The test uses a sample of sperm and adds a substance that binds only to affected sperm.

Semen can cause an immune system response in either the man's or woman's body. The antibodies can damage or kill sperm. If a high number of sperm antibodies come into contact with a man's sperm, it may be hard for the sperm to fertilize an egg. The couple has a hard time becoming pregnant. This is also called immunologic infertility.

A decrease in Antithrombin III may predispose an individual to thrombosis and to failure to respond to heparin therapy. This can occur as a result of a congenital deficiency, secondary to liver transplant, DIC, nephrotic syndrome, cirrhosis, carcinoma, or in patients with chronic liver failure.

Your thyroid is a gland located in your neck. It releases hormones that control your metabolism. It produces a number of different proteins, including thyroglobulin. Your thyroid uses thyroglobulin to make the active thyroid hormones.

If you have an autoimmune condition, it can disrupt your production of thyroglobulin. An autoimmune condition happens when your immune system creates antibodies that attack your body’s own healthy cells. When your immune system attacks the thyroid, it often targets thyroglobulin. This causes it to produce antithyroglobulin antibodies. Your doctor can order an antithyroglobulin antibody test to check the level of these antibodies in your bloodstream. A high level may indicate an autoimmune condition

Apolipoprotein A1 (ApoA1) is the primary protein associated with high-density lipoprotein (HDL) particles, and plays a central role in reverse cholesterol transport.(1) HDL cholesterol (HDL-C) and ApoA1 concentrations are inversely related to the risk for coronary artery disease (CAD).(2) There are a variable number of ApoA1 proteins per HDL particle. Therefore, ApoA1 is not a 1:1 surrogate marker for HDL particles. Similarly, the number of ApoA1 proteins and the amount of cholesterol contained in HDL particles is highly variable. This heterogeneity has led to unique clinical findings related to ApoA1 compared with HDL-C.

Increased ApoA1 concentrations are more strongly associated with a reduction in risk of a first myocardial infarction than HDL-C concentrations.(3) Low concentrations of ApoA1, but not HDL-C, are predictive of preclinical atherosclerosis as assed by computed tomography estimated coronary artery calcium (CAC) scoring.(4) Increased ApoA1, but not HDL-C concentrations, are associated with reduced cardiovascular events among statin-treated patients, even when LDL-C <50 mg/dL.(5) In statin-treated patients, patients whose ApoA1 increased while on treatment were at lower risk than those whose ApoA1 did not increase.

The activated partial thromboplastin time (APTT) assay is used as a screening test to evaluate the overall integrity of the intrinsic/common coagulation pathway and to monitor patients on heparin therapy.

This test reflects the activities of most of the coagulation factors in the intrinsic and common procoagulant pathway, but not the extrinsic procoagulant pathway, which includes factor VII and tissue factor, nor the activity of factor XIII (fibrin stabilizing factor).

Effective November 2016, APTT will no longer be used as the primary method for therapeutic heparin monitoring, for that purpose, order the heparin anti-Xa assay HEPTP / Heparin Anti-Xa Assay, Plasma.

During normal cellular function, proteins are broken down into nitrogen waste products and put into the blood stream as ammonia. The urea cycle transforms this toxin into urea, which can be safely removed by the kidneys as urine. Lack of an enzyme from the urea cycle, such as arginase, can result in the buildup of toxins in the body. There are six diseases that belong in the group of urea cycle disorders . Arginase is thought to be the rarest of these disorders.

The enzyme arginase is the last step of the urea cycle, where it turns arginine into ornithine and urea. If a person is born with arginase deficiency then they build up arginine in their blood. This is called argininemia. Since earlier steps in the urea cycle are left intact, patients may or may not build up ammonia in the blood. Commonly, the build up of arginine presents as a central nervous system disease or developmental delay in young children.

Arginine vasopressin (AVP), or antidiuretic hormone (ADH), is a nonapeptide produced by the hypothalamus and released from the posterior pituitary in response to extracellular fluid hyperosmolarity and hypovolemia. AVP promotes concentration of the urine by increasing water reabsorption in the kidney tubules. Inadequate AVP action causes diabetes insipidus (DI), a syndrome characterized by nonglycosuric polyuria, polydipsia, and dehydration. Central DI refers to insufficient AVP release due to diseases of the hypothalamus, pituitary stalk, and pituitary gland. Nephrogenic DI is the result of impaired renal responsiveness to AVP and may be congenital or due to renal disease, hypokalemia, hypercalcemia, systemic disorders (eg, multiple myeloma and amyloidosis), or drugs (eg, lithium or demeclocycline and ethanol).

DI diagnosis is based on the presence of hyperosmolar serum with inappropriately dilute urine. Central and nephrogenic DI can be differentiated by measuring the plasma AVP level and interpreting it in light of the simultaneous plasma osmolality.

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is manifested by hyponatremia and inappropriately concentrated urine. The diagnosis is confirmed by plasma or urine AVP levels inappropriate for serum osmolality.

Arsenic is perhaps the best known of the metal toxins, having gained notoriety from its extensive use by Renaissance nobility as an antisyphilitic agent and, paradoxically, as an antidote against acute arsenic poisoning. Even today, arsenic is still 1 of the more common toxicants found in insecticides, and leaching from bedrock to contaminate groundwater.

The toxicity of arsenic is due to 3 different mechanisms, 2 of them related to energy transfer. Arsenic covalently and avidly binds to dihydrolipoic acid, a necessary cofactor for pyruvate dehydrogenase. Absence of the cofactor inhibits the conversion of pyruvate to acetyl coenzyme A, the first step in gluconeogenesis. This results in loss of energy supply to anaerobic cells, the predominant mechanism of action of arsenic on neural cells that rely on anaerobic respiration for energy. Neuron cell destruction that occurs after long-term energy loss results in bilateral peripheral neuropathy.

Arsenic also competes with phosphate for binding to adenosine triphosphate during its synthesis by mitochondria via oxidative phosphorylation, causing formation of the lower energy adenosine diphosphate monoarsine. This results in loss of energy supply to aerobic cells. Cardiac cells are particularly sensitive to this form of energy loss; fatigue due to poor cardiac output is a common symptom of arsenic exposure.

Abdominal ultrasonography, diagnostic paracentesis, and ascitic fluid cultures are recommended by the British Society of Gastroenterology, the European Association for the Study of the Liver (EASL), and the American Association for the Study of Liver Diseases (AASLD), particularly in the setting of supsected infection. [1]

Laparoscopy may be valuable for the diagnosis of otherwise unexplained cases, especially if malignant ascites is suspected. [6]  This may be of particular importance in the diagnosis of malignant mesothelioma.

The antistreptolysin O (ASO) titer test is a blood test that checks for a strep infection. When you come into contact with harmful bacteria, your body produces antibodies to defend itself against these bacteria. Your body produces antibodies specific to the bacteria they fight.

The ASO titer test measures antibodies produced by your body in response to a toxin known as streptolysin O. Streptolysin O is a toxin produced by group A Streptococcus (GAS) bacteria. Your body makes the antistreptolysin O antibodies when you have a strep infection caused by GAS bacteria.

Usually, when you have a strep infection like strep throat, you receive antibiotics that kill the strep bacteria. But some people don’t have any symptoms during a strep infection and may not know they need treatment. When this happens, an untreated infection can lead to future complications. These complications are known as post-streptococcal complications.

The ASO titer test can help your doctor determine if you recently had a strep infection by measuring the presence of antistreptolysin antibodies in your blood.

Aspergillus precipitin is a laboratory test performed on your blood. It’s ordered when a doctor suspects that you have an infection caused by the fungus Aspergillus.

The test may also be called:

aspergillus fumigatus 1 precipitin level test

aspergillus antibody test

aspergillus immunodiffusion test

test for precipitating antibodies

Volume regulation and hemodynamic functions change during pregnancy, leading to marked increases in blood volume and cardiac output, peripheral vasodilatation and reduced sensitivity to angiotensin. Atrial natriuretic peptide (ANP) is intimately involved in fluid and sodium homeostasis and exerts marked relaxant activity on vascular smooth muscle pre-contracted with angiotensin. This study was performed to clarify the role of ANP as a regulator of maternal physiology.

Hepatitis B virus (HBV) is endemic throughout the world. The infection is spread primarily through percutaneous contact with infected blood products (eg, blood transfusion, sharing of needles by intravenous drug addicts). The virus is also found in various human body fluids, and it is known to be spread through oral and genital contacts. HBV can be transmitted from mother to child during delivery through contact with blood and vaginal secretions, but it is not commonly transmitted transplacentally.

Hepatitis B surface antigen (HBsAg) is the first serologic marker appearing in the serum at 6 to 16 weeks following exposure to HBV. In acute infection, HBsAg usually disappears in 1 to 2 months after the onset of symptoms. Persistence of HBsAg for more than 6 months in duration indicates development of either a chronic carrier state or chronic HBV infection.

Acid- Fast Bacilli (AFB) smear and culture are two separate tests always performed together at the MSPHL, Tuberculosis (TB) Unit. AFB smear refers to the microscopic examination of a fluorochrome stain of a clinical specimen. The AFB culture is the inoculation of a clinical specimen onto culture media Becton-Dickinson Mycobacteria Growth Indicator Tube (B-D MGIT broth) and Lowenstein-Jensen (L-J) media slant, incubation at 37°C for up to six (6) weeks and detection of growth or no growth during this incubation period. Tuberculosis usually attacks the lungs but can also affect other parts of the body. It is spread through the air when people who have the disease cough, sneeze, or spit. The other widely used tests used in the diagnosis & screening of Tuberculosis infection are:AFB, smear examinationCulture, Mycobacterium TuberculosisMantoux test (Tuberculin skin test)Mycobacterium antibody panel (TB-IgG, IgM, IgA)Mycobacterium Tuberculosis by RT-PCRQuantiferon TB Gold.

The Acid Fast Bacilli - Sputum is done for routine health screenings, to identify the acid-fast bacilli in sputum, fluid or tissue specimen and to manage the medication of mycobacterial infections such as tuberculosis. It may also be used when an atypical mycobacterial infection is suspected.

The Acid Fast Bacilli is generally ordered on suspicion of tuberculosis. The most common symptom of tuberculosis is a chronic cough that produces mucus and sometimes contains blood streaks. Other symptoms of tuberculosis include chest pain, weakness, chills, fever and unexplained weight loss.

The number of neutrophils in the blood is expressed as absolute neutrophil count (ANC) and it measures the percentage of neutrophils in the differential WBC count. The ANC of a healthy individual falls in the range of 2,500 to 6,000 per microliter.

A total blood count gives the levels of the three types of blood cells - white blood cells, red blood cells, and platelets. Neutrophils are present in two forms – polys and bands. Polys are also known as segmented neutrophils and are the most abundant of the WBCs. Bands are also called stabs and are immature polys. Both polys and bands destroy invaders (i.e. microbes) in the body.

The ANC is calculated by multiplying the number of WBCs in blood by the percentage of total neutrophils.  For example, for a WBC count of 7000 per microliter, if neutrophils constitute 40% of the WBCs, the ANC in this case will be 7000 × 0.40 = 2800 per microliter.

An ANC below 1,000 per microliter is called neutropenia. ANCs less than 500 per microliter significantly increase the risk of infection. In cancer patients, frequent blood tests are performed to assess WBC count and ANC to monitor the body’s response to cancer treatment.

Neutrophils constitute nearly 55 to 70% of the total WBC count. Acute infections or trauma are the main triggers for production of neutrophils leading to elevated WBC count also known as neutrophilia or neutrophil leukocytosis.

In cancer patients, ANC is a reflection of the immunologic status of the patient in response to chemotherapy. This therapy suppresses production of WBC and hence neutrophils, thus increasing infection risks. Hence, a low ANC or neutropenia can be an indication of the need for reducing chemotherapy dosage or delaying the next sessions of chemotherapy. ANC also allows prediction of neutropenia-related events including fever after chemo­therapy sessions. It thus offers a clear picture of the patient’s immunologic status.

ANC helps determine the need for antibiotics or other measures along with therapy to decrease complications related to neutro­penia. While for an in-patient, a low ANC may be an indicator of the need to isolate the patient so as to protect him or her from exposure to infectious agents, in case of an out-patient, it can highlight the need to keep away from crowds or people having flu or colds. ANC is thus a powerful monitoring tool in cancer patients who are prone to bone marrow suppression due to radiation, chemotherapy, or bone marrow transplant.

Acetylcholine receptor (AChR) antibodies are autoantibodies produced by the immune system that mistakenly target proteins called acetylcholine receptors that are located on skeletal muscle fibers. This test detects and measures AChR antibodies in the blood.

Acetylcholine receptors function as "docking stations" for acetylcholine, a chemical substance (neurotransmitter) that transmits messages between nerve cells. Muscle movement starts when an impulse is sent down a nerve to the nerve ending, where it stimulates the release of acetylcholine. Acetylcholine travels across a microscopic gap between the nerve ending and a muscle fiber at the "neuromuscular junction." When it reaches the muscle fiber, it binds to one of many acetylcholine receptors and activates it, initiating muscle contraction.

AChR antibodies impede communication between nerves and skeletal muscles, inhibit muscle contraction, and cause rapid muscle fatigue by preventing activation of the acetylcholine receptors. They do this in three major ways:

1.Binding antibodies attach to the receptors on nerve cells and may initiate an inflammatory reaction that destroys the receptors.

2.Blocking antibodies may sit on the receptors, preventing acetylcholine from binding.

3.Modulating antibodies may cross-link the receptors, causing them to be taken up into the muscle cell and removed from the neuromuscular junction.

The end result of this interference is the development of myasthenia gravis (MG), a chronic autoimmune disorder associated with the presence of these antibodies and with their effects on muscle control.

AChR antibodies may be detected in different ways to determine which mechanism may be the problem in a particular individual, and the antibodies may be referred to as "binding," "blocking," or "modulating." However, the technique that measures "binding" is the most commonly performed and, generally speaking, it is rare for the other two tests to be positive without the "binding" test being positive as well. These other approaches may be useful when a healthcare practitioner strongly suspects myasthenia gravis and the "binding" test is negative.

Approximately 90% of patients with myasthenia gravis MG) express antibodies to the acetylcholine receptor (aChR), which can be divided into binding, blocking, and modulating antibody. Binding antibody can activate complement and lead to loss of aChR. Blocking antibody may impair aChR binding to the receptor, leading to poor muscle contraction. Modulating antibody causes receptor endocytosis resulting in loss of aChR expression, which correlates most closely with clinical severity of disease. Approximately 10% of individuals with confirmed myasthenia gravis have no measurable binding, blocking, or modulating antibody. Myasthenia gravis (MG) is an autoimmune disease in which an acetylcholine receptor (AChR) is the antibody target. The AChR in the motor end-plate of skeletal muscle is an integral membrane protein consisting of five subunits (a pentamer). The alpha chain carries both the binding site for cholinergic ligands (binding site for acetylcholine and bungarotoxin) and the main immunogenic region, a region against which a majority of the antibodies of MG patients are directed. In MG, acetylcholine-dependent neuromuscular transmission is impaired by a loss of signal transduction. The final result is that threshold potential in the cell is never reached and the muscle cannot contract. The patient experiences voluntary muscle weakness and fatigue characteristic of the disease, as well as difficulty in swallowing, diplopia, ptosis (in ocular MG), and, in severe cases, death. Individuals who manifest AChR antibodies generally do not express a single, monoclonal antibody population. The antibody population is divided into three classes: • Binding • Blocking • Modulating Binding antibodies are those that are epitopically directed toward the large hydrophilic domain of the receptor. This class of antibodies can activate the complement cascade, resulting in tissue damage and receptor loss. The AChR binding antibody radioimmunoassay detects a wide population of autoantibodies. The use of soluble receptor measures not only antibody directed against the extracellular region of the receptor, presumably the portion involved in the pathophysiology of the disease, but intracellular determinants of the receptor not normally exposed to immunoglobulins. The assay is incapable of differentiating general binding antibodies from the more specific modulating population. Moreover, the binding assay does not easily measure a blocking population. Blocking autoantibodies prevent the binding of acetylcholine to the receptor. They may act by direct steric interference or by an allosteric mechanism. The pathology associated with this type of antibody will result in the most rapid loss of receptor function. Modulating antibodies as a class accelerate endocytosis, resulting in loss of receptors. It is largely this class of antibodies to which clinical severity has been most closely associated. In fifty-three percent of samples with any measurable autoantibody, all three antibody populations were present. Addition of blocking and modulating antibody assays to the binding assay increased the number of samples that tested positive by approximately 10 percent. Studies show that the presence of modulating antibody generally compares more closely to disease severity than either binding or blocking classes. Drachman et al showed that the blocking population has a disease severity correlation nearly as high as that of modulating antibodies (88% vs. 91%). Approximately 90 percent of patients with myasthenia gravis (MG) express antibodies to the acetylcholine receptor (AChR), which can be divided into binding, blocking, and modulating antibody. Binding antibody can activate complement and lead to loss of AChR. Blocking antibody may impair AChR binding to the receptor, leading to poor muscle contraction. Modulating antibody causes receptor endocytosis resulting in loss of AChR expression, which correlates most closely with clinical severity of disease. Approximately 10 percent of individuals with confirmed myasthenia gravis have no measurable binding, blocking, or modulating antibody.

Approximately 85-90% of patients with myasthenia gravis (MG) express antibodies to the acetylcholine receptor (AChR), which can be divided into binding, blocking, and modulating antibodies. Binding antibody can activate complement and lead to loss of AChR. Blocking antibody may impair AChR binding to the receptor, leading to poor muscle contraction. Modulating antibody causes receptor endocytosis resulting in loss of AChR expression, which correlates most closely with clinical severity of disease. Approximately 10-15% of individuals with confirmed myasthenia gravis have no measurable binding, blocking, or modulating antibodies. This test was developed and its performance characteristics determined by ARUP Laboratories. The U.S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Adenosine deaminase (ADA) is a protein that is produced by cells throughout the body and is associated with the activation of lymphocytes, a type of white blood cell that plays a role in the immune response to infections. Conditions that trigger the immune system, such as an infection by Mycobacterium tuberculosis, the bacteria that causes tuberculosis (TB), may cause increased amounts of ADA to be produced in the areas where the bacteria are present. This test measures the amount of adenosine deaminase present in pleural fluid in order to help diagnose a tuberculosis infection of the pleurae.

Pleurae are membranes that cover the chest cavity and the outside of each lung. Small amounts of pleural fluid are continuously produced to lubricate the movement of the lungs against these membranes and the membranes against each other during inhalation and exhalation. A variety of conditions and diseases, including infection, can cause inflammation of the pleurae (pleurisy or pleuritis) and can lead to excessive pleural fluid accumulation (pleural effusion).

Tuberculosis can spread into the lungs and pleurae, causing symptoms such as chest pain, chronic cough, and shortness of breath. Since these symptoms may also be seen with a variety of other conditions, it is important to determine the cause as rapidly as possible in order to properly treat the affected person. Detecting mycobacteria in pleural fluid can be difficult because there may be a large volume of fluid and very low numbers of bacteria present. Though the ADA test is not specific and does not replace the culture for diagnosing TB, it may be positive even when numbers of bacteria are very low and can be used as an adjunct test to help determine whether tuberculosis is the likely source of a person's symptoms.

For several decades, nonspecific methods, which depend upon raised globulin levels, have been used in the diagnosis of VL. Some of the tests used for detecting these nonspecific immunoglobulins are Napier's formol gel or aldehyde test and the Chopra antimony test. Since these tests depend upon raised globulin levels, results can be positive in a host of conditions (13, 14). Lack of specificity, as well as varying sensitivities, renders them highly unreliable.

Several immunodiagnostic methods which are more sensitive and specific have been developed. They are useful in identifying specific cases and can be used for community surveillance. The human body makes an attempt to fight against VL by producing some of the highest levels of antibodies found in response to any disease, all to no avail. This is due to polyclonal activation of the B cells, resulting in marked elevation of levels (in serum) of immunoglobulin G (IgG) and IgM against various nonspecific proteins and haptens (23). The consistent presence of high levels of antibodies against parasite antigens can simplify diagnosis of VL. Several serological techniques are based on detection of these antibodies. The specificity of the antibody depends upon the antigen or epitope used in the test, as the parasite stimulates production of a wide array of antibodies, including group-, genus-, and species-specific antibodies. Therefore, the sensitivity may depend upon the test and its methodology, but the specificity will depend on the antigen rather than the serological procedure used. In most serological tests, the sensitivity and specificity data are compared against demonstration of parasites in various tissues.

Bone Specific Alkaline Phosphatase is one of the isoenzymes of Alkaline Phosphatase.

Bone Specific Alkaline Phosphataseit is associated with osteoblast cell function and thought to have a role in bone mineralization.

The measurement of Bone Specific Alkaline Phosphatase provides information useful in the evaluation and treatment of people with Paget’s disease, osteoporosis, and metastases to bone.

Bone alkaline phosphatase (BAP) is the bone-specific isoform of alkaline phosphatase. A glycoprotein that is found on the surface of osteoblasts, BAP reflects the biosynthetic activity of these bone-forming cells. BAP has been shown to be a sensitive and reliable indicator of bone metabolism.(1)

Normal bone is constantly undergoing remodeling in which bone degradation or resorption is balanced by bone formation. This process is necessary for maintaining bone health. If the process becomes uncoupled and the rate of resorption exceeds the rate of formation, the resulting bone loss can lead to osteoporosis and, consequently, a higher susceptibility to fractures.

Osteoporosis is a metabolic bone disease characterized by low bone mass and abnormal bone microarchitecture. It can result from a number of clinical conditions including states of high bone turnover, endocrine disorders (primary and secondary hyperparathyroidism and thyrotoxicosis), osteomalacia, renal failure, gastrointestinal diseases, long-term corticosteroid therapy, multiple myeloma, and cancer metastatic to the bones.

Paget disease is another common metabolic bone disease caused by excessive rates of bone remodeling resulting in local lesions of abnormal bone matrix. These lesions can result in fractures or neurological involvement. Antiresorptive therapies are used to restore the normal bone structure.