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 Burns are a serious public health problem. A burn is defined as an injury to the skin or other organic tissue primarily caused by heat or due to radiation, radioactivity, electricity, friction or contact with chemicals.

Heat burns occur when some or all of the different layers of cells in the skin are destroyed by a hot liquid (scald), a hot solid (contact burn) or a flame (flame burn). Skin injuries due to ultraviolet radiation, radioactivity, electricity or chemicals, as well as respiratory damage resulting from smoke inhalation, are also considered as burns.

According to WHO estimates about 265 000 deaths occur each year from fires alone globally, with more deaths from scalds, electrical burns, and other forms of burns for which data are not available. The majority of these deaths occur in low- and middle-income countries, with almost half occur in the WHO South-East Asia Region.

In India around 7 million people suffer from burn injuries each year with 1.4 lakh deaths and 2.4 lakh people suffer with disability. Burn death rates have been decreasing in high income countries.

Females and males show similar rates for burns in contrast to other injury patterns where rates of injury are higher in males than females. The higher risk for females is associated with open fire cooking, or unsafe cook stoves, loose clothing. Self-directed or interpersonal violence is also a factor for burn injuries.

Along with adult females, children are also vulnerable to burns. Out of 5 burn victims 4 are women and children. Burns are the fifth most common cause of non-fatal childhood injuries and 11th leading cause of death of children aged 1-9 years. Among all people globally, infants have the highest death rates from burns.

Burns are also a leading cause of morbidity; millions who survive suffer from lifelong disability and disfigurements with resulting emotional trauma and stigma.

Burns are preventable. Increased efforts in prevention and care would lead to significant reduction in burn-related morbidity, mortality and disability.

The National Programme for Prevention, Management and Rehabilitation of Burn Injuries (NPPMRBI) is an initiative by the Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India to strengthen the preventive, curative and rehabilitative services for burn victims.

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Gestational diabetes -- diabetes that develops during pregnancy -- is a relatively common complication of pregnancy, affecting about 6% of all pregnant women.

You may have a greater risk of developing gestational diabetes if you:

Are obese when you become pregnant
Have high blood pressure or other medical complications
Have given birth to a large (greater than 9 pounds) baby before
Have given birth to a baby that was stillborn or suffering from certain birth defects
Have had gestational diabetes in previous pregnancies
Have a family history of diabetes
Come from certain ethnic backgrounds, including African, Hispanic, Asian, Native American, or Pacific Islander
Are older than 30

 

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Hypertension, also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure. Blood is carried from the heart to all parts of the body in the vessels. Each time the heart beats, it pumps blood into the vessels. Blood pressure is created by the force of blood pushing against the walls of blood vessels (arteries) as it is pumped by the heart. The higher the pressure in blood vessels the harder the heart has to work in order to pump blood. If left uncontrolled, hypertension can lead to a heart attack, an enlargement of the heart and eventually heart failure. Blood vessels may develop bulges (aneurysms) and weak spots due to high pressure, making them more likely to clog and burst. The pressure in the blood vessels can also cause blood to leak out into the brain. This can cause a stroke. Hypertension can also lead to kidney failure, blindness, rupture of blood vessels and cognitive impairment.

Blood pressure is measured in millimeters of mercury (mm Hg) and is recorded as two numbers usually written one above the other. The upper number is the systolic blood pressure - the highest pressure in blood vessels when the heart contracts, or beats. The lower number is the diastolic blood pressure - the lowest pressure in blood vessels when the heart muscle relaxes. Normal adult blood pressure is defined as a systolic blood pressure of 120 mm Hg and a diastolic blood pressure of 80 mm Hg.

Hypertension is defined as a systolic blood pressure equal to or above 140 mm Hg and/or diastolic blood pressure equal to or above 90 mm Hg.

More than 1 in 5 adults worldwide have raised blood pressure – a condition that causes around half of all deaths from stroke and heart disease. Complications from hypertension account for 9.4 million deaths worldwide every year.

In nearly all high-income countries, widespread diagnosis and treatment with low-cost medication have led to a significant drop in the proportion of people with raised blood pressure as well as the average blood pressure across populations. This has contributed to a reduction in deaths from heart disease. For example, the prevalence of raised blood pressure in the WHO region of the Americas in 2014 was 18%, as compared to 31% in 1980.

In contrast, low-income countries have the highest prevalence of raised blood pressure. In the WHO African region, more than 30% of adults in many countries are estimated to have high blood pressure. This proportion is increasing and the average blood pressure levels in this region are much higher than global averages.

Many people with high blood pressure in developing countries are not aware of their disease. Those who are diagnosed may not have access to treatment and may not be able to successfully control their illness over the long term. It contributes to the burden of heart disease, stroke and kidney failure and premature mortality and disability.

Detection, treatment and control of hypertension is an important health priority worldwide.

 

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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

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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

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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:

  • 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

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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

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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

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A fecal occult blood test (FOBT) looks at a sample of your stool (feces) to check for blood. Occult blood means that you can't see it with the naked eye. Blood in the stool means there is likely some kind of bleeding in the digestive tract. It may be caused by a variety of conditions, including:

  • Polyps
  • Hemorrhoids
  • Diverticulosis
  • Ulcers
  • Colitis, a type of inflammatory bowel disease

Blood in the stool may also be a sign of colorectal cancer, a type of cancer that starts in the colon or rectum. Colorectal cancer is the second leading cause of cancer-related deaths in the United States and the third most common cancer in men and in women. A fecal occult blood test is a screening test that may help find colorectal cancer early, when treatment is most effective.

Other names: FOBT, stool occult blood, occult blood test, Hemoccult test, guaiac smear test, gFOBT, immunochemical FOBT, iFOBT; FIT

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Globulins are a group of proteins in your blood. They are made in your liver by your immune system. Globulins play an important role in liver function, blood clotting, and fighting infection. There are four main types of globulins. They are called alpha 1, alpha 2, beta, and gamma. Just as there are different types of globulins, there are different types of globulin tests. These include:

  • Total protein test. This blood test measures two types of proteins: globulin and albumin. If protein levels are low, it can mean that you have liver or kidney disease.
  • Serum protein electrophoresis. This blood test measures gamma globulins and other proteins in your blood. It can be used to diagnose a variety of conditions, including disorders of the immune system and a type of cancer called multiple myeloma.

Other names for globulin tests: Serum globulin electrophoresis, total protein

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glucose in urine test measures the amount of glucose in your urine. Glucose is a type of sugar. It is your body's main source of energy. A hormone called insulin helps move glucose from your bloodstream into your cells. If too much glucose gets into the blood, the extra glucose will be eliminated through your urine. A urine glucose test can be used to help determine if blood glucose levels are too high, which may be a sign of diabetes.

Other names: urine sugar test; urine glucose test; glucosuria test

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A hematocrit test is a type of blood test. Your blood is made up of red blood cells, white blood cells, and platelets. These cells and platelets are suspended in a liquid called plasma. A hematocrit test measures how much of your blood is made up of red blood cells. Red blood cells contain a protein called hemoglobin that carries oxygen from your lungs to the rest of your body. Hematocrit levels that are too high or too low can indicate a blood disorderdehydration, or other medical conditions.

Other names: HCT, packed cell volume, PCV, Crit; Packed Cell Volume, PCV; H and H (Hemoglobin and Hematocrit)

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A hemoglobin test measures the levels of hemoglobin in your blood. Hemoglobin is a protein in your red blood cells that carries oxygen from your lungs to the rest of your body. If your hemoglobin levels are abnormal, it may be a sign that you have a blood disorder.

Other names: Hb, Hgb

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MPV stands for mean platelet volume. Platelets are small blood cells that are essential for blood clotting, the process that helps you stop bleeding after an injury. An MPV blood test measures the average size of your platelets. The test can help diagnose bleeding disorders and diseases of the bone marrow.

Other names: Mean Platelet Volume

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potassium blood test measures the amount of potassium in your blood. Potassium is a type of electrolyte. Electrolytes are electrically charged minerals in your body that help control muscle and nerve activity, maintain fluid levels, and perform other important functions. Your body needs potassium to help your heart and muscles work properly. Potassium levels that are too high or too low may indicate a medical problem.

Other names: potassium serum, serum potassium, serum electrolytes, k


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A red cell distribution width (RDW) test is a measurement of the range in the volume and size of your red blood cells (erythrocytes). Red blood cells move oxygen from your lungs to every cell in your body. Your cells need oxygen to grow, reproduce, and stay healthy. If your red blood cells are larger than normal, it could indicate a medical problem.

Other names: RDW-SD (standard deviation) test, Erythrocyte Distribution Width

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A sodium blood test measures the amount of sodium in your blood. Sodium is a type of electrolyte. Electrolytes are electrically charged minerals that help maintain fluid levels and the balance of chemicals in your body called acids and bases. Sodium also helps your nerves and muscles work properly.

You get most of the sodium you need in your diet. Once your body takes in enough sodium, the kidneys get rid of the rest in your urine. If your sodium blood levels are too high or too low, it may mean that you have a problem with your kidneys, dehydration, or another medical condition.

Other names: Na test

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A thyroxine test helps diagnose disorders of the thyroid. The thyroid is a small, butterfly-shaped gland located near the throat. Your thyroid makes hormones that regulate the way your body uses energy. It also plays an important role in regulating your weight, body temperature, muscle strength, and even your mood. Thyroxine, also known as T4, is a type of thyroid hormone. This test measures the level of T4 in your blood. Too much or too little T4 can indicate thyroid disease.

The T4 hormone comes in two forms:

  • Free T4, which enters the body tissues where it's needed
  • Bound T4, which attaches to proteins, preventing it from entering body tissues

A test that measures both free and bound T4 is called a total T4 test. Other tests measure just free T4. A free T4 test is considered more accurate than a total T4 test for checking thyroid function.

Other names: free thyroxine, free T4, total T4 concentration, thyroxine screen, free T4 concentration.

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triglycerides test measures the amount of triglycerides in your blood. Triglycerides are a type of fat in your body. If you eat more calories than you need, the extra calories are changed into triglycerides. These triglycerides are stored in your fat cells for later use. When your body needs energy, triglycerides are released into your bloodstream to provide fuel for your muscles to work. If you eat more calories than you burn off, especially calories from carbohydrates and fats, you may get high triglyceride levels in your blood. High triglycerides may put you at greater risk for a heart attack or stroke.

Other names for a triglycerides test: TG, TRIG, lipid panel, fasting lipoprotein panel.

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A urobilinogen in urine test measures the amount of urobilinogen in a urine sample. Urobilinogen is formed from the reduction of bilirubin. Bilirubin is a yellowish substance found in your liver that helps break down red blood cells. Normal urine contains some urobilinogen. If there is little or no urobilinogen in urine, it can mean your liver isn't working correctly. Too much urobilinogen in urine can indicate a liver disease such as hepatitis or cirrhosis.

Other names: urine test; urine analysis; UA, chemical urinalysis

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Vitamin D is a nutrient that is essential for healthy bones and teeth. There are two forms of vitamin D that are important for nutrition: vitamin D2 and vitamin D3. Vitamin D2 mainly comes from fortified foods like breakfast cereals, milk, and other dairy items. Vitamin D3 is made by your own body when you are exposed to sunlight. It is also found in some foods, including eggs and fatty fish, such as salmon, tuna, and mackerel.

In your bloodstream, vitamin D2 and vitamin D3 are changed into a form of vitamin D called 25 hydroxyvitamin D, also known as 25(OH)D. A vitamin D blood test measures the level of 25(OH)D in your blood. Abnormal levels of vitamin D can indicate bone disorders, nutrition problems, organ damage, or other medical conditions.

Other names: 25-hydroxyvitamin D, 25(OH)D

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Yeast is a type of fungus that can live on the skin, mouth, digestive tract, and genitals. Some yeast in the body is normal, but if there is an overgrowth of yeast on your skin or other areas, it can cause an infection. A yeast test can help determine whether you have a yeast infection. Candidiasis is another name for a yeast infection.

Other names: potassium hydroxide preparation, fungal culture; fungal antigen and antibody tests, calcofluor white stain, fungal smear.

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Bacteria are a large group of one-celled organisms. They can live on different places in the body. Some types of bacteria are harmless or even beneficial. Others can cause infections and disease. A bacteria culture test can help find harmful bacteria in your body. During a bacteria culture test, a sample will be taken from your blood, urine, skin, or other part of your body. The type of sample depends on the location of the suspected infection. The cells in your sample will be taken to a lab and put in a special environment in a lab to encourage cell growth. Results are often available within a few days. But some types of bacteria grow slowly, and it may take several days or longer.

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A bilirubin blood test measures the levels of bilirubin in your blood. Bilirubin is a yellowish substance made during the body's normal process of breaking down red blood cells. Bilirubin is found in bile, a fluid in your liver that helps you digest food. If your liver is healthy, it will remove most of the bilirubin from your body. If your liver is damaged, bilirubin can leak out of your liver and into your blood. When too much bilirubin gets into the bloodstream, it can cause jaundice, a condition that causes your skin and eyes to turn yellow. Signs of jaundice, along with a bilirubin blood test, can help your health care provider find out if you have liver disease.

Other names: Total serum bilirubin, TSB

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Bilirubin in urine is a diagnostic marker used to detect the presence of bilirubin in urine. Typically, bilirubin is not present in urine at detectable levels, as it is largely processed by the liver and eliminated from the body in the feces. However, if the liver is not functioning properly, or if there is a blockage in the bile ducts, bilirubin may accumulate in the bloodstream and be excreted in the urine.

The presence of bilirubin in urine can be a sign of liver or gallbladder disease, certain types of anemia, or other health conditions. A bilirubin in urine test is a non-invasive diagnostic procedure that can help identify these conditions and guide appropriate treatment. The test is typically performed by collecting a urine sample and analyzing it in a laboratory.


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A blood differential test measures the amount of each type of white blood cell (WBC) that you have in your body. White blood cells (leukocytes) are part of your immune system, a network of cells, tissues, and organs that work together to protect you from infection. There are five different types of white blood cells:

  • Neutrophils are the most common type of white blood cell. These cells travel to the site of an infection and release substances called enzymes to fight off invading viruses or bacteria.
  • Lymphocytes. There are two main types of lymphocytes: B cells and T cells. B cells fight off invading viruses, bacteria, or toxins. T cells target and destroy the body's own cells that have been infected by viruses or cancer cells.
  • Monocytes remove foreign material, remove dead cells, and boost the body's immune response.
  • Eosinophils fight infection, inflammation, and allergic reactions. They also defend the body against parasites and bacteria.
  • Basophils release enzymes to help control allergic reactions and asthma attacks.

However, your test results may have more than five numbers. For example, the lab may list the results as counts as well as percentages.

Other names for a blood differential test: Complete blood count (CBC) with differential, Differential, White blood cell differential count, Leukocyte differential count.

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A blood glucose test measures the glucose levels in your blood. Glucose is a type of sugar. It is your body's main source of energy. A hormone called insulin helps move glucose from your bloodstream into your cells. Too much or too little glucose in the blood can be a sign of a serious medical condition. High blood glucose levels (hyperglycemia) may be a sign of diabetes, a disorder that can cause heart diseaseblindnesskidney failure and other complications. Low blood glucose levels (hypoglycemia) can also lead to major health problems, including brain damage, if not treated.

Other names: blood sugar, self-monitoring of blood glucose (SMBG), fasting plasma glucose (FPG), fasting blood sugar (FBS), fasting blood glucose (FBG), glucose challenge test, oral glucose tolerance test (OGTT)

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A test called a urinalysis can detect whether there is blood in your urine. A urinalysis checks a sample of your urine for different cells, chemicals, and other substances, including blood. Most causes of blood in your urine are not serious, But sometimes red or white blood cells in your urine can mean that you have a medical condition that needs treatment, such as a kidney diseaseurinary tract infection, or liver disease.

Other names: microscopic urine analysis, microscopic examination of urine, urine test, urine analysis, UA

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A blood smear is a sample of blood that's tested on a specially treated slide. For a blood smear test, a laboratory professional examines the slide under a microscope and looks at the size, shape, and number of different types of blood cells. These include:

  • Red blood cells, which carry oxygen from your lungs to the rest of your body
  • White blood cells, which fight infection
  • Platelets, which help your blood to clot

Many blood tests use computers to analyze results. For a blood smear, the lab professional looks for blood cell problems that may not be seen on a computer analysis.

Other names: peripheral smear, peripheral blood film, smear, blood film, manual differential, differential slide, blood cell morphology, blood smear analysis

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A BUN, or blood urea nitrogen test, can provide important information about your kidney function. The main job of your kidneys is to remove waste and extra fluid from your body. If you have kidney disease, this waste material can build up in your blood and may lead to serious health problems, including high blood pressureanemia, and heart disease.

The test measures the amount of urea nitrogen in your blood. Urea nitrogen is one of the waste products removed from your blood by your kidneys. Higher than normal BUN levels may be a sign that your kidneys aren't working efficiently.

People with early kidney disease may not have any symptoms. A BUN test can help uncover kidney problems at an early stage when treatment can be more effective.

Other names for a BUN test: Urea nitrogen test, serum BUN

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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

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The aspartate aminotransferase (AST) blood test is a common diagnostic tool used to evaluate the health of the liver and other organs. It measures the level of AST, an enzyme found in various tissues, including the liver, heart, and skeletal muscle, in the bloodstream. High levels of AST can indicate liver damage, such as hepatitis or cirrhosis, or damage to other organs, such as the heart. The test is typically performed as part of a routine blood panel or as a follow-up to other abnormal liver function tests.
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A calcium blood test measures the amount of calcium in your blood. Calcium is one of the most important minerals in your body. You need calcium for healthy bones and teeth. Calcium is also essential for proper functioning of your nerves, muscles, and heart. About 99% of your body's calcium is stored in your bones. The remaining 1% circulates in the blood. If there is too much or too little calcium in the blood, it may be a sign of bone diseasethyroid diseasekidney disease, or other medical conditions.

Other names: total calcium, ionized calcium

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A calcium in urine test measures the amount of calcium in your urine. Calcium is one of the most important minerals in your body. You need calcium for healthy bones and teeth. Calcium is also essential for proper functioning of your nerves, muscles, and heart. Almost all of your body's calcium is stored in your bones. A small amount circulates in the blood, and the remainder is filtered by the kidneys and passed into your urine. If urine calcium levels are too high or too low, it may mean you have a medical condition, such as kidney disease or kidney stones. Kidney stones are hard, pebble-like substances that can form in one or both kidneys when calcium or other minerals build up in the urine. Most kidney stones are formed from calcium.

Too much or too little calcium in the blood can also indicate a kidney disorder, as well as certain bone diseases, and other medical problems. So if you have symptoms of one of these disorders, your health care provider may order a calcium blood test, along with a calcium in urine test. In addition, a calcium blood test is often included as part of a regular check-up.

Other names: urinalysis (calcium)

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Carbon dioxide (CO2) is an odorless, colorless gas. It is a waste product made by your body. Your blood carries carbon dioxide to your lungs. You breathe out carbon dioxide and breathe in oxygen all day, every day, without thinking about it. A CO2 blood test measures the amount of carbon dioxide in your blood. Too much or too little carbon dioxide in the blood can indicate a health problem.

Other names: carbon dioxide content, CO2 content, carbon dioxide blood test, bicarbonate blood test, bicarbonate test, total CO2; TCO2; carbon dioxide content; CO2 content; bicarb; HCO3

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Chlamydia is one of the most common sexually transmitted diseases (STDs). It is a bacterial infection spread through vaginal, oral, or anal sex with an infected person. Many people with chlamydia have no symptoms, so someone may spread the disease without even knowing they are infected. A chlamydia test looks for the presence of chlamydia bacteria in your body. The disease is easily treated with antibiotics. But if it's not treated, chlamydia can cause serious complications, including infertility in women and swelling of the urethra in men.

Other names: Chlamydia NAAT or NAT, Chlamydia/GC STD Panel

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A chloride blood test measures the amount of chloride in your blood. Chloride is a type of electrolyte. Electrolytes are electrically charged minerals that help control the amount of fluids and the balance of acids and bases in your body. Chloride is often measured along with other electrolytes to diagnose or monitor conditions such as kidney diseaseheart failureliver disease, and high blood pressure.

Other names: CI, Serum chloride

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Cholesterol is a waxy, fat-like substance that's found in your blood and every cell of your body. You need some cholesterol to keep your cells and organs healthy. Your liver makes all the cholesterol your body needs. But you can also get cholesterol from the foods you eat, especially meat, eggs, poultry, and dairy products. Foods that are high in dietary fat can also make your liver produce more cholesterol.

There are two main types of cholesterol: low-density lipoprotein (LDL), or "bad" cholesterol, and high-density lipoprotein (HDL), or "good" cholesterol. A cholesterol test is a blood test that measures the amount of each type of cholesterol and certain fats in your blood.

Too much LDL cholesterol in your blood may put you at risk for heart disease and other serious conditions. High LDL levels can cause the build-up of plaque, a fatty substance that narrows the arteries and blocks blood from flowing normally. When blood flow to the heart is blocked, it can cause a heart attack. When blood flow to the brain is blocked, it can lead to stroke and peripheral artery disease.

Other names for a cholesterol test: Lipid profile, Lipid panel

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A complete blood count or CBC is a blood test that measures many different parts and features of your blood, including:

  • Red blood cells, which carry oxygen from your lungs to the rest of your body
  • White blood cells, which fight infection. There are five major types of white blood cells. A CBC test measures the total number of white cells in your blood. A test called a CBC with differentialalso measures the number of each type of these white blood cells
  • Platelets, which help your blood to clot and stop bleeding
  • Hemoglobin, a protein in red blood cells that carries oxygen from your lungs and to the rest of your body
  • Hematocrit, a measurement of how much of your blood is made up of red blood

A complete blood count may also include measurements of chemicals and other substances in your blood. These results can give your health care provider important information about your overall health and risk for certain diseases.

Other names for a complete blood count: CBC, full blood count, blood cell count

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Cortisol is a hormone that affects almost every organ and tissue in your body. It plays an important role in helping you to:


  • Respond to stress
  • Fight infection
  • Regulate blood sugar
  • Maintain blood pressure
  • Regulate metabolism, the process of how your body uses food and energy

Cortisol is made by your adrenal glands, two small glands located above the kidneys. A cortisol test measures the level of cortisol in your blood, urine, or saliva. Blood tests are the most common way of measuring cortisol. If your cortisol levels are too high or too low, it may mean you have a disorder of your adrenal glands. These disorders can be serious if not treated.

Other names: urinary cortisol, salivary cortisol, free cortisol, dexamethasone suppression test, DST, ACTH stimulation test, blood cortisol, plasma cortisol, plasma

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Your urine contains many chemicals. Sometimes these chemicals form solids, called crystals. A crystals in urine test looks at the amount, size, and type of crystals in your urine. It's normal to have a few small urine crystals. Larger crystals or specific types of crystals can become kidney stones. Kidney stones are hard, pebble-like substances that can get stuck in the kidneys. A stone can be as small as a grain of sand, as big as a pea, or even larger. While kidney stones rarely cause serious damage, they can be very painful.

Other names: urinalysis (crystals) microscopic urine analysis, microscopic examination of urine

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Hair loss, also known as alopecia or baldness, refers to a loss of hair from part of the head or body. Typically at least the head is involved. The severity of hair loss can vary from a small area to the entire body. Typically inflammation or scarring is not present.Hair loss in some people causes psychological distress.

Common types include: male-pattern hair loss, female-pattern hair loss, alopecia areata, and a thinning of hair known as telogen effluvium.The cause of male-pattern hair loss is a combination of genetics and male hormones, the cause of female pattern hair loss is unclear, the cause of alopecia areata is autoimmune, and the cause of telogen effluvium is typically a physically or psychologically stressful event.Telogen effluvium is very common following pregnancy.

Less common causes of hair loss without inflammation or scarring include the pulling out of hair, certain medications including chemotherapy, HIV/AIDS, hypothyroidism, and malnutrition including iron deficiency. Causes of hair loss that occurs with scarring or inflammation include fungal infection, lupus erythematosus, radiation therapy, and sarcoidosis.Diagnosis of hair loss is partly based on the areas affected.

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Libido (/lɪˈbiːdoʊ/), colloquially known as sex drive, is a person's overall sexual drive or desire for sexual activity. Sex drive is influenced by biological, psychological and social factors. Biologically, the sex hormones and associated neurotransmitters that act upon the nucleus accumbens (primarily testosterone and dopamine, respectively) regulate libido in humans.Social factors, such as work and family, and internal psychological factors, like personality and stress, can affect libido. Sex drive can also be affected by medical conditions, medications, lifestyle and relationship issues, and age (e.g., puberty). A person who has extremely frequent or a suddenly increased sex drive may be experiencing hypersexuality, while the opposite condition is hyposexuality.

A person may have a desire for sex, but not have the opportunity to act on that desire, or may on personal, moral or religious reasons refrain from acting on the urge. Psychologically, a person's urge can be repressed or sublimated. On the other hand, a person can engage in sexual activity without an actual desire for it. Multiple factors affect human sex drive, including stress, illness, pregnancy, and others.

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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.

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Abdominal pain is a common symptom associated with non-serious and serious causes.

Common causes of pain in the abdomen include gastroenteritis and irritable bowel syndrome. In a third of cases the exact cause is unclear. About 10% of people have a more serious underlying condition such as appendicitis, leaking or ruptured abdominal aortic aneurysm, diverticulitis, or ectopic pregnancy.Determining the cause can be difficult, because many diseases can cause this symptom.
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Tuberculosis (TB) is an infectious disease usually caused by the bacterium Mycobacterium tuberculosis (MTB). Tuberculosis generally affects the lungs, but can also affect other parts of the body. Most infections do not have symptoms, in which case it is known as latent tuberculosis. About 10% of latent infections progress to active disease which, if left untreated, kills about half of those infected. The classic symptoms of active TB are a chronic cough with blood-containing sputum, fever, night sweats, and weight loss. The historical term "consumption" came about due to the weight loss. Infection of other organs can cause a wide range of symptoms.

Tuberculosis is spread through the air when people who have active TB in their lungs cough, spit, speak, or sneeze. People with latent TB do not spread the disease. Active infection occurs more often in people with HIV/AIDS and in those who smoke. Diagnosis of active TB is based on chest X-rays, as well as microscopic examination and culture of body fluids. Diagnosis of latent TB relies on the tuberculin skin test (TST) or blood tests.
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Tobacco smoking is the practice of burning tobacco and inhaling the smoke (consisting of particle and gaseous phases). (A more broad definition may include simply taking tobacco smoke into the mouth, and then releasing it, as is done by some with tobacco pipes and cigars.) The practice was believed to begin as early as 5000–3000 BC. Tobacco was introduced to Eurasia in the late 17th century where it followed common trade routes. The practice encountered criticism from its first import into the Western world onwards, but embedded itself in certain strata of a number of societies before becoming widespread upon the introduction of automated cigarette-rolling apparatus.


German scientists identified a link between smoking and lung cancer in the late 1920s, leading to the first anti-smoking campaign in modern history, albeit one truncated by the collapse of Nazi Germany at the end of World War II. In 1950, British researchers demonstrated a clear relationship between smoking and cancer. Evidence continued to mount in the 1980s, which prompted political action against the practice. Rates of consumption since 1965 in the developed world have either peaked or declined. However, they continue to climb in the developing world.

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The eyebrow is an area of thick, delicate hairs above the eye that follows the shape of the lower margin of the brow ridges of some mammals. Their main function is hypothesized to prevent sweat, water, and other debris from falling down into the eye socket, but they are also important to human communication and facial expression. It is not uncommon for people to modify their eyebrows by means of hair addition, removal and makeup.

According to the 2016 United States census, roughly 3% of the population suffers from a disease called madarosis, which is a deficiency where individuals cannot grow eyebrows or eyelashes.
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Testosterone is the primary male sex hormone and an anabolic steroid. In male humans, testosterone plays a key role in the development of male reproductive tissues such as the testis and prostate, as well as promoting secondary sexual characteristics such as increased muscle and bone mass, and the growth of body hair. In addition, testosterone is involved in health and well-being, and the prevention of osteoporosis. Insufficient levels of testosterone in men may lead to abnormalities including frailty and bone loss.

Testosterone is also used as a medication to treat male hypogonadism and certain types of breast cancer. Since testosterone levels gradually decrease as men age, synthetic testosterone is sometimes prescribed to older men to counteract this deficiency.

Testosterone is a steroid from the androstane class containing a keto and hydroxyl groups at the three and seventeen positions respectively. It is biosynthesized in several steps from cholesterol and is converted in the liver to inactive metabolites. It exerts its action through binding to and activation of the androgen receptor.
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Back pain is a common reason for absence from work and doctor visits. Although back pain may be painful and uncomfortable, it is not usually serious.

Even though back pain can affect people of any age, it is significantly more common among adults aged between 35 and 55 years. Experts say that back pain is associated with the way our bones, muscles and ligaments in our backs work and connect together.

Pain in the lower back may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdomen and pelvic internal organs, and the skin around the lumbar area. Pain in the upper back may be due to disorders of the aorta, tumors in the chest, and spine inflammation.

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Tennis elbow or lateral epicondylitis is a condition in which the outer part of the elbow becomes sore and tender at the lateral epicondyle. The forearm muscles and tendons become damaged from repetitive overuse. This leads to pain and tenderness on the outside of the elbow.

Any activity, including playing tennis, that involves repetitive use of the extensor muscles of the forearm can cause acute or chronic tendonitis of the tendinous insertion of these muscles at the lateral epicondyle of the elbow. The condition is common in carpenters and laborers who swing a hammer or other tool with the forearm, and is similar to golfer's elbow, which affects the medial epicondyle on the inside of the elbow. Continuing activity after onset of the condition and avoiding mandatory rest may lead to permanent onset of pain and only treatable via surgery.
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Defination

Bacterial vaginosis also is referred to as nonspecific vaginitis, is a vaginal condition that can produce vaginal discharge and results from an overgrowth of certain kinds of bacteria in the vagina. In the past, the condition was called Gardnerella vaginitis, after the bacteria that were thought to cause the condition. However, the newer name, bacterial vaginosis, reflects the fact that there are a number of species of bacteria that naturally live in the vaginal area and may grow to excess, rather than a true infection with foreign bacteria, such as occurs with many sexually-transmitted disease

Facts & Symptoms


Bacterial vaginosis (BV) is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina. It is not a true bacterial infection but rather an imbalance of the bacteria that are normally present in the vagina.
Bacterial vaginosis is not dangerous, but it can cause disturbing symptoms.
Most women do not experience symptoms of bacterial vaginosis, but when they do they are:

    vaginal discharge, and
    vaginal odor.

In diagnosing bacterial vaginosis, it is important to exclude other serious vaginal infections, such as the STDs gonorrhea and Chlamydia.
Treatment options for relief of bacterial vaginosis include prescription oral antibiotics and vaginal gels. Metronidazole (Flagyl) is one option for treating bacterial vaginosis.
Serious complications of bacterial vaginosis can occur during pregnancy, and recurrence is possible even after


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Bad breath, also known as halitosis or fetor oris, affects an estimated 25% of people, globally. There are a number of potential causes of halitosis but the vast majority come down to oral hygiene.

Halitosis can cause significant worry, embarrassment and anxiety but, generally, it is relatively easy to remedy.

In this article, we will discuss the potential origins of bad breath, diagnosis and how to treat it.
   

Fast facts on bad breath

Here are some key points about bad breath. More detail and supporting information is in the main article.

    Bad breath is estimated to affect 1 in 4 people globally
    The most common cause of halitosis is bad oral hygiene
    If particles of food are left in the mouth, their breakdown by bacteria produces sulfur compounds
    There are a number of common causes of bad breath, including smoking, tooth decay and alcohol consumption
    Keeping the mouth hydrated can reduce mouth odor
    Bad breath in children is often due to a trapped item in the nasal cavity
    Rarer causes of bad breath include bowel obstruction, ketoacidosis and aspiration pneumonia
    The best treatment for bad breath is regular brushing, flossing and hydration
    Crash diets can cause bad breath because of the build-up of ketones.

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A balance disorder is a condition that makes you feel unsteady or dizzy, as if you are moving, spinning, or floating, even though you are standing still or lying down. Balance disorders can be caused by certain health conditions, medications, or a problem in the inner ear or the brain.


Our sense of balance is primarily controlled by a maze-like structure in our inner ear called the labyrinth, which is made of bone and soft tissue. At one end of the labyrinth is an intricate system of loops and pouches called the semicircular canals and the otolithic organs, which help us maintain our balance. At the other end is a snail-shaped organ called the cochlea, which enables us to hear. The medical term for all of the parts of the inner ear involved with balance is the vestibular system

Symptoms

How do I know if I have a balance disorder?

Everyone has a dizzy spell now and then, but the term “dizziness” may mean something different to different people. For some people, dizziness might be a fleeting sensation of spinning, while for others it's intense and lasts a long time. Experts believe that more than four out of 10 Americans will experience an episode of dizziness significant enough to send them to a doctor.


To help you decide whether or not you should seek medical help for a dizzy spell, ask yourself the following questions. If you answer “yes” to any of these questions, talk to your doctor.


    Do I feel unsteady?

    Do I feel as if the room is spinning around me?

    Do I feel as if I'm moving when I know I'm sitting or standing still?

    Do I lose my balance and fall?

    Do I feel as if I'm falling?

    Do I feel “lightheaded” or as if I might faint?

    Do I have blurred vision?

    Do I ever feel disoriented, such as losing my sense of time or where I am?


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1. The Golden Rule

Do: Make sure you always (and we mean always) remove your makeup before hitting the sheets. The skin needs to breathe overnight. And makeup prevents that, as leaving it on overnight clogs the pores which may cause blemishes and/or blackheads. Don’t possess a makeup remover? Just put some olive oil on a cotton pad and gently massage the oil onto your face to get rid of the makeup and dirt.
Don’t: Forget that exfoliation is indispensable. At least once or twice a week, exfoliate your skin to remove the layers of dead skin, sure to leave you with a more healthy glow and brighter skin. You can also apply a paste of walnut in powder form with yogurt to exfoliate your skin, as the antioxidants present in walnuts help remove dirt and promote radiant skin.
 

Never forget to exfoliate your skin and remove the makeup before calling it a night.

2. Sun and Skin

Do: Apply sunscreen with SPF of at least 15 that blocks both UVA and UVB rays. Since a lifetime of sun exposure can cause wrinkles, age spots and other skin problems, you have to protect your skin from the sun. Make sure the label reads ‘noncomedogenic’ or ‘nonacnegenic’ so that the product does not tend to block pores.  

Don’t: Skip the sunscreen, whether it's cloudy or cold outside (no excuses). If you’re heading to a beach or around reflective surfaces like snow or ice, lather your skin up with some more sunscreen with SPF of at least 30.
 

Sunscreen with SPF of at least 15 that blocks both UVA and UVB rays.

3. You are What You Eat

Do: Keep a note of what you put on your plate. Eat fresh fruits, greens, sufficient protein and vitamins. A diet rich in vitamin C and low in fats and sugar promotes radiant skin. Consider a low-sugar diet, which can keep insulin levels down, allowing cells to maintain a healthy balance.

"Don’t: Eat spicy and fermented foods, salt, citrus fruits, fried food. Instead favour blander foods such as rice, oatmeal and applesauce”, advises American author and Ayurvedic physician, Vasant Lad, in The Complete Book of Ayurvedic Home Remedies.


Fresh fruits and greens is what healthy skin needs.

4. Sweat It Out!

Do: Exercise regularly. Running, jogging and yoga will give your body the necessary blood circulation, and also accelerate the cleansing process of your entire body. You will notice a glow on your face after working out. Racing against time? Just take a brisk walk around the block.

Don’t: Skip skincare before and after a workout. Apply a toner to help minimize oil production before heading out. Exfoliate after, and then apply shea butter or olive oil to moisturize the skin.
 
Running, jogging and yoga will accelerate the cleaning process of your body.

5. Beauty Sleep

Do: Try to sleep at least 8 hours every night. If you don’t get enough shut eye, your skin gets tired just like you - it sags and you get bags. So don’t risk it. You can also apply honey on your face twice or thrice a week to naturally soothe and heal your skin.

“Don’t: Forget to wash and moisturize your face before going to bed”, recommends Dr. Rahul Nagar, Dermatologist, Max Hospitals. “For dry skin, use milder cleansers that are free from alcohol. Apply lots of moisturizer, and avoid hot water as it dries out the skin excessively.”
 

Never forget to wash your face before sleeping and moisturize well.

6. H2O to The Rescue

Do: Hydrate yourself. Drink lots of water daily, at least 8 glasses if not more. Also, eats fruits and vegetables that have a high water content such as watermelon, cucumber, orange, strawberry, grapefruit and cantaloupe. Ayurvedic physician, Vasant Lad recommends to “drink water from a blue coloured bottle”, since it has a cooling effect.

Don’t: Ignore rose water. It helps prevent and reduce eye puffiness in the morning, maintains pH balance and naturally hydrates your skin if you spritz it on during the day.
 
Rose water maintains pH balance and  naturally hydrates the skin.

7. Goodbye Acne

“Do: Wash your face with warm water, three times a day, and gently massage your face in circular motions, ensuring that the cleanser contains alpha hydroxyl acid or beta hydroxyl acid. Face packs that contain multani mitti (fuller’s earth) work really well too. After cleansing, pat dry and apply a lotion which contains benzoyl peroxide”, suggests Dr. Zaheer Ahmed, Dermatologist, Max Hospitals. Benzoyl peroxide appears to be effective due to its antibacterial actions.

Don’t: Pop pimples because it can lead to more swelling, redness, and even scarring. Feel a pimple is on its way? Just clean the area with rose water, and place a chilled green tea bag for 10 minutes. Also, if you wear glasses or sunglasses, make sure you clean them frequently to keep oil from clogging the pores around your eyes and nose.
 
Never pop your pimples. Use rose water or chilled green tea bags.

8. Go Back to Your Roots

Do: Use Ayurvedic scrubs to nourish the skin, and help it breathe better. Luckily for you, everything you need is already in your kitchen. 2 tbsp chickpea flour, ½ tsp turmeric powder, a pinch of camphor and sandalwood with some rose water/milk/water is your perfect skincare pack. Yes, the secrets of beauty lies in ancient Ayurveda.

Don’t: Neglect the basics. Make Sudarshan Kriya your beauty mantra. Yes, it’s that easy. Just breathing right could rid you of spots and pimples. Nidhi Gureja, Art of Living, says “Sudarshan Kriya is a breathing technique which incorporates specific natural rhythms of the breath that harmonize the body, mind and emotions. This helps releasing accumulated stresses, and each individual’s experience is different.”
 
Sudarshan Kriya is a breathing technique which incorporates specific natural rhythms that helps in releasing accumulated stresses.

9. Spa Day Everyday?

Do: Have a regular skin care regimen. “For dry skin, use a fresh cherry mask. Apply the pulp of fresh cherries on your face before going to bed. Leave for 15 minutes and wash with lukewarm water”, adds American author Vasant Lad.

Don’t: Forget to pamper yourself. A gentle facial massage with oils could work wonders. Depending on your skin type, choose oils from mustard, coconut, almond or Kumkadi as they are excellent nourishing agents which help to get glowing skin. Better still – switch on some soothing instrumental music. After 20 minutes, what do you have? Beautiful skin and a relaxed you.

Pamper yourself occasionally with spa treatments.

10. Healthy Habits

Do: Take out time for yourself, and try to avoid stress as much as possible. Have you ever noticed that when you are stressed, you tend to break out more? This is because stress causes your body to produce cortisol and other hormones, making the skin more oily. Practice stress management techniques like breathing exercises, yoga and meditation. The more you meditate, the more you radiate.

Don’t: Neglect your jawline and facial muscles. For just 5 minutes a day, perform a few facial exercises. You can jut out your lower lip in such a way that wrinkles are created on the chin, then lower your chin to your chest. Another exercise that works wonders is to look up towards the ceiling and pout. It stretches out the muscles making the skin more firm. “18 till I die”, why not?
 
The more you meditate, the more you radiate.

You’re dressed to perfection, yet you need something to complete the look. Your smile! While we spend so much time and energy on honing our bodies and looks, we forget to express our inner joy and happiness. “Keeping a smile on your face will help maintain the tone of your facial muscles and skin. People may say you look 10 years younger than you are!”, adds the Ayurvedic physician, Vasant Lad.
   

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Sanskrit: सूर्यनमस्कार IPA: Sun Salutation, is a Yoga warm up routine based on a sequence of gracefully linked asanas. The nomenclature refers to the symbolism of Sun as the soul and the source of all life. It was developed in the 20th century.

A yogi may develop a personalized yoga warm up routine as surya-namaskar to precede his or her asana practice.
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Sunburn is a form of radiation burn that affects living tissue, such as skin, that results from an overexposure to ultraviolet (UV) radiation, commonly from the sun. Common symptoms in humans and other animals include red or reddish skin that is hot to the touch, pain, general fatigue, and mild dizziness. An excess of UV radiation can be life-threatening in extreme cases. Exposure of the skin to lesser amounts of UV radiation will often produce a suntan.


Excessive UV radiation is the leading cause of primarily non-malignant skin tumors. Sunscreen is widely agreed to prevent sunburn and some types of skin cancer. Clothing, including hats, is considered the preferred skin protection method. Moderate sun tanning without burning can also prevent subsequent sunburn, as it increases the amount of melanin, a photoprotective pigment that is the skin's natural defense against overexposure. Importantly, both sunburn and the increase in melanin production are triggered by direct DNA damage. When the skin cells' DNA is overly damaged by UV radiation, type I cell-death is triggered and the skin is replaced.

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Don’t let the bed bugs bite

Despite their role in an adorable bedtime proverb, bed bugs are pesky little pests. They sneak into your bed, your furniture, even your carpet, and while you sleep or watch TV, they bite you. The next morning, you’re left wondering why you’re red and itchy.


We pick these items based on the quality of the products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline may receive a portion of the revenues when you buy something using the links below.

What are bed bugs?

Bed bugs are small, flat, oval-shaped insects. They do not have wings and rely on humans to carry them from one place to the next. Bed bugs are a reddish-brown color and can be between 1 and 7 millimeters. They feed on blood from humans or animals, and they’re most active at night, feeding on their victims while they sleep.

What do bed bug bites look like?

Some people will not experience a reaction to a bed bug bite at all. Those that do experience symptoms of a bite are likely to experience one or more of the following:


    a bite with a red, swollen area and a dark red center
    bites in a line or grouped together in a small area
    blisters or hives at the bite site


Bites can happen anywhere on the body. Most commonly they occur on areas of skin that are exposed while sleeping, such as the face, arms, legs, and hands.


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Can you treat and eliminate the bed bugs on your own? Bed bugs are challenging pests to get rid of, since they hide so well and reproduce so quickly. In addition, the egg stage is resistant to many forms of treatment, so a single attempt may not be sufficient to complete the job.

Treating bed bugs is complex. Your likelihood of success depends on many factors, including:
Person inspecting furniture for pest infestation

    Extent of the infestation.
    Site-specific challenges.
        Clutter.
        Neighbors with infestations.
        Ability of all of the residents to participate.

Achieving complete control can take weeks to months, depending on the nature and extent of the infestation, and everyone will need to cooperate and do their part.

Before starting, you should lay out all of the steps on a calendar. The following steps will help you begin:

    Identify the problem
    Develop a strategy
    Keep the infestation from expanding
    Prepare for treatment
    Kill the bed bugs
    Evaluate and prevent


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What causes pressure sores?

Things that cause pressure sores include:

    Pressure on the skin and tissues. This is the most common cause.
    Sliding down in a bed or chair, which can cause the skin to fold over itself (shear force).
    Being pulled across bed sheets or other surfaces, which can cause friction burns.
    Excess moisture, such as from sweat, urine, or feces. Skin that is often wet is more likely to break down and form pressure sores.

    
    
What increases the risk of getting pressure sores?

Things that make a person more likely to get pressure sores include:

    Not being able to move easily. This often happens because of a spinal injury, paralysis, coma, or surgery.
    Poor bladder or bowel control.
    Poor nutrition. A diet that doesn't have enough protein can lead to unhealthy skin and slow healing.
    Decreased alertness, which may be due to a health problem or taking certain medicines. People who are not alert may not take the steps to prevent pressure sores or understand why prevention is important.
    Aging. As people age, their skin becomes thinner, drier, and less elastic, so it is more easily injured.
    Smoking. Smoking dries out the skin and reduces blood flow to the skin.
    Having a health problem that interferes with healing, such as diabetes.

    
Caring for a Pressure Sore

Stage I or II sores will heal if cared for carefully. Stage III and IV sores are harder to treat and may take a long time to heal. Here's how to care for a pressure sore at home.

Relieve the pressure on the area.

    Use special pillows, foam cushions, booties, or mattress pads to reduce the pressure. Some pads are water- or air-filled to help support and cushion the area. What type of cushion you use depends on your wound and whether you are in bed or in a wheelchair. Talk with your doctor about what choices would be best for you, including what shapes and types of material.
    Change positions often. If you are in a wheelchair, try to change your position every 15 minutes. If you are in bed, you should be moved about every 2 hours.

Care for the sore as directed by your health care provider. Keep the wound clean to prevent infection. Clean the sore every time you change a dressing.

    For a stage I sore, you can wash the area gently with mild soap and water. If needed, use a moisture barrier to protect the area from bodily fluids. Ask your provider what type of moisturizer to use.
    Stage II pressure sores should be cleaned with a salt water (saline) rinse to remove loose, dead tissue. Or, your provider may recommend a specific cleanser.
    DO NOT use hydrogen peroxide or iodine cleansers. They can damage skin.
    Keep the sore covered with a special dressing. This protects against infection and helps keep the sore moist so it can heal.
    Talk with your provider about what type of dressing to use. Depending on the size and stage of the sore, you may use a film, gauze, gel, foam, or other type of dressing.
    Most stage III and IV sores will be treated by your provider. Ask about any special instructions for home care.

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Bedwetting, or nocturnal enuresis, refers to the unintentional passage of urine during sleep. Enuresis is the medical term for wetting, whether in the clothing during the day or in bed at night. Another name for enuresis is urinary incontinence.

For infants and young children, urination is involuntary. Wetting is normal for them. Most children achieve some degree of bladder control by 4 years of age. Daytime control is usually achieved first, while nighttime control comes later.

The age at which bladder control is expected varies considerably.

    Some parents expect dryness at a very early age, while others not until much later. Such a time line may reflect the culture and attitudes of the parents and caregivers.
    Factors that affect the age at which wetting is considered a problem include the following:
        The child's gender: Bedwetting is more common in boys.
        The child's development and maturity
        The child's overall physical and emotional health. Chronic illness and/or emotional and physical abuse may predispose to bedwetting.

Bedwetting is a very common problem.

    Parents must realize that enuresis is involuntary. The child who wets the bed needs parental support and reassurance.

Bedwetting is a treatable condition.

    While children with this embarrassing problem and their parents once had few choices except waiting to "grow out of it," there are now treatments that work for many children.
    Several devices, treatments, and techniques have been developed to help these children stay dry at night.

What Causes Bedwetting?

While bedwetting can be a symptom of an underlying disease, the large majority of children who wet the bed have no underlying illness. In fact, a true organic cause is identified in only a small percentage of children who wet the bed. However, this does not mean that the child who wets the bed can control it or is doing it on purpose. Children who wet the bed are not lazy, willful, or disobedient.

There are two types of bedwetting: primary and secondary. Primary bedwetting refers to bedwetting that has been ongoing since early childhood without a break. A child with primary bedwetting has never been dry at night for any significant length of time. Secondary bedwetting is bedwetting that starts again after the child has been dry at night for a significant period of time (at least six months).

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Incontinence is a term that describes any accidental or involuntary loss of urine from the bladder (urinary incontinence) or bowel motion, faeces or wind from the bowel (faecal or bowel incontinence).

Incontinence is a widespread condition that ranges in severity from 'just a small leak' to complete loss of bladder or bowel control. In fact, over 4.8 million Australians have bladder or bowel control problems for a variety of reasons. Incontinence can be treated and managed.  In many cases it can also be cured.
Think you might have a problem?

If you experience bladder or bowel problems, but are not sure if you should seek help, try the questionnaire below.
Bladder and bowel questionnaire

    Do you sometimes feel you have not completely emptied your bladder?

    Do you have to rush to use the toilet?

    Are you frequently nervous because you think you might lose control of your bladder or bowel?

    Do you wake up twice or more during the night to go to the toilet?

    Do you sometimes leak before you get to the toilet?

    Do you sometimes leak when you lift something heavy, sneeze, cough or laugh?

    Do you sometimes leak when you exercise or play sport?

    Do you sometimes leak when you change from a seated or lying position to a standing position?

    Do you strain to empty to bowel?

    Do you sometimes soil your underwear?

    Do you plan your daily routine around where the nearest toilet is?

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Dirt, bacteria, fungus, and other germs can get trapped inside your belly button and start to multiply. This can cause an infection. You might notice white, yellow, brown, or bloody discharge seeping out of your belly button. That discharge might also have an unpleasant smell. Here are a few of the causes of belly button discharge, and how to treat them.


Causes of belly button discharge include infections, surgery, and cysts.

Bacterial infection

The average belly button is home to nearly 70 different types of bacteria. If you don’t clean the area well, these bacteria could cause an infection. Piercings in your navel can also get infected.

Bacterial infections cause a yellow or green, foul-smelling discharge. You can also have swelling, pain, and a scab around your belly button.


Yeast infection

Candidiasis is a yeast infection caused by Candida, a type of yeast that typically grows in damp, dark areas of the body. It can occur between skin folds, such as in your groin area and under your arms. Yeast can also take up residence in your belly button, especially if you don’t keep it clean and dry.

Candidiasis in your belly button causes a red, itchy rash on your navel and may also cause a thick, white discharge.
Diabetes

People with diabetes are more likely to get yeast infections. This is because yeast feeds on sugar, and high blood sugar is a hallmark of poorly treated diabetes. A study of Brazilian woman showed that women with diabetes were more prone to vaginal yeast infections than women who didn’t have diabetes.

Other studies suggest that other forms of yeast infections, including yeast infections in the belly button, may be more common among people with diabetes.


Surgery

If you’ve recently had abdominal surgery, such as hernia repair, you might notice pus draining from your belly button. If this happens, call your doctor. It could be a sign of an infection that needs to be treated.

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Benign prostatic hyperplasia (BPH) is an enlarged prostate. The prostate goes through two main growth periods as a man ages. The first occurs early in puberty, when the prostate doubles in size. The second phase of growth begins around age 25 and continues during most of a man's life. As you age, your prostate may get larger. Benign prostatic hyperplasia often occurs with the second growth phase.


As the prostate enlarges, it can then squeeze down on your urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty completely, leaving some urine in the bladder. The narrowing of the urethra and urinary retention--the inability to empty the bladder completely--cause many of the problems associated with benign prostatic hyperplasia. BPH is benign. This means it is not cancer. It does not cause nor lead to cancer. But BPH and cancer can happen at the same time.

BPH is common in aging men. About half of all men between the ages of 51 and 60 have BPH. Up to 90% of men over age 80 have BPH.
The Prostate


The prostate is part of the male reproductive system. It is about the size of a walnut and weighs about an ounce. The prostate is below the bladder and in front of the rectum. The prostate goes all the way around a tube called the urethra. The urethra carries urine from the bladder out through the penis. The main job of the prostate is to make fluid for semen. During ejaculation, sperm made in the testicles moves to the urethra. At the same time, fluid from the prostate and the seminal vesicles also moves into the urethra. This mixture-semen-goes through the urethra and out the penis.


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    More than 5 million people in the United States have bipolar disorder.
    People with bipolar disorder typically have mood swings that range from highs called mania, to lows called depression.
    Unless you have severe mania, bipolar disorder can be difficult to diagnose.

Bipolar disorder is a mental illness marked by extreme mood swings from high to low, and from low to high. Highs are periods of mania, while lows are periods of depression. The mood swings may even become mixed, so you might feel elated and depressed at the same time.

Bipolar disorder isn’t a rare diagnosis. A 2005 study found that 2.6 percent of the U.S. population, or more than 5 million people, are living with some form of bipolar disorder. Symptoms tend to appear in a person’s late teens or early adult years, but they can occur in children as well. Women are more likely to receive bipolar diagnoses than men, though the reason for this remains unclear.

Bipolar disorder can be hard to diagnose, but there are warning signs or symptoms that you can look for.


7 signs of mania

Mania can cause other symptoms as well, but seven of the key signs of this phase of bipolar disorder are:

    feeling overly happy or “high” for long periods of time
    having a decreased need for sleep
    talking very fast, often with racing thoughts
    feeling extremely restless or impulsive
    becoming easily distracted
    having overconfidence in your abilities
    engaging in risky behavior, such as having impulsive sex, gambling with life savings, or going on big spending sprees


    
    7 signs of depression

Like mania, depression can cause other symptoms as well, but here are seven of the key signs of depression from bipolar disorder:

    feeling sad or hopeless for long periods of time
    withdrawing from friends and family
    losing interest in activities that you once enjoyed
    having a significant change in appetite
    feeling severe fatigue or lack of energy
    having problems with memory, concentration, and decision making
    thinking about or attempting suicide, or having a preoccupation with death


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 Bipolar I disorder (pronounced "bipolar one" and also known as manic-depressive disorder or manic depression) is a form of mental illness. A person affected by bipolar I disorder has had at least one manic episode in his or her life. A manic episode is a period of abnormally elevated mood and high energy, accompanied by abnormal behavior that disrupts life.

Most people with bipolar I disorder also suffer from episodes of depression. Often, there is a pattern of cycling between mania and depression. This is where the term "manic depression" comes from. In between episodes of mania and depression, many people with bipolar I disorder can live normal lives.


Who Is at Risk for Bipolar I Disorder?

Virtually anyone can develop bipolar I disorder. About 2.5% of the U.S. population suffers from bipolar disorder -- almost 6 million people.

Most people are in their teens or early 20s when symptoms of bipolar disorder first appear. Nearly everyone with bipolar I disorder develops it before age 50. People with an immediate family member who has bipolar are at higher risk.
What Are the Symptoms of Bipolar I Disorder?

During a manic episode in someone with bipolar disorder, elevated mood can manifest itself as either euphoria (feeling "high") or as irritability.

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 Bipolar II disorder (pronounced "bipolar two") is a form of mental illness. Bipolar II is similar to bipolar I disorder, with moods cycling between high and low over time.

However, in bipolar II disorder, the "up" moods never reach full-blown mania. The less-intense elevated moods in bipolar II disorder are called hypomanic episodes, or hypomania.

A person affected by bipolar II disorder has had at least one hypomanic episode in his or her life. Most people with bipolar II disorder suffer more often from episodes of depression. This is where the term "manic depression" comes from.

In between episodes of hypomania and depression, many people with bipolar II disorder typically live normal lives.


Who Is at Risk for Bipolar II Disorder?

Virtually anyone can develop bipolar II disorder. About 2.5% of the U.S. population suffers from some form of bipolar disorder - nearly 6 million people.
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You're not ready to have a child yet but unsure if you want to use birth control pills or get a contraceptive injection. Have you considered using herbal birth control yet?

Several herbs are effective in preventing pregnancy. The best part? They're all-natural, so you don't have to worry about harsh chemicals or side effects.

This post will discuss the most effective herbal birth control methods and how to use them.

Herbal Birth Control: What is it??

Herbal birth control is a method of avoiding pregnancy that uses natural herbs. These herbs work to prevent the woman from ovulating or releasing eggs. You can choose the best birth control herbs from a variety of options with the assistance of your doctor.


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Black eye facts

    A black eye often results from injury to the face or the head, and is caused when blood and other fluids collect in the space around the eye. Swelling and dark discoloration result in a "black eye."
    Most black eyes are relatively minor injuries. Many heal on their own in a few days, but they may signify a more serious injury.
    The most common cause of a black eye is a blow to the eye, nose, or forehead.
    Pain and swelling are the most common signs and symptoms of a black eye.
    Call a doctor if the injured individual has changes in vision, severe pain, or swelling that does not go away, the swelling around the eyes is not related to an injury, there are signs of infection (for example, fever, warmth, redness, pus-like drainage), if the person has behavioral changes, forgetfulness or lethargy, nausea, vomiting and/or dizziness, loss of vision (especially double vision), or an inability to move the eye itself (i.e., unable to look in different directions).
    Home remedies for black eye include rest and ice applied early after the injury help to decrease swelling and pain. Do not use raw meat on an eye injury, this creates potential for infection.
    Avoid a black eye with basic injury prevention. Wear the appropriate protective gear for any athletic or work-related activity.
    Complications include traumatic iritis and uveitis, hyphema, glaucoma, orbital floor fracture (blowout fracture), and retinal detachment.

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Blackheads are small bumps that appear on your skin due to clogged hair follicles. These bumps are called blackheads because the surface looks dark or black. Blackheads are a mild type of acne that usually form on the face, but they can also appear on the following body parts:


back

chest

neck

arms

shoulders

Acne affects nearly 50 million Americans and is the most common skin disorder in the United States, according to the American Academy of Dermatology.

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UTIs are a key reason we're often told to wipe from front to back after using the bathroom. That's because the urethra -- the tube that transports urine from the bladder to the outside of the body -- is located close to the anus. Bacteria from the large intestine, such as E. coli, are in the perfect position to escape the anus and invade the urethra. From there, they can travel up to the bladder, and if the infection isn't treated, continue on to infect the kidneys. Women may be especially prone to UTIs because they have shorter urethras, which allow bacteria quick access to the bladder. Having sex can introduce bacteria into the urinary tract, too.

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The cause of a blemish is the clogging of pores with dead skin cells and excessive oil, which results in acne. When this happens in the upper layers of the epidermis, we get whiteheads and blackheads.

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As one of the trickiest, painful and most annoying skin issues, dealing with acne and breakouts is no easy feat. But before you go slathering on all of the spot treatments you can find, it's important to understand how your breakouts form and what can cause them.

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Blisters is very painful to experience blister over the tongue as this does not allow us to have our food in a comfortable way. Even it becomes very hard to get the taste of every food we intake as the pain becomes intolerable. The burning sensation can develop if you have unmindfully eaten up a hot food or a hot drink that imperatively have affected the outer layer of the tongue.

The first thing which you should do is spilt away the food or drink which you have taken inside your mouth unmindfully. Since it is burning of a portion of your body, it is important to go ahead with some simple and common first aid before going for a deeper treatment.

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Stomach bloating is so common these days it’s been called an “epidemic.” With most people’s poor diets, high levels of stress, need for daily medications and exposure to various pollutants, it’s no wonder they’re suffering some sort of bloating more days than not.

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A blood blister is a type of blister that forms when subdermal tissues and blood vessels are damaged without piercing the skin. It consists of a pool of lymph, blood and other body fluids trapped beneath the skin. If punctured, it suppurates a dark fluid. Sometimes the fluids are cut off from the rest of the body and dry up, leaving behind dead cell material inside the blister with a texture like putty. Some blood blisters can be extremely painful due to bruising where the blister occurred.

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Have you ever felt your fingers and toes going numb? Most of us face this problem once in a while, but if this numbness becomes an everyday thing for you, you need help. Blood serves several important functions in the body. It provides oxygen and nutrients to every cell and organ in the body. It balances body temperature, providing warmth to the fingers, nose and toes.

Poor blood circulation is much more unpleasant than it sounds. It occurs when the blood flow becomes restricted to certain parts of the body like heart, legs, hands, toes, feet and fingers. In mild situations, poor blood circulation causes only discomfort. But if not handled in time, it can lead to several other serious health conditions. The health problems caused due to poor blood circulation include varicose veins, kidney issue and other blood restriction difficulties.

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Hyperthyroidism occurs when your thyroid produces too much of the hormone thyroxine. ... An excess of this hormone can cause your body's metabolism to increase, which leads to a rising body temperature. Graves' disease is the most common cause of hyperthyroidism

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Body odour is the unpleasant smell produced by bacteria on the skin that break down the acids in your sweat. The medical term is bromhidrosis. Anyone who has reached puberty can produce body odour, as this is when the apocrine sweat glands develop, which produce the sweat that bacteria can quickly break down.

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A boil is a localized infection in the skin that begins as a reddened, tender area. Over time, the area becomes firm, hard, and increasingly tender. Eventually, the center of the boil softens and becomes filled with infection-fighting white blood cells from the bloodstream to eradicate the infection. This collection of white blood cells, bacteria, and proteins is known as pus. Finally, the pus "forms a head," which can be surgically opened or may spontaneously drain out through the surface of the skin. Pus enclosed within tissue is referred to as an abscess. A boil is also referred to as a skin abscess. Boils can occur anywhere on the body, including the trunk, extremities, buttocks, groin, or other areas.

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A boil is often caused by an infection within a hair follicle or oil gland. They're usually caused by staph bacteria, which are naturally present on your skin. Boils can develop anywhere on your body, but are commonly found in places on the body where there is friction.A boil is often caused by an infection within a hair follicle or oil gland. They're usually caused by staph bacteria, which are naturally present on your skin. Boils can develop anywhere on your body, but are commonly found in places on the body where there is friction.

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Treatment. Although there is no cure for osteoporosis, there are steps you cantake to prevent, slow or stop its progress. In some cases, you may even be able to improve bone density and reverse the disorder to some degree. Getting enough calcium and vitamin D are essential to bone health.

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A bone spur (osteophyte) is a bony growth formed on normal bone. Most people think of something sharp when they think of a "spur," but a bone spur is just extra bone. It's usually smooth, but it can cause wear and tear or pain if it presses or rubs on other bones or soft tissues such as ligaments, tendons, or nerves in the body. Common places for bone spurs include the spine, shoulders, hands, hips, knees, and feet.

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Breast cancer starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. The tumor is malignant (cancer) if the cells can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. Breast cancer occurs almost entirely in women, but men can get breast cancer, too.

Cells in nearly any part of the body can become cancer and can spread to other areas. To learn more about cancer and how all cancers start and spread, see Cancer Basics.

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Oncology rehabilitation for breast cancer. Breast cancer and its treatment may affect your physical functioning and energy. ... Exercise may also help you manage treatment-related fatigue, especially during radiation treatments.

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Breast enlargement is the enlargement of the breasts. It may occur naturally as in mammoplasia or may occur artificially through active intervention. Many women regard their breasts, which are female secondary sex characteristics, as important to their sexual attractiveness, as a sign of femininity that is important to their sense of self. Due to this, when a woman considers her breasts deficient in some respect, she might choose to engage in some activity intended to enhance them

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A breast infection, also known as mastitis, is an infection that occurs within the tissue of the breast. Breast infections are most common among women who are breastfeeding, when bacteria from a baby's mouth enters and infects the breast. This is also known as lactation mastitis.A breast infection, also known as mastitis, is an infection that occurs within the tissue of the breast. Breast infections are most common among women who are breastfeeding, when bacteria from a baby's mouth enters and infects the breast. This is also known as lactation mastitis.

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Breast milk is the milk produced by the breasts (or mammary glands) of a human female to feed a child. Milk is the primary source of nutrition for newborns before they are able to eat and digest other foods; older infants and toddlers may continue to be breastfed, either exclusively or in combination with other foods from around six months of age when solid foods may be introduced.

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Breast pain is any discomfort, tenderness, or pain in the breast or underarm region, and it may occur for a number of reasons. Generally, breast pain is not a sign of breast cancer.Breast pain is any discomfort, tenderness, or pain in the breast or underarm region, and it may occur for a number of reasons. Generally, breast pain is not a sign of breast cancer.

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Breasts develop from embryological tissues, and the high estrogen level in females during puberty causes breasts to start growing bigger.

Breasts are mammary glands composed of layers of different types of tissue, including adipose, glandular and connective tissues. As these tissues have hormone receptors, there is often fluctuation in breast sizes and volumes based on hormonal changes in the body.

As breasts are considered a sign of femininity and beauty, women want their breasts to be perfectly shaped and sized. However, at times the breasts become larger in size, which can be due to several factors including genetics, obesity, pregnancy, breastfeeding, hormonal changes in the body and side effects of certain drugs.

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Onychoschizia or splitting of the fingernails is a common problem seen by dermatologists. The term onychoschizia includes splitting, brittle, soft or thin nails. Onychoschizia is more common in women. Only very rarely are internal disease or vitamin deficiencies the reason (iron deficiency is the most common).

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Age spots are the result of an excess production of melanin, or skin pigment. Doctors don't always know why age spots develop. Skin aging, sun exposure, or other forms of ultraviolet (UV) light exposure, such as tanning beds, are all possible causes.

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Bruises often induce pain, but small bruises are not normally dangerous alone. Sometimes bruises can be serious, leading to other more life-threatening forms of hematoma, such as when associated with serious injuries, including fractures and more severe internal bleeding. The likelihood and severity of bruising depends on many factors, including type and healthiness of affected tissues. Minor bruises may be easily recognized in people with light skin color by characteristic blue or purple appearance (idiomatically described as "black and blue") in the days following the injury.

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The Body's Response to Sports Injury. A bruise or 'contusion' is damage to small blood vessels which causes bleeding within the tissues. A muscle strain is a small tear of muscle fibres and a ligament sprain is a small tear of ligament tissue.The Body's Response to Sports Injury. A bruise or 'contusion' is damage to small blood vessels which causes bleeding within the tissues. A muscle strain is a small tear of muscle fibres and a ligament sprain is a small tear of ligament tissue.

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The kidneys are two bean-shaped organs located on each side of the spine. They’re responsible for filtering out of the blood waste products, excess water, and other impurities. These important organs also control the pH, salt levels, and potassium levels in the body. The kidneys even produce hormones that manage red blood cell production and regulate blood pressure.

A blood urea nitrogen (BUN) test is used to determine how well your kidneys are working. It does this by measuring the amount of urea nitrogen in the blood. Urea nitrogen is a waste product that’s created in the liver when the body breaks down proteins. Normally, the kidneys filter out this waste, and urinating removes it from the body.

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A burning sensation in your feet may be caused by nerve damage in the legs, also called neuropathy. Although many medical conditions can cause burning feet, diabetes is the most common. Most burning feet treatments focus on preventing further nerve damage and reducing pain.

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A burn is a type of injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or radiation. Most burns are due to heat from hot liquids, solids, or fire. While rates are similar for males and females the underlying causes often differ. Among women in some areas, risk is related to use of open cooking fires or unsafe cook stoves. Amongong men, risk is related to the work environments. Alcoholism and smoking are other risk factors. Burns can also occur as a result of self harm or violence between people.

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Cannabidiol—CBD—is a cannabis compound that has significant medical benefits, but does not make people feel “stoned” and can actually counteract the psychoactivity of THC. The fact that CBD-rich cannabis is non-psychoactive or less psychoactive than THC-dominant strains makes it an appealing option for patients looking for relief from inflammation, pain, anxiety, psychosis, seizures, spasms, and other conditions without disconcerting feelings of lethargy or dysphoria.

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Shortness of breath, also known as dyspnea, is a feeling like one cannot breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity", and recommends evaluating dyspnea by assessing the intensity of the distinct sensations, the degree of distress involved, and its burden or impact on activities of daily living. Distinct sensations include effort/work, chest tightness, and air hunger (the feeling of not enough oxygen).

Dyspnea is a normal symptom of heavy exertion but becomes pathological if it occurs in unexpected situations or light exertion. In 85% of cases it is due to asthma, pneumonia, cardiac ischemia, interstitial lung disease, congestive heart failure, chronic obstructive pulmonary disease, or psychogenic causes, such as panic disorder and anxiety. Treatment typically depends on the underlying cause.
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Chilblains are small, itchy swellings on the skin that occur as a reaction to cold temperatures.

They most often affect the body's extremities, such as the toes, fingers, heels, ears and nose.

Chilblains can be uncomfortable, but rarely cause any permanent damage. They normally heal within a few weeks if further exposure to the cold is avoided.

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Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to keep you healthy by doing the jobs listed. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time. Chronic kidney disease may be caused by diabetes, high blood pressure and other disorders. Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.

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Chubby Cheeks is a nursery rhyme about rosy lips, curly hair and lovely blue eyes... But who is this beauty? Sing the song (or read the lyrics below) to find out!

Chubby Cheeks can be used with both boys and girls, but it actually a typical "girlish" nursery rhyme. Why not use it as a mother-daughter-thing? Try to sing "Chubby Cheek" loud next time you are driving car with your daughter? Or sing it and dance next time you are hoime alone? Good luck - and enjoy!

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Colic is uncontrollable crying in an otherwise healthy baby. Your baby is considered colicky if he’s younger than 5 months old and cries for more than three hours in a row on three or more days a week for at least three weeks (phew!). Colic isn't a disease and won't cause your baby any long-term harm, but it's a tough thing to go through for babies and their parents.

If your baby is colicky, find more than 20 sanity-saving tips to help you deal with it in our article about coping with colic.

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Some couples are almost desperate to conceive a baby of one particular gender. Fathers especially, can be eager to have a boy but there are also mothers who long for a son. Most couples however, are happy with either a boy or a girl baby, as long as it is healthy and strong. But if you are keen to try to sway the odds of having a boy then there is no harm in trying. Just remember that there are no guarantees and the odds of conceiving a boy or a girl are almost exactly the same for each and every pregnancy.

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Scabies, previously known as the seven-year itch, is a contagious skin infestation by the mite Sarcoptes scabiei. The most common symptoms are severe itchiness and a pimple-like rash. Occasionally, tiny burrows may be seen in the skin. In a first ever infection a person will usually develop symptoms in between two and six weeks. During a second infection symptoms may begin in as little as 24 hours. These symptoms can be present across most of the body or just certain areas such as the wrists, between fingers, or along the waistline. The head may be affected, but this is typically only in young children. The itch is often worse at night. Scratching may cause skin breakdown and an additional bacterial infection of the skin.

Scabies is caused by infection with the female mite Sarcoptes scabiei var. hominis. The mites burrow into the skin to live and deposit eggs. The symptoms of scabies are due to an allergic reaction to the mites. Often, only between 10 and 15 mites are involved in an infection. Scabies is most often spread during a relatively long period of direct skin contact with an infected person (at least 10 minutes) such as that which may occur during sex. Spread of disease may occur even if the person has not developed symptoms yet. Crowded living conditions, such as those found in child-care facilities, group homes, and prisons, increase the risk of spread. Areas with a lack of access to water also have higher rates of disease. Crusted scabies is a more severe form of the disease. It typically only occurs in those with a poor immune system and people may have millions of mites, making them much more contagious. In these cases, spread of infection may occur during brief contact or by contaminated objects. The mite is very small and usually not directly visible. Diagnosis is based on the signs and symptoms.
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Pulmonary fibrosis (literally "scarring of the lungs") is a respiratory disease in which scars are formed in the lung tissues, leading to serious breathing problems. Scar formation, the accumulation of excess fibrous connective tissue (the process called fibrosis), leads to thickening of the walls, and causes reduced oxygen supply in the blood. As a consequence patients suffer from perpetual shortness of breath.

In some patients the specific cause of the disease can be diagnosed, but in others the probable cause cannot be determined, a condition called idiopathic pulmonary fibrosis. There is no known cure for the scars and damage in the lung due to pulmonary fibrosis.
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Prediabetes is the precursor stage before diabetes mellitus in which not all of the symptoms required to diagnose diabetes are present, but blood sugar is abnormally high. This stage is often referred to as the "grey area." It is not a disease; the American Diabetes Association says, "Prediabetes should not be viewed as a clinical entity in its own right but rather as an increased risk for diabetes and cardiovascular disease (CVD). Prediabetes is associated with obesity (especially abdominal or visceral obesity), dyslipidemia with high triglycerides and/or low HDL cholesterol, and hypertension." It is thus a metabolic diathesis or syndrome, and it usually involves no symptoms and only high blood sugar as the sole sign.

Impaired fasting blood sugar and impaired glucose tolerance are two forms of prediabetes that are similar in clinical definition (glucose levels too high for their context) but are physiologically distinct. Insulin resistance, the insulin resistance syndrome (metabolic syndrome or syndrome X), and prediabetes are closely related to one another and have overlapping aspects.
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A fold of fat that some people have under their chin and that looks like a second chin

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A small sore situated on the face or in the mouth that causes pain, burning, or itching before bursting and crusting over. The favorite locations are on the lips, chin or cheeks and in the nostrils. Less frequented sites are the gums or roof of the mouth (the palate).

Fever blisters are caused by herpes simplex virus type 1. It lies latent (dormant) in the body and is reawakened (reactivated) by factors such as stress, sunburn, or fever from a wide range of infectious diseases including colds. Recurrences are less common after age 35. Sunscreen (SPF 15 or more) on the lips prevents recurrences of herpes from sunburn.

The virus is highly contagious when fever blisters are present. It is spread by kissing. Children become infected by contact with someone who has a fever blister and then they spread the virus by rubbing their cold sore and touching other children. A person with fever blisters should be careful not to touch the blisters and spread the virus to new sites, such as the eyes or genitals.

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Fibroids are the most frequently seen tumors of the female reproductive system. Fibroids, also known as uterine myomas, leiomyomas, or fibromas, are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. It is estimated that between 20 to 50 percent of women of reproductive age have fibroids, although not all are diagnosed. Some estimates state that up to 30 to 77 percent of women will develop fibroids sometime during their childbearing years, although only about one-third of these fibroids are large enough to be detected by a health care provider during a physical examination.

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Fibromyalgia: A disease characterized by chronic pain, stiffness, and tenderness of muscles, tendons, and joints, without detectable inflammation. Fibromyalgia does not cause body damage or deformity. However, undue fatigue plagues 90 percent of patients with fibromyalgia. Sleep disorder is also common in patients with fibromyalgia. Fibromyalgia can be associated with other rheumatic conditions, and irritable bowel syndrome (IBS) can occur with fibromyalgia. There is no definitive medical test for the diagnosis of fibromyalgia, so diagnosis is made by eliminating other possible causes of the symptoms. The most effective treatment is a combination of education, stress reduction, exercise, and medication. Formerly known as fibrositis.


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A blister is a small pocket of body fluid (lymph, serum, plasma, blood, or pus) within the upper layers of the skin, typically caused by forceful rubbing (friction), burning, freezing, chemical exposure or infection. Most blisters are filled with a clear fluid, either serum or plasma.[1] However, blisters can be filled with blood (known as "blood blisters") or with pus (if they become infected).

The word "blister" entered English in the 14th century. It came from the Middle Dutch "bluyster" and was a modification of the Old French "blostre", which meant a leprous nodule—a rise in the skin due to leprosy. In dermatology today, the words vesicle and bulla refer to blisters of smaller or greater size, respectively.

To heal properly, a blister should not be popped unless medically necessary. If popped, the excess skin should not be removed because the skin underneath needs that top layer to heal properly.

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Have you ever noticed how the skin on your elbows and knees is often darker than the rest of the skin on your arms and legs? It's a bit funny-looking, isn't it? Some people think it's the result of dirt (and sometimes it is), but you'd be surprised to find that dirt often has nothing to do with the dark spots on your elbows and knees.

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Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel.


With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain a normal glucose level.

More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There's no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy.


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Gynecomastia is enlargement of the glandular tissue of the male breast.
The condition may occur during infancy and puberty in normally-developing boys.
Gynecomastia results from an imbalance in the hormonal environment in the body, with a relative excess of estrogens (female hormones) when compared to androgens (male hormones).

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Cystic fibrosis is an inherited disorder that causes severe damage to the lungs, digestive system and other organs in the body.


Cystic fibrosis affects the cells that produce mucus, sweat and digestive juices. These secreted fluids are normally thin and slippery. But in people with cystic fibrosis, a defective gene causes the secretions to become sticky and thick. Instead of acting as a lubricant, the secretions plug up tubes, ducts and passageways, especially in the lungs and pancreas.


Although cystic fibrosis requires daily care, people with the condition are usually able to attend school and work, and often have a better quality of life than people with cystic fibrosis had in previous decades. Improvements in screening and treatments mean people with cystic fibrosis now may live into their mid- to late 30s, on average, and some are living into their 40s and 50s.

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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).


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Mosquito bites are the itchy bumps that appear after mosquitoes use their mouthparts to puncture your skin and feed on your blood. The bump usually clears up on its own in a few days. Occasionally a mosquito bite causes a large area of swelling, soreness and redness. This type of reaction, most common in children, is sometimes referred to as skeeter syndrome.

Bites from mosquitoes carrying certain viruses or parasites can cause severe illness. Infected mosquitoes in many parts of the world transmit West Nile virus to humans. Other mosquito-borne infections include yellow fever, malaria and some types of brain infection (encephalitis).

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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.



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An individual’s blood type is determined by the genes inherited from his/her parents. 


Whether your blood type is common, rare, or somewhere in between, your donations are vital in maintaining a good supply of that blood type in your community. To save and improve the lives of individuals living there who are in need. 


Therefore, keep doing the noble job of blood donation regularly and register your name for a good cause.


Read Also: B Negative Blood

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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).


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Your child may bite his nails for any number of reasons – curiosity, boredom, stress relief, habit, or imitation. Nail-biting is the most common of the so-called "nervous habits," which include thumb-sucking, nose picking, hair twisting or tugging, and teeth grinding.

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As an O Positive donor you are incredibly important to maintaining the blood supply in our community. O Positive is the most common blood type and therefore needed by so many patients.

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 O+ blood (approximately 37.4% of the population).


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A blood donation occurs when a person voluntarily has blood drawn and used for transfusions and/or made into biopharmaceutical medications by a process called fractionation (separation of whole-blood components). Donation may be of whole blood (WB), or of specific components directly (the latter called apheresis). Blood banks often participate in the collection process as well as the procedures that follow it.

Today in the developed world, most blood donors are unpaid volunteers who donate blood for a community supply. In poorer countries, established supplies are limited and donors usually give blood when family or friends need a transfusion (directed donation). Many donors donate as an act of charity, but in countries that allow paid donation some donors are paid, and in some cases there are incentives other than money such as paid time off from work. Donors can also have blood drawn for their own future use (autologous donation). Donating is relatively safe, but some donors have bruising where the needle is inserted or may feel faint.

Potential donors are evaluated for anything that might make their blood unsafe to use. The screening includes testing for diseases that can be transmitted by a blood transfusion, including HIV and viral hepatitis. The donor must also answer questions about medical history and take a short physical examination to make sure the donation is not hazardous to his or her health. How often a donor can donate varies from days to months based on what component they donate and the laws of the country where the donation takes place. For example, in the United States, donors must wait eight weeks (56 days) between whole blood donations but only seven days between plateletpheresis donations and twice per seven-day period in plasmapheresis.

The amount of blood drawn and the methods vary. The collection can be done manually or with automated equipment that takes only specific components of the blood. Most of the components of blood used for transfusions have a short shelf life, and maintaining a constant supply is a persistent problem. This has led to some increased interest in autotransfusion, whereby a patient's blood is salvaged during surgery for continuous reinfusion—or alternatively, is "self-donated" prior to when it will be needed. (Generally, the notion of "donation" does not refer to giving to one's self, though in this context it has become somewhat acceptably idiomatic.)

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Vocational rehabilitation services are based on individual needs and defined as any goods or services an individual might need to be employable, such as assistive technology devices and services. For instance, a person who is blind would need screen reading software to access a computer and people with a cognitive or mental disability might need a talking electronic reminder device programmed to prompt them when it is time to perform certain tasks.

Vocational rehabilitation can be provided by private organizations, but is not typically funded under managed care arrangements. Thus, most people apply to state vocational rehabilitation agencies that are funded through federal and state monies. Typically, state agencies have offices in their state's major cities and towns. State VR agencies do not necessarily offer the same services or deliver services in the same way in every state, so individuals seeking services must learn how to access the VR program in their own state. The federal VR component is administered by the U.S. Department of Education Rehabilitation Services Administration and authorized by the Rehabilitation Act of 1973 as amended in the 1988 reauthorization.Most vocational rehabilitation services are free for eligible applicants; however, applicants may be asked to use other benefits, such as: insurance, Pell grants or other financial aid for training or higher education, to pay part of program costs.

Best practices in vocational rehabilitation include individual choice, person-centered planning, integrated setting, natural supports, rapid placement, and career development. The term integrated setting refers to placing individuals in usual employment situations rather than making placements into sheltered workshops or other segregated settings. Natural supports are the person's already existing support network, including family members, service providers, and friends, who can help the person reach a goal, such as the employment of their choice. Person-centered planning is a technique in which a plan for a person's future is developed by a team consisting of the person and his or her natural supports, and the team develops a practical plan based on the person's wishes and dreams. Each teammember agrees to perform certain tasks identified in the plan to help the person reach goals. Unfortunately, not all VR programs incorporate all of these best practices.


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Vision rehabilitation is the process of treatment and education that helps individuals who are visually disabled attain maximum function, a sense of well being, a personally satisfying level of independence, and optimum quality of life. Function is maximized by evaluation, diagnosis and treatment including, but not limited to, the prescription of optical, non-optical, electronic and/or other treatments. The rehabilitation process includes the development of an individual rehabilitation plan specifying clinical therapy and/or instruction in compensatory approaches.

Vision rehabilitation may be necessitated by any condition, disease, or injury that causes a visual impairment which results in functional limitation or disability. In addition to the evaluation, diagnosis and management of visual impairment by an eye care physician (optometrist or ophthalmologist), vision rehabilitation may include, but is not limited to, optometric, medical, allied health, social, educational and psychological services.

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Psychosocial rehabilitation (also termed psychiatric rehabilitation or PSR) promotes personal recovery, successful community integration and satisfactory quality of life for persons who have a mental illness or mental health concern.  Psychosocial rehabilitation services and supports are collaborative, person directed, and individualized, and an essential element of the human services spectrum.  They focus on helping individuals develop skills and access resources needed to increase their capacity to be successful and satisfied in the living, working, learning and social environments of their choice and include a wide continuum of services and supports.  (PSR/RPS Canada, 2013)

PSR approaches are evidence-based best and promising practices in the key life domains of Employment, Education, Leisure, Wellness and Basic Living Skills as well as Family Involvement and Peer Support and Peer Delivered services. Because of their demonstrated effectiveness and recovery orientation, these approaches should be widely available to people living with long term mental illness and/or substance use problems.

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By definition, physical therapy is a unique science and art that utilizes a wide variety of procedures to restore function to the body, reduce pain and help prevent future injury. When daily life is altered due to an injury, accident, chronic medical condition or re-injury, we realize we are responsible for helping to put our patients' lives back on course and help each individual get back to life.Physical therapy utilizes a variety of evidence-based treatments, physical exercises and hands-on modalities to begin the rehabilitation process at the onset of injury or pain.


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Physical medicine and rehabilitation (PM&R), also known as physiatry or rehabilitation medicine, aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons. A physician having completed training in this field is referred to as a physiatrist. Unlike other medical specialties that focus on a medical “cure,” the goals of the physiatrist are to maximize patients’ independence in activities of daily living and improve quality of life.

Physiatrists are experts in designing comprehensive, patient-centered treatment plans, and are integral members of the care team. They utilize cutting-edge as well as time-tested treatments to maximize function and quality of life for their patients, who can range in age from infants to octogenarians.

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Occupational rehabilitation is the process of restoring function to injured workers so they can return to work. Rehabilitation professionals assess the needs of the person and the demands of the workplace in order to develop a plan of action to get the employee back to work that is suitable and safe for him as soon as possible. Depending on the type of injury, the individual may have to be trained in a new line of work.

A number of professionals are involved in the practice of occupational rehabilitation. Doctors, physiotherapists, occupational therapists, psychologists and massage therapists all have a different role in the rehabilitation of injured workers. Some of the problems treated by these clinicians are amputations, overuse injuries, back pain, neck pain, headaches, fractures, spinal cord injuries, and a host of other injuries.

Increased computer usage has resulted in a growing number of people seeking occupational rehabilitation because of common overuse conditions such as carpal tunnel syndrome, tendonitis, as well as problems brought on by poor sustained postures such as thoracic outlet syndrome or cervical headaches. Other common work injuries are lower back problems such as intervertebral disc bulges especially among those who work with heavy machinery. Physiotherapists and occupational therapists work together to improve the employee's posture (standing as well as sitting), the ergonomics of the work place and the way the individual performs his duties. Many problems like shoulder, back and neck pain, which were believed to be chronic, have been improved by making adjustments in workplace ergonomics and posture and through exercise programmes to restore correct muscle balance and joint alignment.

Active rehabilitation programmes in gym-based settings are a proactive way to rehabilitate injured workers. Once the initial injury has been treated by the physiotherapist in the clinic, many physiotherapists are now designing and supervising exercise programmes in local gymnasiums. These exercise programmes aim to accelerate the return of strength and function of the injured workers and prevent re-injury on their return to work, often with excellent results. Many patients finish the rehabilitation programmes stronger and fitter than before they were even injured and with a renewed passion for exercise!

By participating in active rehabilitation, injured workers can prevent loss of wages due to injuries and can enjoy a more productive working environment. Employers can preserve their bottom line by avoiding decreased man-hours and ongoing medical expenses. With a physiotherapy prescribed rehabilitation programme everyone benefits.

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Drug rehabilitation (often drug rehab or just rehab) is the processes of medical or psychotherapeutic  treatment for dependency on psychoactive substances such as alcohol, prescription drugs, and street drugs such as cocaine, heroin or amphetamines. The general intent is to enable the patient to confront substance dependence, if present, and cease substance abuse to avoid the psychological, legal, financial, social, and physical consequences that can be caused, especially by extreme abuse. Treatment includes medication for depression or other disorders, counseling by experts and sharing of experience with other addicts.


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The goal of wildlife rehabilitation is to provide professional care to sick, injured, and orphaned wild animals so ultimately they can be returned to their natural habitat. Wild animals that sustain injuries or illnesses preventing them from living successfully in the wild usually are euthanized (have their suffering ended in a humane fashion). Occasionally, individual animals that have recovered from their injuries but are not able to survive in the wild are placed in educational facilities.

Wildlife rehabilitation is not an attempt to turn wild animals into pets. Patients are held in captivity only until able to live independently in the wild. Fear of humans is a necessary survival trait for wild animals and every effort is made to minimize human contact and prevent the taming of rehabilitation patients. Often wildlife rehabilitation is an elaborate and time-consuming process.

Wildlife rehabilitators work with veterinarians to assess injuries and diagnose a variety of illnesses. Due to the important differences between wild animals and domestic animals, rehabilitators need extensive knowledge about the species in care, including natural history, nutritional requirements, behavioral issues, and caging considerations. They also need to understand any dangers the animals may present to rehabilitators. Rehabilitators must also be able to administer basic first aid and physical therapy, and understand any dangers the animals may present to rehabilitators.

Almost all birds are protected by federal law; state laws protect most other kinds of wildlife. To work with mammals, reptiles, and amphibians, wildlife rehabilitators must be issued special permits from their state wildlife agencies. Before receiving these permits, individuals must meet various requirements such as specialized training, participation in mentorship programs, facility inspections, and written or oral exams. Rehabilitators who wish to care for birds also must get permits from the US Fish & Wildlife Service. Once they receive the permits, conscientious rehabilitators continue their education by attending conferences, seminars, and workshops, keeping up with published literature, and networking with others in the field. 



Because of their training, wildlife rehabilitators can help concerned people decide whether an animal truly needs help. Young birds and mammals should be returned to their families if at all possible; even well trained rehabilitators are not equivalent replacements for biological parents. Rehabilitators can provide instructions on how to reunite wildlife families, keeping the safety of the animals and the rescuers in mind, and they can suggest humane, long-term solutions when conflicts arise between humans and their wild neighbors. 



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Rehabilitation of sensory and cognitive function typically involves methods for retraining neural pathways or training new neural pathways to regain or improve neurocognitive functioning that has been diminished by disease or trauma. Three common neuropsychological problems treatable with rehabilitation are attention deficit/hyperactivity disorder (ADHD), concussion, and spinal cord injury. Rehabilitation research and practices are a fertile area for clinical neuropsychologists and others.


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Bleeding from the blood vessels of the nose. The nose is rich in blood vessels and is situated in a vulnerable position on the face. As a result, any trauma to the face can cause bleeding, which may be profuse. Nosebleeds can also occur spontaneously when the nasal membranes dry out, crust, and crack, as is common in dry climates or during winter months, when the air is dry and warm from household heaters. People have increased susceptibility to nosebleeds if they are taking medications that prevent normal blood clotting, such as warfarin (brand name: Coumadin), aspirin, or any anti-inflammatory medication. Other predisposing factors include infection, trauma, allergic and nonallergic rhinitis, hypertension, alcohol abuse, and inherited bleeding problems. Also known as epistaxis.

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Numbness in one or both hands describes a loss of sensation or feeling in your hand or fingers. Often, hand numbness may be accompanied by other changes, such as a pins-and-needles sensation, burning or tingling. Your arm, hand or fingers may feel clumsy or weak.

Numbness can occur along a single nerve in one hand, or it may occur symmetrically in both hands.

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Obesity traditionally has been defined as a weight at least 20% above the weight corresponding to the lowest death rate for individuals of a specific height, gender, and age (ideal weight). Twenty to forty percent over ideal weight is considered mildly obese; 40-100% over ideal weight is considered moderately obese; and 100% over ideal weight is considered severely, or morbidly, obese. More recent guidelines for obesity use a measurement called BMI (body mass index) which is the individual's weight multiplied by 703 and then divided by twice the height in inches. BMI of 25.9-29 is considered overweight; BMI over 30 is considered obese. Measurements and comparisons of waist and hip circumference can also provide some information regarding risk factors associated with weight. The higher the ratio, the greater the chance for weight-associated complications. Calipers can be used to measure skin-fold thickness to determine whether tissue is muscle (lean) or adipose tissue (fat).
Much concern has been generated about the increasing incidence of obesity among Americans. Some studies have noted an increase from 12% to 18% occurring between 1991 and 1998. Other studies have actually estimated that a full 50% of all Americans are overweight. The World Health Organization terms obesity a worldwide epidemic, and the diseases which can occur due to obesity are becoming increasingly prevalent.
Excessive weight can result in many serious, potentially life-threatening health problems, including hypertension, Type II diabetes mellitus (non-insulin dependent diabetes), increased risk for coronary disease, increased unexplained heart attack, hyperlipidemia, infertility, and a higher prevalence of colon, prostate, endometrial, and, possibly, breast cancer. Approximately 300,000 deaths a year are attributed to obesity, prompting leaders in public health, such as former Surgeon General C. Everett Koop, M.D., to label obesity "the second leading cause of preventable deaths in the United States."

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When You wake up with a stench of onion still on your breath and cant get rid of it all day, even after plentiful brushing of teeth.

When you eat foodage containing onion and cannot get rid of the stench from your breath.

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If you have ever experienced any pain in your neck or back, you’ve probably heard the term “pinched nerve.” In fact, if you have seen a doctor about neck or back pain that did not go away on its own after a few weeks, you’ve probably been diagnosed with a spinal pinched nerve. A pinched nerve is often the result of any type of degenerative spine condition that causes pain and other symptoms. Though this is a common occurrence for most people at some point in their lives, a pinched nerve can be difficult to treat because there are so many potential causes for nerve compression.


The best thing you can do when you start to develop pain that you believe comes from a pinched nerve is to schedule an appointment with your doctor. If diagnosed in time, you may be able to find pain relief with several weeks or months of conservative treatment. Take a moment to read below about what causes a pinched nerve and some warning signs you should be aware of to know whether or not you should see a doctor.

As part of the body’s nervous system, nerves branch out from the brain and spinal cord to carry instructions to every area of the body. Essentially, the nerves are like electrical wires that allow signals to travel from the brain to the spinal cord to the organs and extremities, and back again.

Nerves within the brain and spinal cord are part of the central nervous system, while nerves that run from the spine to other areas of the body are called peripheral nerves. The peripheral nerves originate as nerve roots that exit the spinal cord and then branch off to spread throughout the body. The nerves that travel to muscles allow the muscles to move. Nerves also pass to the skin, providing the ability to feel.


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An unreasonable sort of fear that can cause avoidance and panic. Phobias are a relatively common type of anxiety disorder. Phobias can be treated with cognitive behavioral therapy, using exposure and fear-reduction techniques. In many cases, antianxiety or antidepressant medication proves helpful, especially during the early stages of therapy.

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IBS affects between 25 and 45 million Americans. Most of them are women. People are most likely to get the condition in their late teens to early 40s.

IBS is a mix of belly discomfort or pain and trouble with bowel habits: either going more or less often than normal (diarrhea or constipation) or having a different kind of stool (thin, hard, or soft and liquid).

It’s not life-threatening, and it doesn't make you more likely to get other colon conditions, such as ulcerative colitis, Crohn's disease, or colon cancer. But IBS can be a long-lasting problem that changes how you live your life. People with IBS may miss work or school more often, and they may feel less able to take part in daily activities. Some people may need to change their work setting: shifting to working at home, changing hours, or even not working at all.


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Probiotics are the latest health obsession thanks to their seemingly endless list of health benefits. But the hype may be warranted; these friendly bacteria are the real deal. Various probiotic strains have been shown to support the gastrointestinal (GI) tract, prevent inflammation, boost immunity and alleviate conditions ranging from allergies to diarrhea, although more research needs to be done to sort out specific strains, outcomes and dosages. “Conventionally, when people hear about probiotics, they typically think of yogurt or supplements,” says Dr. B.J. Hardick, founder of the Centre for Maximized Living in London, Ontario. “Most people are unfortunately unaware of several other incredible -- and typically better -- sources of healthy gut bacteria.” Among those sources is a wide array of cultured and fermented foods. On the next slides, we’ll describe the benefits of 13 probiotic foods – some may surprise you

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Continuing the theme of transitions from some of my  have you noticed that in times of transition (like when summer turns to fall, or winter turns to spring) you are particularly susceptible to feeling off balance? It seems to me that in months like September and June, when there’s a lot of change going on, I hear the phrase, “There’s just not enough time in the day to do everything I need to do…” even more often than most other times of the year.
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A breast rash describes redness and irritation of the skin on your breast. A breast rash can also be itchy, scaly, painful or blistered.

Other terms used to describe a breast rash include dermatitis and hives.

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Razor burn can affect any person who shaves part of their body. If you’ve ever had a red rash after shaving, you were likely experiencing razor burn.

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Sagging breasts is a very common problem and are a natural consequence of aging. The medical term for this condition is ‘Ptosis’ of the breast and the causes are still not clearly defined or understood.

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Metabolic syndrome is a cluster of metabolic risk factors that come together in a single individual. These metabolic factors include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for blood clotting. Affected individuals are most often overweight or obese. An association between certain metabolic disorders and cardiovascular disease has been known since the 1940s.

Metabolic syndrome is considered to be a risk factor for cardiovascular diseases and type 2 diabetes. Insulin resistance refers to the diminished ability of cells to respond to the action of insulin in promoting the transport of the sugar glucose, from blood into muscles and other tissues. Type 2 diabetes is caused by insulin resistance.Metabolic syndrome is also known as syndrome X, insulin resistance syndrome, or dysmetabolic syndrome.


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Inflammation and erythema of the skin, often with blistering, caused by overexposure to the ultraviolet rays of direct sunlight.

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A dark spot refers to a hyper-pigmentation of the skin commonly occurring in middle aged women. Dark spots, aka pigmentations, occur when a localized patch of melanin produced accumulates on a specific area on the skin. It can be located on the forehead, face or cheek bone area. Some dark spots could mean serious skin problems and thus you should consult a dermatologist if you become suspicious. 

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Itching or irritation anywhere on the body can cause discomfort. But when it occurs in an area as sensitive as the vagina and vulva (the labia, clitoris, and vaginal opening), it can be especially uncomfortable. Most genital itching and irritation isn't a major concern. But because they can be symptoms of an infection, it's always a good idea to call your health care provider.

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Your heart is an amazing organ. It continuously pumps oxygen and nutrient-rich blood throughout your body to sustain life. This fist-sized powerhouse beats (expands and contracts) 100,000 times per day, pumping five or six quarts of blood each minute, or about 2,000 gallons per day.

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Heartburn is a sensation of burning in the chest caused by stomach acid backing up into the esophagus (food pipe). The burning is usually in the upper and central part of the chest, just behind the sternum (breast bone). The burning can worsen or can be brought on by lying flat or on the right side. Pregnancy tends to aggravate heartburn.

Many people experience heartburn and there are a large number of over-the-counter (OTC) medications and home remedies available to treat heartburn or the symptoms of heartburn.


In most cases you will not need to see a health-care professional, except if the symptoms are frequent (several times a week) or severe.


If heartburn is severe or the pain is accompanied with additional symptoms such as shortness of breath, radiation into your arms or neck, you will need to see a doctor to distinguish these symptoms from more serious medical conditions such as a heart attack.

GERD (Gastroesophageal reflux disease) is a chronic and more serious form of heartburn.

If your heartburn symptoms occur more than twice a week you should see your health-care professional to make sure no serious problems are present.

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Keratosis pilaris (ker-uh-TOE-sis pih-LAIR-is) is a common, harmless skin condition that causes dry, rough patches and tiny bumps, usually on the upper arms, thighs, cheeks or buttocks. The bumps generally don't hurt or itch.Keratosis pilaris is often considered a variant of normal skin. It can't be cured or prevented. But you can treat it with moisturizers and prescription creams to help improve the appearance of the skin. The condition usually disappears by age 30.


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The oxygen-carrying pigment and predominant protein in the red blood cells. Hemoglobin forms an unstable, reversible bond with oxygen. In its oxygenated state it is called oxyhemoglobin and is bright red. In the reduced state it is called deoxyhemoglobin and is purple-blue.


Each hemoglobin molecule is made up of four heme groups surrounding a globin group. Heme contains iron and gives a red color to the molecule. Globin consists of two linked pairs of polypeptide chains. The development of each chain is controlled at a separate genetic locus. Changes in the amino acid sequence of these chains results in abnormal hemoglobins. For example, hemoglobin S is found in sickle-cell disease, a severe type of anemia in which the red cells become sickle-shaped when oxygen is in short supply.


When red blood cells die, the hemoglobin within them is released and broken up: the iron in hemoglobin is salvaged, transported to the bone marrow by a protein called transferrin and used again in the production of new red blood cells; the remainder of the hemoglobin becomes a chemical called bilirubin that is excreted into the bile which is secreted into the intestine, where it gives the feces their characteristic yellow-brown color.

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Liver

The liver is a large organ on the upper right side of your torso, opposite the stomach and behind the ribcage. One of its main functions is to make a substance called bile (composed mostly of bilirubin, bile salts, and cholesterol) that is required to digest food in the small intestine.


The liver is divided into two sections: a right lobe and a left lobe. Both lobes are made up of cells called hepatocytes. These cells produce bile and secrete it into the bile ducts, which carry bile to the gallbladder where it is stored until used by the small intestine.


Gallbladder and Bile Ducts

The gallbladder is a pear-shaped sac under the right lobe of the liver. Between meals, it stores and concentrates bile, which is produced at a constant rate by the liver. When it is not full of bile, the gallbladder is about 3 inches long and 1 inch wide at its thickest part.


After meals, the gallbladder releases bile into the duodenum to aid with digestion. The cystic duct carries bile from the gallbladder to the common bile duct, which empties into the duodenum. Entry of bile into the duodenum is regulated by layers of muscle called the sphincter of Oddi.


Between meals, the sphincter of Oddi closes and prevents bile from entering the duodenum. During and after meals, this sphincter opens and allows bile to enter the duodenum.


Pancreas

The pancreas is a long, thin gland that lies horizontally behind the bottom part of your stomach. It makes digestive enzymes that flow through the pancreatic duct to the small intestine. These enzymes, along with bile from the gallbladder, break down food for use as energy by the body. The pancreas also makes insulin and glucagon, hormones that help regulate blood glucose (sugar) levels.


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The pathophysiology of lower back pain is a source of fascination, frustration, and, often, confusion by clinicians and scientists who both treat and study patients who have this problem. The statement that we do not know the origin of low back pain in the majority of cases has become a mantra to any introduction to the topic. The Agency for Health Care Policy and Research (AHCPR) Guidelines on Low Back Problems and similar guidelines in other countries have given up on attempts to define the origin of the pain in patients who have this problem and have instead resorted to differentiating between so-called Red Flag pathologic conditions and patients who have nonspecific low back pain, with or without leg symptoms.


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Low blood pressure might seem desirable, and for some people, it causes no problems. However, for many people, abnormally low blood pressure (hypotension) can cause dizziness and fainting. In severe cases, low blood pressure can be life-threatening.

A blood pressure reading lower than 90 millimeters of mercury (mm Hg) for the top number (systolic) or 60 mm Hg for the bottom number (diastolic) is generally considered low blood pressure.

The causes of low blood pressure can range from dehydration to serious medical or surgical disorders. It's important to find out what's causing your low blood pressure so that it can be treated.


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A breast infection, also known as mastitis, is an infection that occurs within the tissue of the breast. Breast infections are most common among women who are breastfeeding, when bacteria from a baby’s mouth enters and infects the breast. This is also known as lactation mastitis. Mastitis also occurs in women who aren’t breastfeeding, but this is not as common.Infection typically affects the fatty tissue in the breast, causing swelling, lumps, and pain. Although most infections are due to breastfeeding or clogged milk ducts, a small percentage of breast infections are associated with rare kinds of breast cancer.


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Hormonal imbalance occurs when normal levels and production of hormones in the endocrine system, or their ratio to other hormones, is disrupted. When it comes to hormonal imbalance, we tend to focus most on sex hormones related to pregnancy, periods and menopause.

But you have many types of hormones and they control many other functions including metabolism and weight, thyroid function, sleep cycles and your body’s response to stress. Even though all your hormones together form the foundation of your health.

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Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is a chronic condition that you'll need to manage long term.


Only a small number of people with IBS have severe signs and symptoms. Some people can control their symptoms by managing diet, lifestyle and stress. More-severe symptoms can be treated with medication and counseling.


IBS doesn't cause changes in bowel tissue or increase your risk of colorectal cancer.

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On the whole, your immune system does a remarkable job of defending you against disease-causing microorganisms. But sometimes it fails: A germ invades successfully and makes you sick. Is it possible to intervene in this process and boost your immune system? What if you improve your diet? Take certain vitamins or herbal preparations? Make other lifestyle changes in the hope of producing a near-perfect immune response?

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High blood pressure is also known as hypertension. Blood pressure is the amount of force exerted against the walls of the arteries as blood flows through them.


In the United States, approximately 85 million people have high blood pressure - about 1 in every 3 adults over 20, according to the American Heart Association (AHA).

The National Institutes of Health (NIH) estimate that about two-thirds of people over the age of 65 in the U.S. have high blood pressure.

If left untreated or uncontrolled, high blood pressure can cause many health problems. These conditions include heart failure, vision loss, stroke, and kidney disease.

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Heavy menstrual bleeding (called menorrhagia by health care professionals) is defined as soaking a pad and/or tampon every hour or less during each menstrual cycle. For many women, heavy menstrual bleeding is a huge obstacle to their lifestyles. Have you ever had to reschedule an activity around your menstrual period? Then, you know the toll it can take. You may not know that heavy bleeding can be more than a schedule buster. The heavy bleeding can also lead to iron-deficient anemia, the most common health-related threat of menorrhagia. While most cases of anemia are easily treated with oral iron supplements, sometimes the bleeding is so severe a woman's entire volume of blood drops, leading to shortness of breath, severe fatigue and heart palpitations that require hospitalization.


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Making the right diagnosis, finding a mental health professional and obtaining health insurance coverage are the main challenges families face. Many insurers do not provide equal benefits for mental health services as they do for other general medical services. There are often long waiting lists to receive quality services. Patients who have a "dual diagnosis" of developmental and/or medical conditions along with their mental health condition seem to have the most difficulty finding appropriate services.Cincinnati Children's has compiled a list of Greater Cincinnati and national resources that provide mental health services.

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Here's a secret: slaving away inside your body—right this minute—is your very own personal trainer working tirelessly to help you burn calories and shed fat. It's called your metabolism, and it's the sum of everything your body does. Each time you eat, enzymes in your body's cells break down the food and turn it into energy that keeps your heart beating, your mind thinking, and your legs churning during a grueling workout. A fast metabolism means more calories burned. The more you burn, the easier it is to drop pounds. And get this—you can make increase you metabolism so it works harder, a lot harder, 24 hours a day.To some degree, our bodies hum along at a preset speed determined by gender and genetics, but there's still plenty of wiggle room. "You have a huge amount of control over your metabolic rate," says John Berardi, Ph.D., C.S.C.S., author of The Metabolism Advantage. "You can't affect how many calories it takes to keep your heart beating, but you can burn an extra 500 to 600 calories a day by exercising properly and eating right." And by making a few changes to your routine.To make those changes simpler, we enlisted the help of leading experts and came up with a round-the-clock, turn-up-the-burn plan complete with new moves that will throw that slow metabolism into overdrive.


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Nutrition & Metabolism publishes studies with a clear focus on nutrition and metabolism with applications ranging from nutrition needs, exercise physiology, clinical and population studies, as well as the underlying mechanisms in these aspects.The areas of interest for Nutrition & Metabolism encompass studies in molecular nutrition in the context of obesity, diabetes, lipedemias, metabolic syndrome and exercise physiology. Manuscripts related to molecular, cellular and human metabolism, nutrient sensing and nutrient–gene interactions are also in interest, as are submissions that have employed new and innovative strategies like metabolomics/lipidomics or other omic-based biomarkers to predict nutritional status and metabolic diseases


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Newborn jaundice is a yellowing of a baby’s skin and eyes. Newborn jaundice is very common and can occur when babies have a high level of bilirubin, a yellow pigment produced during normal breakdown of red blood cells. In older babies and adults, the liver processes bilirubin, which then passes it through the intestinal tract. However, a newborn’s still-developing liver may not be mature enough to remove bilirubin.


The good news is that in most cases, newborn jaundice goes away on its own as a baby’s liver develops and as the baby begins to feed, which helps bilirubin pass through the body.


In most cases, jaundice will disappear within 2 to 3 weeks. Jaundice that persists longer than three weeks may be a symptom of an underlying condition. Additionally, high levels of bilirubin can put a baby at risk for deafness, cerebral palsy, or other forms of brain damage. That’s why the American Academy of Pediatrics (AAP) recommends that all newborn babies be examined for jaundice every time their vital signs are measured (or at least every 8 to 12 hours), before discharge from the hospital, and again a few days after discharge.

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Botulism (or botulism poisoning) is a rare but very serious illness that transmits through food, contact with contaminated soil, or through an open wound. Without early treatment, botulism can lead to paralysis, breathing difficulties, and death.

There are three main types of botulism:

    infant botulism
    foodborne botulism
    wound botulism

Botulism poisoning is due to a toxin produced by a type of bacteria called Clostridium botulinum. Although very common, these bacteria can only thrive in conditions where there’s no oxygen. Certain food sources, such as home-canned foods, provide a potent breeding ground.

According to the Centers for Disease Control and Prevention (CDC), about 145 cases of botulism are reported every year in the United States. About 3 to 5 percent of those with botulism poisoning die.

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Rabies is a viral illness spread via the saliva of an infected animal. This occurs usually through biting a human or another animal. Transmission can also occur through saliva touching an open wound or touching mucous membranes.

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Bedwetting, or nocturnal enuresis, refers to the unintentional passage of urine during sleep. Enuresis is the medical term for wetting, whether in the clothing during the day or in bed at night. Another name for enuresis is urinary incontinence.
For infants and young children, urination is involuntary. Wetting is normal for them. Most children achieve some degree of bladder control by 4 years of age. Daytime control is usually achieved first, while nighttime control comes later.

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A bone density test determines if you have osteoporosis — a disorder characterized by bones that are more fragile and more likely to break.

In the past, osteoporosis would be suspected only after you broke a bone. By that time, however, your bones could be quite weak. A bone density test enhances the accuracy of calculating your risk of breaking bones.

A bone density test uses X-rays to measure how many grams of calcium and other bone minerals are packed into a segment of bone. The bones that are most commonly tested are in the spine, hip and sometimes the forearm.

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Liver blood tests are designed to show evidence that abnormalities, for example, inflammation, liver cell damage, has or is occurring within the liver.The blood tests most frequently used for liver disease are the aminotransferases (alanine aminotransferase or ALT and aspartate aminotransferase or AST).Normal levels of ALT ranges from about 7-56 units/liter, and 10-40units/liters for AST.Elevated levels of AST and ALT may signify the level of liver damage in a person.Common causes of elevated ALT and AST areheart failure.

Many drugs may cause elevated AST, and ALT and some medications can cause severe damage (for example, acetaminophen [Tylenol liver damage]).Less common causes of abnormal AST and ALT levels are wide ranging (for example, toxins, and autoimmune diseases)People with mild to moderate elevations of AST and ALT with no or few symptoms should follow-up with their doctor for potential underlying causes of elevated AST and/or ALT.Repeated test levels (monitoring) is useful in some patients (for example, viral-caused and Tylenol-caused elevations) to guide therapeutic treatments.Other liver enzymes, although not measured routinely, may add additional information about liver functions.

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Sleep disorders are a group of conditions that affect the ability to sleep well on a regular basis. Whether they are caused by a health problem or by too much stress, sleep disorders are becoming increasingly common in the United States. In fact, more than 75 percent of Americans between ages 20 and 59 report having sleeping difficulties fairly regularly.

Most people occasionally experience sleeping problems due to stress, hectic schedules, and other outside influences. However, when these issues begin to occur on a regular basis and interfere with daily life, they may indicate a sleeping disorder.

Depending on the type of sleep disorder, people may have a difficult time falling asleep and may feel extremely tired throughout the day. The lack of sleep can have a negative impact on energy, mood, concentration, and overall health.

In some cases, sleep disorders can be a symptom of another medical or mental health condition. These sleeping problems may eventually go away once treatment is obtained for the underlying cause. When sleep disorders aren’t caused by another condition, treatment normally involves a combination of medical treatments and lifestyle changes.

It’s important to receive a diagnosis and treatment right away if you suspect you might have a sleep disorder. When left untreated, the negative effects of sleep disorders can lead to further health consequences. They can also affect your performance at work, cause strain in relationships, and impair your ability to perform daily activities.

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Chances are we have all crossed our legs a time or two in hopes of making it to the closest restroom in time. But there's a big difference between having to go, and always feeling like you have to go. For those who live with bladder spasms, that feeling is a painful reality that can lead to embarrassing wetting accidents and an unwanted shift in lifestyle. However, there are a variety of treatment options available to manage the symptoms. Here's what you need to know about bladder spasms, from the causes to what you can do to ease the pain.


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Primary biliary cirrhosis, sometimes called PBC, is a disease in which the bile ducts in your liver are slowly destroyed. Bile, a fluid produced in your liver, plays a role in digesting food and helps rid your body of worn-out red blood cells, cholesterol and toxins.When bile ducts are damaged, as in primary biliary cirrhosis, harmful substances can build up in your liver and sometimes lead to irreversible scarring of liver tissue (cirrhosis).

Primary biliary cirrhosis is considered an autoimmune disease, in which the body turns against its own cells.Researchers think it is triggered by a combination of genetic and environmental factors. Primary biliary cirrhosis usually develops slowly and medication can slow its progression, especially if treatment begins early.


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Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. This disease is characterized by increasing breathlessness.

Many people mistake their increased breathlessness and coughing as a normal part of aging. In the early stages of the disease, you may not notice the symptoms. COPD can develop for years without noticeable shortness of breath. You begin to see the symptoms in the more developed stages of the disease. That’s why it is important that you talk to your doctor as soon as you notice any of these symptoms. Ask your doctor about taking a spirometry test.


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Glioblastoma is an aggressive type of cancer that can occur in the brain or spinal cord. Glioblastoma forms from cells called astrocytes that support nerve cells.


Glioblastoma can occur at any age, but tends to occur more often in older adults. It can cause worsening headaches, nausea, vomiting and seizures.


Glioblastoma, also known as glioblastoma multiforme, can be very difficult to treat and a cure is often not possible. Treatments may slow progression of the cancer and reduce signs and symptoms.

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Golfers elbow or medial epicondylitis is an overuse injury similar to tennis elbow (on the outside of the arm) but causing pain on the inside of the elbow instead. It is sometimes known as throwers elbow or little league elbow. We explain the symptoms, causes and treatment to return you back to full fitness in the shortest time.

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Male breast cancer is a rare cancer that forms in the breast tissue of men. Though breast cancer is most commonly thought of as a woman's disease, male breast cancer does occur.Male breast cancer is most common in older men, though it can occur at any age.Men diagnosed with male breast cancerat an early stage have a good chance for a cure. Still, many men delay seeing their doctors if they notice one of the usual signs or symptoms, such as a breast lump. For this reason, many male breast cancers are diagnosed when the disease is more advanced.


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Bladder cancer is one of the most common cancers, affecting approximately 68,000 adults in the United States each year. Bladder cancer occurs in men more frequently than it does in women and usually affects older adults, though it can happen at any age.


Bladder cancer most often begins in the cells (urothelial cells) that line the inside of your bladder — the hollow, muscular organ in your lower abdomen that stores urine. Although it's most common in the bladder, this same type of cancer can occur in other parts of the urinary tract drainage system.


About seven out of every 10 bladder cancers diagnosed start out at an early stage — when bladder cancer is highly treatable. However, even early-stage bladder cancer may recur in the bladder. For this reason, people with bladder cancer typically need follow-up tests for years after treatment to look for bladder cancer that recurs or advances to a higher stage.

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Urinary incontinence — the loss of bladder control — is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time.


Though it occurs more often as people get older, urinary incontinence isn't an inevitable consequence of aging. If urinary incontinence affects your daily activities, don't hesitate to see your doctor. For most people, simple lifestyle changes or medical treatment can ease discomfort or stop urinary incontinence

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The brain is the body organ composed of nerve cells and supportive tissues like glial cells and meninges – there are three major parts – they control your activity like breathing (brain stem), activity like moving muscles to walk (cerebellum) and your senses like sight and our memory, emotions, thinking and personality (cerebrum).

Primary brain tumors can be either malignant (contain cancer cells) or benign (do not contain cancer cells). A primary brain tumor is a tumor which begins in the brain tissue. If a cancerous tumor starts elsewhere in the body, it can spread cancer cells, which grow in the brain. These type of tumors are called secondary or metastatic brain tumors.

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MEdulloblastoma is a cancerous tumor—also called cerebellar primitive neuroectodermal tumor (PNET)—that starts in the region of the brain at the base of the skull, called the posterior fossa. These tumors tend to spread to other parts of the brain and to the spinal cord


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Membranous nephropathy (MEM-bruh-nus nuh-FROP-uh-thee) occurs when the small blood vessels in the kidney (glomeruli), which filter wastes from the blood, become damaged and thickened. As a result, proteins leak from the damaged blood vessels into the urine (proteinuria). For many, loss of these proteins eventually causes signs and symptoms known as nephrotic syndrome.In mild cases, membranous nephropathy may get better on its own, without any treatment. As protein leakage increases, so does the risk of long-term kidney damage. In many, the disease ultimately leads to kidney failure. There's no absolute cure for membranous nephropathy, but successful treatment can lead to remission of proteinuria and a good long-term outlook.


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Hepatitis B is a virus that infects the liver camera.gif. Most adults who get it have it for a short time and then get better. This is called acute hepatitis B.


Sometimes the virus causes a long-term infection, called chronic hepatitis B. Over time, it can damage your liver. Babies and young children infected with the virus are more likely to get chronic hepatitis B.


You can have hepatitis B and not know it. You may not have symptoms. If you do, they can make you feel like you have the flu. But as long as you have the virus, you can spread it to others.


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Diabetes insipidus (die-uh-BEE-teze in-SIP-uh-dus) is an uncommon disorder that causes an imbalance of water in the body. This imbalance leads to intense thirst even after drinking fluids (polydipsia), and excretion of large amounts of urine (polyuria).


While the names diabetes insipidus and diabetes mellitus sound similar, they're not related. Diabetes mellitus — which can occur as type 1 or type 2 — is the more common form of diabetes.


There's no cure for diabetes insipidus, but treatments are available to relieve your thirst and normalize your urine output.

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Diabetes mellitus (or diabetes) is a chronic, lifelong condition that affects your body's ability to use the energy found in food. There are three major types of diabetes: type 1 diabetes, type 2 diabetes, and gestational diabetes.


All types of diabetes mellitus have something in common. Normally, your body breaks down the sugars and carbohydrates you eat into a special sugar called glucose. Glucose fuels the cells in your body. But the cells need insulin, a hormone, in your bloodstream in order to take in the glucose and use it for energy. With diabetes mellitus, either your body doesn't make enough insulin, it can't use the insulin it does produce, or a combination of both.


Since the cells can't take in the glucose, it builds up in your blood. High levels of blood glucose can damage the tiny blood vessels in your kidneys, heart, eyes, or nervous system. That's why diabetes -- especially if left untreated -- can eventually cause heart disease, stroke, kidney disease, blindness, and nerve damage to nerves in the feet.

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A double uterus is a rare congenital abnormality. In a female fetus, the uterus starts out as two small tubes. As the fetus develops, the tubes normally join to create one larger, hollow organ — the uterus.


Sometimes, however, the tubes don't join completely. Instead, each one develops into a separate structure. A double uterus may have one opening (cervix) into one vagina, or each uterine cavity may have a cervix. In many cases, a thin wall of tissue runs down the length of the vagina, dividing it into two separate openings.


Women who have a double uterus often have successful pregnancies. But the condition can increase the risk of miscarriage or premature birth.

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Earwax blockage occurs when earwax (cerumen) accumulates in your ear or becomes too hard to wash away naturally.

Earwax is a helpful and natural part of your body's defenses. It cleans, lubricates and protects your ear canal by trapping dirt and slowing the growth of bacteria.

If earwax blockage becomes a problem, you or your doctor can take simple steps to remove the wax safely.

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Myelofibrosis is a serious bone marrow disorder that disrupts your body's normal production of blood cells. The result is extensive scarring in your bone marrow, leading to severe anemia, weakness, fatigue and often an enlarged spleen.Myelofibrosis is an uncommon type of chronic leukemia — a cancer that affects the blood-forming tissues in the body. Myelofibrosis belongs to a group of diseases called myeloproliferative disorders.Many people with myelofibrosis get progressively worse, and some may eventually develop a more serious form of leukemia. Yet it's also possible to have myelofibrosis and live symptom-free for years. Treatment for myelofibrosis, which focuses on relieving symptoms, can involve a variety of options.

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Myxofibrosarcoma is a common connective tissue neoplasm of malignant fibrocytes in a myxoid matrix favoring the extremities. Like many other tumors of connective tissue, soft tissue sarcoma exhibits high recurrence rates but is rarely known to metastasize. We present a patient with myxofibrosarcoma of the hand with metastases to the lungs, pleura, and mediastinum. The mediastinal metastasis presented clinically with gastrointestinal symptoms due to compression of the gastroesophageal junction. To our knowledge, this is the first report of metastatic myxofibrosarcoma of the hand and also the first report of metastatic myxofibrosarcoma to mediastinal lymph nodes at the level of the gastroesophageal junction. We also performed a comprehensive literature review of metastatic myxofibrosarcoma.

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Neurofibromatosis is a genetic disorder that causes tumors to form on nerve tissue. These tumors can develop anywhere in your nervous system, including your brain, spinal cord and nerves. Neurofibromatosis is usually diagnosed in childhood or early adulthood.The tumors are usually noncancerous (benign), but sometimes can become cancerous (malignant). Symptoms are often mild. However, complications of neurofibromatosis can include hearing loss, learning impairment, heart and blood vessel (cardiovascular) problems, loss of vision, and severe pain.Neurofibromatosis treatment aims to maximize healthy growth and development and to manage complications as soon as they arise. When neurofibromatosis causes large tumors or tumors that press on a nerve, surgery can help ease symptoms. Some people may benefit from other therapies, such as stereotactic radiosurgery or medications to control pain.

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 Central nervous system (CNS) embryonal tumors form in embryonic cells that remain in the brain after birth. CNS embryonal tumors tend to spread through the cerebrospinal fluid (CSF) to other parts of the brain and spinal cord.

The tumors may be malignant (cancer) or benign (not cancer). Most CNS embryonal tumors in children are malignant. Malignant brain tumors are likely to grow quickly and spread into other parts of the brain. When a tumor grows into or presses on an area of the brain, it may stop that part of the brain from working the way it should. Benign brain tumors grow and press on nearby areas of the brain. They rarely spread to other parts of the brain. Both benign and malignant brain tumors can cause signs or symptoms and need treatment.

Although cancer is rare in children, brain tumors are the third most common type of childhood cancer, after leukemia and lymphoma. This summary is about the treatment of primary brain tumors (tumors that begin in the brain). The treatment of metastatic brain tumors, which begin in other parts of the body and spread to the brain, is not discussed in this summary. For information about the different types of brain and spinal cord tumors, see the PDQ summary on Childhood Brain and Spinal Cord Tumors Treatment Overview.

Brain tumors occur in both children and adults. Treatment for adults may be different from treatment for children. See the PDQ summary on Adult Central Nervous System Tumors Treatment for more information on the treatment of adults.

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The University of Michigan C.S. Mott Children’s Hospital offers one of the nation’s leading treatment programs for infants, children and adolescents with neurological problems (problems affecting the nervous system).Our specialists treat children with brain and neurological conditions with a multidisciplinary approach led by physicians in our department of neurosurgery and our pediatric neurology service. Together with our colleagues in many other pediatric specialties throughout Mott Children’s Hospital, we provide our patients and their families with individualized treatment plans.The pediatric neurology service coordinates medical treatment and therapy for children with neurological conditions

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Epidermolysis bullosa (ep-ih-dur-MOL-uh-sis buhl-LOE-sah) is a group of rare diseases that cause fragile, blistering skin. The blisters may appear in response to minor injury, even from heat, rubbing, scratching or adhesive tape. In severe cases, the blisters may occur inside the body, such as the lining of the mouth or the stomach.


Most types of epidermolysis bullosa are inherited. The condition usually shows up in infancy or early childhood. Some people don't develop signs and symptoms until adolescence or early adulthood.


Epidermolysis bullosa has no cure, though mild forms may improve with age. Treatment focuses on caring for blisters and preventing new ones.

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Cryoglobulinemia is a medical condition that is caused by proteins called cryoglobulins, which are present in the blood. Cryoglobulins are abnormal proteins that by definition have the unusual property of precipitating from the serum when it is chilled in the laboratory and then dissolves back into the serum upon rewarming.


Cryoglobulins may or may not cause disease. Cryoglobulins can accompany another condition (such as dermatomyositis, multiple myeloma, viral infections, or lymphoma) or be an isolated condition themselves, called cryoglobulinemia.

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Esthesioneuroblastoma (es-THEE-zee-o-NOO-row-blas-TOE-muh) is a rare type of cancer that begins in the upper portion of the nasal cavity.


The area where esthesioneuroblastoma begins is separated from the brain by a bone that contains tiny holes that allow the nerves that control smell (olfactory nerves) to pass through. Esthesioneuroblastoma is also called olfactory neuroblastoma.


Esthesioneuroblastoma, which can occur at any age in adults, generally begins as a tumor in the nasal cavity and may grow or extend into the sinus, eyes and brain. People with esthesioneuroblastoma can lose their sense of smell, have frequent nosebleeds and experience difficulty breathing through their nostrils as the tumor grows.


Esthesioneuroblastoma can also spread to the lymph nodes in the neck and the parotid glands. In advanced cases, esthesioneuroblastoma can spread to other parts of the brain and other parts of the body, such as the lungs, liver and bones.


Esthesioneuroblastoma treatment usually includes surgery. Often, radiation and chemotherapy are recommended, as well.

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Eustachian tubes are small tubes that run between your middle ears and the upper throat. They are responsible for equalizing ear pressure and draining fluid from the middle ear, the part of the ear behind the eardrum. The eustachian tubes are usually closed except for when you chew, swallow, or yawn.


These passageways are small in size and can get plugged for a variety of reasons. Blocked eustachian tubes can cause pain, hearing difficulties, and a feeling of fullness in the ears. Such a phenomenon is referred to as eustachian tube dysfunction (ETD).


ETD is a relatively common condition. Depending on the cause, it may resolve on its own or through simple at-home treatment measures. Severe or recurring cases may require a visit to the doctor.

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A febrile seizure is a convulsion in a child that may be caused by a spike in body temperature, often from an infection. Your child's having a febrile seizure can be alarming, and the few minutes it lasts can seem like an eternity.


Febrile seizures represent a unique response of a child's brain to fever, usually the first day of a fever. Fortunately, they're usually harmless and typically don't indicate an ongoing problem. You can help by keeping your child safe during a febrile seizure and by comforting him or her afterward.

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Fibroadenomas (fy-broe-ad-uh-NO-muhz) are solid, noncancerous breast lumps that occur most often in women between the ages of 15 and 35.


A fibroadenoma might feel firm, smooth, rubbery or hard and has a well-defined shape. Usually painless, it might feel like a marble in your breast, moving easily under your skin when examined. Fibroadenomas vary in size, and they can enlarge or shrink on their own.


Fibroadenomas are among the most common noncancerous (benign) breast lumps in young women. Treatment might include monitoring to detect changes in size or feel, a biopsy to evaluate the lump or surgery to remove it.

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Fibrocystic breasts are composed of tissue that feels lumpy or rope-like in texture. Doctors call this nodular or glandular breast tissue.


It's not at all uncommon to have fibrocystic breasts. More than half of women experience fibrocystic breast changes at some point in their lives. In fact, medical professionals have stopped using the term "fibrocystic breast disease" and now simply refer to "fibrocystic breasts" or "fibrocystic breast changes" because having fibrocystic breasts isn't really a disease. Breast changes categorized as fibrocystic are considered normal.


Although many women with fibrocystic breasts don't have symptoms, some women experience breast pain, tenderness and lumpiness — especially in the upper, outer area of the breasts. Breast symptoms tend to be most bothersome just before menstruation. Simple self-care measures can usually relieve discomfort associated with fibrocystic breasts.

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Fibromuscular dysplasia is a condition that causes narrowing (stenosis) and enlargement (aneurysm) of the medium-sized arteries in your body. Reduced blood flow from narrowed arteries to the organs can affect the function of the organs.


Fibromuscular dysplasia appears most commonly in the arteries leading to the kidneys. Fibromuscular dysplasia can also affect the arteries leading to your brain, heart, abdomen, arms and legs.


Fibromuscular dysplasia can cause a number of complications, such as high blood pressure or tears of the artery (arterial dissection), if left untreated. Arterial dissection, or spontaneous coronary artery dissection (SCAD), can limit blood flow to the organ supplied by the injured artery.

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Fibrous dysplasia is an uncommon bone disorder in which scar-like (fibrous) tissue develops in place of normal bone. This irregular tissue can weaken the affected bone and cause it to deform or fracture.


In most cases, fibrous dysplasia occurs at a single site in one bone, but can occur at multiple sites in multiple bones. Single bone involvement usually occurs in adolescents and young adults. People who have more than one affected bone typically develop symptoms before the age of 10.


Although fibrous dysplasia is a genetic disorder, it's caused by a gene mutation that's not passed from parent to child. There's no cure for the disorder. Treatment, which may include surgery, focuses on relieving pain and repairing or stabilizing bones.

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Frostbite occurs when the skin is exposed to extreme or prolonged cold. The skin freezes, as do tissues beneath the surface of the skin. In extreme cases, muscle, nerves, and blood vessels may also freeze.


Skin may freeze within minutes when exposed to temperatures that fall below freezing. Even if temperatures are above freezing, the skin is likely to freeze if it’s wet or exposed to severe wind chills.


Frostbite also occurs when your skin directly contacts very cold surfaces. This type of exposure may immediately freeze the skin that touches the frozen surface.

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Gallbladder cancer is cancer that begins in the gallbladder.


Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder stores bile, a digestive fluid produced by your liver.


Gallbladder cancer is uncommon. When gallbladder cancer is discovered at its earliest stages, the chance for a cure is very good. But most gallbladder cancers are discovered at a late stage, when the prognosis is often very poor.


Gallbladder cancer is difficult to diagnose because it often causes no specific signs or symptoms. Also, the relatively hidden nature of the gallbladder makes it easier for gallbladder cancer to grow without being detected.

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Gastrointestinal (GI) bleeding is a symptom of a disorder in your digestive tract. The blood often appears in stool or vomit but isn't always visible, though it may cause the stool to look black or tarry. The level of bleeding can range from mild to severe and life-threatening.


Bleeding in the stomach or colon can usually be easily identified, but finding the cause of bleeding that occurs in the small intestine can be difficult. But sophisticated imaging technology can usually locate the problem, and minimally invasive procedures often can fix it.

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Your hip is the joint where your thigh bone meets your pelvis. It is called a ball-and-socket joint, because the ball-like top of your thigh bone fits into a cup-like area within your pelvis, much like a baseball fits into a glove.


Hip


Normally, the ball glides smoothly within the socket, but a problem with the ball or socket rim can interfere with smooth motion. This problem can cause hip impingement or femoro acetabular impingement (FAI). It is believed to be a major cause of early osteoarthritis of the hip, particularly in those under age 40.

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High blood sugar (hyperglycemia) affects people who have diabetes. Several factors can contribute to hyperglycemia in people with diabetes, including food and physical activity choices, illness, nondiabetes medications, or skipping or not taking enough glucose-lowering medication.


It's important to treat hyperglycemia, because if left untreated, hyperglycemia can become severe and lead to serious complications requiring emergency care, such as a diabetic coma. In the long term, persistent hyperglycemia, even if not severe, can lead to complications affecting your eyes, kidneys, nerves and heart.

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Pediatric brain tumors are masses or growths of abnormal cells that occur in a child's brain or the tissue and structures that are near it. Many different types of pediatric brain tumors exist — some are noncancerous (benign) and some are cancerous (malignant).Treatment and chance of recovery (prognosis) depend on the type of tumor, its location within the brain, whether it has spread, and your child's age and general health. Because new treatments and technologies are continually being developed, several options may be available at different points in treatment.Treatment for brain tumors in children is typically quite different from treatment for adult brain tumors, so it's very important to enlist the expertise and experience of pediatric specialists in neurology and cancer.

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IBS affects between 25 and 45 million Americans. Most of them are women. People are most likely to get the condition in their late teens to early 40s.


IBS is a mix of belly discomfort or pain and trouble with bowel habits: either going more or less often than normal (diarrhea or constipation) or having a different kind of stool (thin, hard, or soft and liquid).


It’s not life-threatening, and it doesn't make you more likely to get other colon conditions, such as ulcerative colitis, Crohn's disease, or colon cancer. But IBS can be a long-lasting problem that changes how you live your life. People with IBS may miss work or school more often, and they may feel less able to take part in daily activities. Some people may need to change their work setting: shifting to working at home, changing hours, or even not working at all.

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Inflammatory bowel disease (IBD) is an umbrella term used to describe disorders that involve chronic inflammation of your digestive tract. Types of IBD include:


Ulcerative colitis. This condition causes long-lasting inflammation and sores (ulcers) in the innermost lining of your large intestine (colon) and rectum.

Crohn's disease. This type of IBD is characterized by inflammation of the lining of your digestive tract, which often spreads deep into affected tissues.

Both ulcerative colitis and Crohn's disease usually involve severe diarrhea, abdominal pain, fatigue and weight loss.

IBD can be debilitating and sometimes leads to life-threatening complications.

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Digested food particles must travel through 25 feet or more of intestines as part of normal digestion. These digested wastes are constantly in motion. However, intestinal obstruction can put a stop to this. An intestinal obstruction occurs when your small or large intestine is blocked. The blockage can be partial or total, and it prevents passage of fluids and digested food.


If intestinal obstruction happens, food, fluids, gastric acids, and gas build up behind the site of the blockage. If enough pressure builds up, your intestine can rupture, leaking harmful intestinal contents and bacteria into your abdominal cavity. This is a life-threatening complication.


There are many potential causes of intestinal obstruction. Often, this condition can’t be prevented. Early diagnosis and treatment are crucial. An untreated intestinal obstruction can be fatal.

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Invasive lobular carcinoma is a type of breast cancer that begins in the milk-producing glands (lobules) of the breast.


Invasive cancer means the cancer cells have broken out of the lobule where they began and have the potential to spread to the lymph nodes and other areas of the body.


Invasive lobular carcinoma makes up a small portion of all breast cancers. The most common type of breast cancer begins in the breast ducts (invasive ductal carcinoma).


Invasive lobular carcinoma typically doesn't form a lump, which is common in breast cancer. Instead, there is a change in the breast that feels like a thickening or fullness in one part of the breast and is different from the surrounding breast tissue.

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Pineoblastoma is one of several different types of tumors that arise in the area of the pineal gland, requiring different therapies. The exact diagnosis is critical for choosing the correct therapy. Pineal tumors typically present with hydrocephalus, a buildup of fluid pressure within the brain

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A placental abruption is a serious condition in which the placenta partially or completely separates from your uterus before your baby's born.The condition can deprive your baby of oxygen and nutrients, and cause severe bleeding that can be dangerous to you both. A placental abruption also increases the risk that your baby will have growth problems (if the abruption is small and goes unnoticed), be born prematurely, or be stillborn.Placental abruption happens in about one in 150 pregnancies. It's most common in the third trimester but can happen any time after 20 weeks.


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Juvenile-onset fibromyalgia (JFM) is a poorly understood chronic pain condition most commonly affecting adolescent girls. The condition is characterized by widespread musculoskeletal pain and other associated symptoms, including fatigue, nonrestorative sleep, headaches, irritable bowel symptoms, dysautonomia and mood disorders such as anxiety and/or depression. In the past few years, there has been a greater focus on understanding JFM in adolescents. Research studies have provided insight into the clinical characteristics of this condition and its effect on both short-term and long-term psychosocial and physical functioning. The importance of early and effective intervention is being recognized, as research has shown that symptoms of JFM tend to persist and do not resolve over time as was previously believed. Efforts to improve treatments for JFM are underway, and new evidence strongly points to the potential benefits of cognitive–behavioural therapy on improving mood and daily functioning. Research into pharmacotherapy and other nonpharmacological options is in progress. Advancements in the understanding of adult fibromyalgia have paved the way for future studies on diagnosis, assessment and management of JFM. This Review focuses on our current knowledge of the condition, provides an update of the latest research advances, and highlights areas for further study.

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A bursa is a closed, fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. Bursae is plural for bursa. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees. When a bursa becomes inflamed, the condition is known as bursitis. Most commonly, bursitis is caused by local soft-tissue trauma or strain injury, and there is no infection (aseptic bursitis). On rare occasions, particularly when the immune system is suppressed, the bursa can become infected with bacteria. This condition is called septic bursitis.

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Krabbe disease, also known as globoid cell leukodystrophy or galactosylceramide lipidosis, is an autosomal-recessive sphingolipidosis caused by deficient activity of the lysosomal hydrolase galactosylceramide beta-galactosidase (GALC). GALC degrades galactosylceramide, a major component of myelin, and other terminal beta-galactose–containing sphingolipids, including psychosine (galactosylsphingosine). Increased psychosine levels are believed to lead to widespread destruction of oligodendroglia in the CNS and to subsequent demyelination. [1, 2, 3]


Krabbe originally described a condition with infantile onset that was characterized by spasticity and a rapidly progressive neurologic degeneration leading to death. Since the original description, numerous cases have been documented that show a wide distribution in age of onset.

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Amblyopia, commonly known as lazy eye, is the eye condition noted by reduced vision not correctable by glasses or contact lenses and is not due to any eye disease. The brain, for some reason, does not fully acknowledge the images seen by the amblyopic eye. This almost always affects only one eye but may manifest with reduction of vision in both eyes. It is estimated that three percent of children under six have some form of amblyopia.

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Lewy body dementia (LBD) is a progressive brain disorder in which Lewy bodies (abnormal deposits of a protein called alpha-synuclein) build up in areas of the brain that regulate behavior, cognition, and movement.

 

A complex disease, LBD can present with a range of symptoms including problems with thinking, memory, moving, sleep and/or changes in behavior, to name a few of the physical, cognitive, and behavioral symptoms.

 

LBD also affects autonomic body functions, such as blood pressure control, temperature regulation, and bladder and bowel function. Progressively debilitating, LBD can also cause people to experience visual hallucinations or act out their dreams.

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White blood cells (leukocytes) orchestrate the host response to pathogens. Leukocytes are divided into myeloid (eosinophils, monocytes, neutrophils, basophils) and lymphoid (B cells, T cells, and natural killer (NK) cells) elements. Monocytes and neutrophils mediate innate immune defenses and present antigens to lymphocytes, the principal effectors of the adaptive immune system. Eosinophils and basophils defend against parasitic pathogens, play important roles in inflammation, and mediate allergic reactions.Monocytes and neutrophils, as part of innate immunity, phagocytose bacteria and debris, eliminate virus-infected cells, and destroy parasites and fungi. Phagocytosis is assisted by serum complement proteins, which adhere to pathogens and promote chemotaxis and opsonization. Monocytes mature in tissue to become macrophages, where they, along with dendritic cells and B cells, serve as antigen presenting cells (APCs) to the adaptive immune system.B and T cells, as part of adaptive immunity, confer long-term protection against pathogens, especially extracellular bacterial infections. Adaptive immunity orchestrates both antibody-mediated humoral immunity and T-cell mediated cellular cytotoxicity. B cells secrete neutralizing antigen-specific antibodies (i.e. humoral) upon stimulation by the macrophages, dendritic cells, and T cells. In contrast, T cells and NK cells, upon stimulation, can directly kill aberrant cells (i.e. cell-mediated). These aberrant cells include those infected with viruses, bacteria, and fungi, tumorigenic cells, and transplanted tissue.


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X-linked agammaglobulinemia (XLA) is a condition that affects the immune system and occurs almost exclusively in males. People with XLA have very few B cells, which are specialized white blood cells that help protect the body against infection. B cells can mature into the cells that produce special proteins called antibodies or immunoglobulins. Antibodies attach to specific foreign particles and germs, marking them for destruction. Individuals with XLA are more susceptible to infections because their body makes very few antibodies.Children with XLA are usually healthy for the first 1 or 2 months of life because they are protected by antibodies acquired before birth from their mother. After this time, the maternal antibodies are cleared from the body, and the affected child begins to develop recurrent infections. In children with XLA, infections generally take longer to get better and then they come back again, even with antibiotic medications. The most common bacterial infections that occur in people with XLA are lung infections (pneumonia and bronchitis), ear infections (otitis), pink eye (conjunctivitis), and sinus infections (sinusitis). Infections that cause chronic diarrhea are also common. Recurrent infections can lead to organ damage. People with XLA can develop severe, life-threatening bacterial infections; however, affected individuals are not particularly vulnerable to infections caused by viruses. With treatment to replace antibodies, infections can usually be prevented, improving the quality of life for people with XLA.


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Thrombocytosis is a disorder in which your body produces too many platelets (thrombocytes), which play an important role in blood clotting. The disorder is called reactive thrombocytosis or secondary thrombocythemia when it's caused by an underlying condition, such as an infection.Thrombocytosis (throm-boe-sie-TOE-sis) may also, less commonly, be caused by a blood and bone marrow disease. When caused by a bone marrow disorder, thrombocytosis is called autonomous, primary or essential thrombocytosis, or essential thrombocythemia.Your doctor may detect thrombocytosis in routine blood test results that show a high platelet level. If your blood test indicates thrombocytosis, it's important to determine whether it's reactive thrombocytosis or if you have essential thrombocythemia, which is more likely to cause blood clots.


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Thrombophlebitis is inflammation of a vein caused by a blood clot. It typically occurs in the legs. A blood clot is a solid formation of blood cells that clump together. Blood clots can interfere with normal blood flow throughout your body, and are considered dangerous. Thrombophlebitis can occur in veins near the surface of your skin or deeper, down in between your muscle layers.


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A joint is where bones connect and move.  Arthritis is thinning of the cartilage, which is the smooth covering of the joint.  The body reacts to loss of the joint surface by forming bone spurs (osteophytes) Thumb arthritis is a genetic predisposition: like graying and thinning of the hair, it comes with age and it shows up earlier in some families.  Unlike thinning of the hair, women tend to get thumb arthritis sooner than men do.


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IBS affects between 25 and 45 million Americans. Most of them are women. People are most likely to get the condition in their late teens to early 40s.


IBS is a mix of belly discomfort or pain and trouble with bowel habits: either going more or less often than normal (diarrhea or constipation) or having a different kind of stool (thin, hard, or soft and liquid).


It’s not life-threatening, and it doesn't make you more likely to get other colon conditions, such as ulcerative colitis, Crohn's disease, or colon cancer. But IBS can be a long-lasting problem that changes how you live your life. People with IBS may miss work or school more often, and they may feel less able to take part in daily activities. Some people may need to change their work setting: shifting to working at home, changing hours, or even not working at all.

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Bones give people shape. They hold the body upright, and also protect organs like the heart and the kidneys. They store the minerals calcium and phosphorus, and also contain bone marrow, where new blood cells are made.


There are different types of muscles and joints, each with different functions.


Skeletal muscle is muscle that you can consciously control. When your brain tells a muscle to contract, it shortens, pulling one bone towards another across a joint. Muscles work in pairs – when one shortens, a corresponding muscle lengthens. Physical activity maintains or increases the strength of skeletal muscles.


Smooth muscle sits in and around blood vessels and organs. You can’t consciously control smooth muscle. It helps regulate your blood pressure, airways and digestion.


The heart is made of special muscle called cardiac muscle. You can’t control it consciously. It contracts to make your heart beat.


Joints in the arms and legs are synovial joints which means they have fluid in them (synovial fluid) so bones can move over each other.


Joints in the spine and pelvis are cartilaginous joints – they provide more stability and less movement.


There are also fibrous joints that allow no movement at all – just stability. You have fibrous joints in your skull.

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Tinea Barbae which is common term known as Beard Fungus or Barber's Itch is a fungal infection of the skin in the area of the face where there is growth of beard meaning that it affects mainly the bottom area of the face and some part of the neck. As the name suggest, Tinea Barbae is solely limited to males and does not affect females in any way. It is usually found in adolescents or young adults. Tinea Barbae has now become quite rare due to the modern hygiene practices which prevent any fungal infections especially in the facial area.


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Precocious puberty is when a child's body begins changing into that of an adult (puberty) too soon. Puberty that begins before age 8 in girls and before age 9 in boys is considered precocious puberty.


Puberty includes rapid growth of bones and muscles, changes in body shape and size, and development of the body's ability to reproduce.


The cause of precocious puberty often can't be found. Rarely, certain conditions, such as infections, hormone disorders, tumors, brain abnormalities or injuries, may cause precocious puberty. Treatment for precocious puberty typically includes medication to delay further development.

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A premature baby is one who is born too early, before 37 weeks. Premature babies may have more health problems and may need to stay in the hospital longer than babies born later. 


They also may have long-term health problems that can affect their whole lives. About 1 in 10 babies is born prematurely each year in the United States. 


The earlier in pregnancy a baby is born, the more likely he is to have health problems. Some premature babies have to spend time in a hospital’s neonatal intensive care unit (also called NICU). This is the part of a hospital that takes care of sick newborns. But thanks to advances in medical care, even babies born very prematurely are more likely to survive today than ever before.

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Presbyopia is when your eyes gradually lose the ability to see things clearly up close. It is a normal part of aging. In fact, the word “presbyopia” means “old eye” in Greek. You may start to notice presbyopia shortly after age 40. You will probably find that you hold reading materials farther away in order to see them clearly.

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Abusing some prescription drugs can lead to addiction. These include opioids, sedatives, tranquilizers, and stimulants.


Every medicine has some risk of side effects. Doctors take this into account when prescribing medicines. People who abuse these drugs may not understand the risks. The medicines may not be safe for them, especially at higher doses or when taken with other medicines.

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Transient global amnesia is a sudden, temporary episode of memory loss that can't be attributed to a more common neurological condition, such as epilepsy or stroke.During an episode of transient global amnesia, your recall of recent events simply vanishes, so you can't remember where you are or how you got there. In addition, you may not remember anything about what's happening in the here and now. Consequently, you may keep repeating the same questions because you don't remember the answers you've just been given. You may also draw a blank when asked to remember things that happened a day, a month or even a year ago.With transient global amnesia, you do remember who you are, and recognize the people you know well. But that doesn't make your memory loss less disturbing.Fortunately, transient global amnesia is rare, seemingly harmless and unlikely to happen again. Episodes are usually short-lived, and afterward your memory is fine.

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Traumatic brain injury (TBI) is a complex injury with a broad spectrum of symptoms and disabilities. The impact on a person and his or her family can be devastating. The purpose of this site is to educate and empower caregivers and survivors of traumatic brain injuries. This site aims to ease the transition from shock and despair at the time of a brain injury to coping and problem solving. Bookmark this site for the latest medical breakthroughs and brain research, the highest quality treatment for brain damage, the symptoms of brain injuries and the nation's best traumatic brain injury rehabilitation centers and resource information.


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Premature labor is also called preterm labor. It’s when your body starts getting ready for birth too early in your pregnancy. Labor is premature if it starts more than three weeks before your due date.

Premature labor can lead to an early birth. But the good news is that doctors can do a lot to delay an early delivery. The longer your baby gets to grow inside you -- right up to your due date -- the less likely he or she is to have problems after birth.


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Pseudobulbar affect (PBA) is a condition that’s characterized by episodes of sudden uncontrollable and inappropriate laughing or crying. Pseudobulbar affect typically occurs in people with certain neurological conditions or injuries, which might affect the way the brain controls emotion.

If you have pseudobulbar affect you'll experience emotions normally, but you'll sometimes express them in an exaggerated or inappropriate way. As a result, the condition can be embarrassing and disruptive to your daily life.

Pseudobulbar affect often goes undiagnosed or is mistaken for mood disorders. Once diagnosed, however, pseudobulbar affect can be managed with medication.

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Pseudomembranous colitis (PMC) is inflammation in your colon that happens when there's too much of certain bacteria in your system. The most common bacterium that causes PMC isClostridium difficile, or C. diff.

PMC is also called antibiotic-associated colitis or C. difficilecolitis. Most of the time, it's a side effect of taking antibiotics.

People in hospitals or nursing homes also can get PMC, especially if they've just had surgery or are receiving treatment for cancer.

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Pseudotumor cerebri is a condition in which the pressure around your brain increases, causing headaches and vision problems. The name means “false brain tumor” because its symptoms are similar to those caused by brain tumors. It’s also known as idiopathic intracranial hypertension. This condition is treatable, but it can return in some cases.

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Tuberous sclerosis complex (TSC) is a genetic disorder affecting cellular differentiation, proliferation, and migration early in development, resulting in a variety of hamartomatous lesions that may affect virtually every organ system of the body.The best-known cutaneous manifestation of TSC is adenoma sebaceum, which often does not appear until late childhood or early adolescence. This lesion is an angiofibroma (ie, cutaneous hamartoma) and is not related to excessive sebum or acne. Flat, reddish macular lesions develop first, which can be mistaken for freckles early on. See the image below.

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An umbilical hernia creates a soft swelling or bulge near the navel (umbilicus). If your baby has an umbilical hernia, you may notice the bulge only when he or she cries, coughs or strains. The bulge may disappear when your baby is calm or lies on his or her back.Umbilical hernias in children are usually painless. Umbilical hernias that appear during adulthood may cause abdominal discomfort.

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Unstable angina belongs to the spectrum of clinical presentations referred to collectively as acute coronary syndromes (ACSs), which also includes ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). [1, 2] Unstable angina is considered to be an ACS in which there is myocardial ischemia without detectable myocardial necrosis (ie, cardiac biomarkers of myocardial necrosis —such as creatine kinase MB isozyme, troponin, myoglobin—are not released into the circulation). See the image below.

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Ureteral obstructions are blockages in your urinary tract, which includes your kidneys, bladder, the tubes that carry urine from your kidneys to your bladder (ureters), and the tube that connects your bladder to the outside of your body (urethra). Blockages can develop for many reasons, including gastrointestinal problems. Ureteral obstructions are more common in men, especially as they get older and their prostate gland enlarges.Obstructions can be cured with surgery, but they need to be treated promptly. If they’re not, they can lead to severe illness, kidney damage and life-threatening infections.

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Uterine fibroids are benign tumors that originate in the uterus (womb). Although they are composed of the same smooth muscle fibers as the uterine wall (myometrium), they are much denser than normal myometrium. Uterine fibroids are usually round.Uterine fibroids are often described based upon their location within the uterus. Subserosal fibroids are located beneath the serosa (the lining membrane on the outside of the uterus). These often appear localized on the outside surface of the uterus or may be attached to the outside surface by a pedicle. Submucosal (submucous) fibroids are located inside the uterine cavity beneath the inner lining of the uterus. Intramural fibroids are located within the muscular wall of the uterus.

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Solitary fibrous tumors are rare growths of soft tissue cells that can form nearly anywhere in the body.Solitary fibrous tumors most often occur in the lining around the outside of the lungs (pleural solitary fibrous tumors). Solitary fibrous tumors have also been found in the head and neck, breast, kidney, prostate, spinal cord, and other sites.Most solitary fibrous tumors are noncancerous (benign), but in rare cases, solitary fibrous tumors can be cancerous (malignant). Solitary fibrous tumors tend to grow slowly and may not cause signs and symptoms until they become very large.

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Concern or fear about certain situations, activities, animals or objects is not uncommon. Many people feel anxious when faced with a snake or spider, heights, or travelling by plane. Fear is a rational response to situations that can pose a threat to our safety.However, some people react to objects, activities or situations (the phobic stimulus) by imagining or irrationally exaggerating the danger. Their feelings of panic, fear or terror are completely out of proportion to the actual threat. Sometimes the mere thought of the phobic stimulus, or the sight of it on TV, is enough to cause a reaction. These types of excessive reactions may be indicative of a specific phobia.People with specific phobias are often well aware that their fears are exaggerated or irrational, but feel that their anxious reaction is automatic or uncontrollable. Specific phobias are often associated with panic attacks, during which the person experiences overwhelming physical sensations that may include a pounding heart, choking, nausea, faintness, dizziness, chest pain, hot or cold flushes and perspiration.

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Spider bites are quite rare. Spiders are not bloodsucking creatures and do not feed on humans.In fact, many species' fangs cannot pierce human skin.The only reason a spider would bite a human is defense. Spiders will bite when they are surprised or feel trapped.Quickly putting a hand or foot into a place where a spider lives, like a shoe or box, may surprise the spider and cause it to attack.A spider may also attack if it is trapped, such as in a jacket that has been hanging in the closet for some time.

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Spina bifida means open spine. The spine (backbone) protects the spinal cord, a bundle of nerves that runs down the middle of your back. The spinal cord carries signals back and forth between your body and your brain. Spina bifida happens when the bones in the spine don’t form correctly, or when the spinal cord doesn’t form correctly, leaving a gap or opening. Spina bifida can happen anywhere along the spine.Spina bifida is the most common kind of neural tube defect (also called NTD). NTDs are birth defects of the brain and spinal cord. Birth defects are health conditions that are present at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, in how the body develops or in how the body works.A baby’s neural tube normally develops into the brain and spinal cord. It starts out as a tiny, flat ribbon that turns into a tube by the end of the first month of pregnancy. NTDs happen if the tube doesn’t close completely. About 1,500 to 2,000 babies are born with spina bifida each year in the United States.

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The subarachnoid space is the area between the brain and the skull. It is normally filled with cerebrospinal fluid (CSF), which acts as a floating cushion to protect the brain (see Anatomy of the Brain When blood is released into the subarachnoid space, it irritates the lining of the brain, increases pressure on the brain, and damages brain cells. At the same time, the area of brain that previously received oxygen-rich blood from the affected artery is now deprived of blood, resulting in a stroke. SAH is frequently a sign of a ruptured aneurysm


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Takotsubo cardiomyopathy is a weakening of the left ventricle, the heart's main pumping chamber, usually as the result of severe emotional or physical stress, such as a sudden illness, the loss of a loved one, a serious accident, or a natural disaster such as an earthquake. (For additional examples, see "Stressors associated with takotsubo cardiomyopathy.") That's why the condition is also called stress-induced cardiomyopathy, or broken-heart syndrome. The main symptoms are chest pain and shortness of breath.

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The features of seizures beginning in the temporal lobe can be extremely varied, but certain patterns are common. There may be a mixture of different feelings, emotions, thoughts, and experiences, which may be familiar or completely foreign. In some cases, a series of old memories resurfaces. In others, the person may feel as if everything – including home and family – appears strange. Hallucinations of voices, music, people, smells, or tastes may occur. These features are called “auras” or “warnings.” They may last for just a few seconds or may continue as long as a minute or two.Experiences during temporal lobe seizures vary in intensity and quality. Sometimes the seizures are so mild that the person barely notices. In other cases, the person may be consumed with fright, intellectual fascination, or even pleasure.The experiences and sensations that accompany these seizures are often impossible to describe, even for the most eloquent adult. And of course it is even more difficult to get an accurate picture of what people are feeling.

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The temporomandibular joint (TMJ) is the joint that connects your mandible (lower jaw) to your skull. The joint can be found on both sides of your head in front of your ears. It allows your jaw to open and close, enabling you to speak and eat.This abbreviation is also used to refer to a group of health problems related to your jaw. These disorders can cause tenderness at the joint, facial pain, and difficulty moving the joint. According to the National Institute of Dental and Craniofacial Research, as many as 10 million Americans suffer from TMJ. TMJ is more common among women than men. These disorders are treatable, but there are many different possible causes. This can make diagnosis difficult.Keep reading to learn more about TMJ. You should discuss any concerns with your doctor.

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Thromboangiitis obliterans (TAO), an inflammatory vasculopathy also known as Buerger disease, is characterized by an inflammatory endarteritis that causes a prothrombotic state and subsequent vaso-occlusive phenomena. The inflammatory process is initiated within the tunica intima. It characteristically affects small and medium-sized arteries as well as veins of the upper and lower extremities. The condition is strongly associated with heavy tobacco use, and disease progression is closely linked to continued use. (See Pathophysiology and Etiology.)Patients often present with moderate-to-severe claudication that can quickly progress to critical limb ischemia featuring rest pain or tissue loss. Features of acute limb ischemia (eg, pain, paresthesia, palor, mottling, poikilothermia, paresis, and pulselessness) are common signs and symptoms encountered in the emergency setting. [1, 2, 3, 4] (See Presentation.)Pharmacologic therapy is generally ineffective; abstinence from tobacco is the only measure known to prevent disease progression. (See Treatment.) Given the arteritis of the small and medium-sized vessels, surgical or endovascular revascularization may not be possible, because of the absence of a distal target for revascularization. As the disease evolves, amputation may be the only viable option.


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Thrombocytopenia is a condition in which you have a low blood platelet count. Platelets (thrombocytes) are colorless blood cells that help blood clot. Platelets stop bleeding by clumping and forming plugs in blood vessel injuries.Thrombocytopenia often occurs as a result of a separate disorder, such as leukemia or an immune system problem. Or it can be a side effect of taking certain medications. It affects both children and adults.Thrombocytopenia may be mild and cause few signs or symptoms. In rare cases, the number of platelets may be so low that dangerous internal bleeding occurs. Treatment options are available.

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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.


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Zumba is an exercise fitness program created by Colombian dancer and cyclist/choreographer Alberto "Beto" "Power Pedal" Perez during the 1990s.[1] Zumba is a trademark owned by Zumba Fitness, LLC. The Brazilian pop singer Claudia Leitte has become the international ambassador to Zumba Fitness. Zumba involves dance and aerobic movements performed to energetic music. The choreography incorporates hip-hop, soca, samba, salsa, merengue and mambo. Squats and lunges are also included.[3] Zumba Fitness, the owner of the Zumba program, does not charge licensing fees to gyms or fitness centers.[4] Approximately 15 million people take weekly Zumba classes in over 200,000 locations across 180 countries


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Those who are looking to feel the burn, baby! Looking to strengthen and tone your legs and glutes? Step right up.We combine the awesome toning and strengthening power of Step aerobics, with the fun fitness-party that only Zumba® brings to the dance-floor.Zumba® Step increase cardio and calorie burning, while adding moves that define and sculpt your core and legs.


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Step aerobics is a classic cardio workout. It's lasted for decades for a simple reason: It delivers results.The "step" is a 4-inch to 12-inch raised platform. You step up, around, and down from the platform in different patterns to boost your heart rate and breathing, and strengthen your muscles.Step aerobics moves range from simple to advanced. The most basic is a step-up, step-down. Once you get more experienced, you do moves that take you over the top and around the step forwards, sideways, and backwards.Most people take step aerobics classes at a gym, with an instructor showing you each move. The instructor and the upbeat music motivate you to keep going.Your class will start with a warm-up, followed by choreographed routines on the step, and a cooldown at the end. In some classes, you'll use hand weights for strength-training moves off the step.


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An exercise ball, also known as a Swiss Ball, is a ball constructed of soft elastic with a diameter of approximately 35 to 85 centimeters (14 to 34 inches) and filled with air. The air pressure is changed by removing a valve stem and either filling with air or letting the ball deflate. It is most often used in physical therapy, athletic training and exercise. It can also be used for weight training. The ball, while often referred to as a Swiss ball, is also known by a number of different names, including balance ball, birth ball, body ball, ball, fitness ball, gym ball, gymnastic ball, physio ball, pilates ball, Pezzi ball, stability ball, Swedish ball, therapy ball, or yoga ball


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If you are bored of lifting heavy weights, doing yoga and other regular stretching exercises then AEROBICS is the right option for you. You will not only enjoy doing it but also reap several health benefits out of it. Aerobics is a kind of cardio workout that causes you to breathe harder, makes you sweat and gets your heart pumping faster than at rest. Dance moves you perform in this, makes the heart and lungs work harder as the body’s need for oxygen is increased. So, get your heart pumping with Bong beauty Bipasha Basu, performing aerobics dance workout.


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The direct antiglobulin test (DAT) looks for antibodies attached to red blood cells (RBCs) circulating in the bloodstream. The test may help to detect or identify conditions in which antibodies become attached to RBCs, causing them to break apart (hemolyze).


RBCs have structures on their surfaces called antigens. Each person has their own individual set of RBC antigens, determined by inheritance from their parents. The major antigens or surface identifiers on human RBCs are the O, A, and B antigens, and a person's blood is grouped into an A, B, AB, or O blood type according to the presence or absence of these antigens. Another important surface antigen is the D antigen in the Rh blood group system. If it is present on someone's red blood cells, that person's blood type is Rh+ (positive); if it is absent, the blood is type Rh- (negative). (For more on these antigens, see the article on Blood Typing.) In addition, there are many other types of RBC antigens that make up lesser known but still clinically significant blood groups, such as Kell, Duffy, and Kidd

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An indirect Coombs' test determines whether there are antibodies to the Rh factor in the mother’s blood.


A normal (negative) result means that the mother has not developed antibodies against the fetus's blood. A negative Coombs' test indicates that the fetus is not presently in danger from problems relating to Rh incompatibility.

An abnormal (positive) result means that the mother has developed antibodies to the fetal red blood cells and is sensitized. However, a positive Coombs' test only indicates that an Rh-positive fetus has a possibility of being harmed. A positive test cannot indicate the amount of fetal harm that has occurred or is likely to occur.

If test results show that antibody amounts are increasing during pregnancy, the fetus may be at greater risk of harm.


A fetus who is Rh-negative will not be harmed, even if the mother is sensitized.

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Copper is an essential mineral that the body incorporates into enzymes. These enzymes play a role in the regulation of iron metabolism, formation of connective tissue, energy production at the cellular level, the production of melanin (the pigment that produces skin color), and the function of the nervous system. This test measures the amount of copper in the blood, urine, or liver (hepatic).


Copper is found in many foods including nuts, chocolate, mushrooms, shellfish, whole grains, dried fruits, and liver. Drinking water may acquire copper as it flows through copper pipes, and food may acquire it when people cook or serve food in copper dishes. Normally, the body absorbs copper from food or liquids in the intestines, converts it to a non-toxic form by binding it to a protein, and transports it to the liver. The liver stores some of the copper and binds most of the rest to another protein called apoceruloplasmin to produce the enzyme ceruloplasmin. About 95% of the copper in the blood is bound to ceruloplasmin, and most of the rest is bound to other proteins such as albumin. Only a small amount is normally present in the blood in a free (unbound) state. The liver eliminates excess copper into the bile and it is removed from the body in the stool. Some copper is also eliminated in the urine.


Both excess and deficiency of copper are rare. Wilson disease, a rare inherited disorder, can lead to excess storage of copper in the liver, brain, and other organs. Copper excess (toxicity) can also occur when a person is exposed to and absorbs large amounts over a short period of time (acute exposure) or various amounts over a long period (chronic exposure).


Copper deficiency may occasionally occur in people who have conditions associated with severe malabsorption, such as cystic fibrosis and celiac disease, and in infants exclusively fed cow-milk formulas.


A rare X-linked genetic condition called Menkes kinky hair syndrome leads to copper deficiency in the brain and liver of affected infants. The disease, which affects primarily males, is associated with seizures, delayed development, abnormal artery development in the brain, and unusual gray brittle kinky hair.

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Corticosterone is a steroid hormone and a precursor molecule for aldosterone. It is produced from deoxycorticosterone, further converted to 18-hydroxy corticosterone and, finally, to aldosterone in the mineralocorticoid pathway.


The adrenal glands, ovaries, testes, and placenta produce steroid hormones, which can be subdivided into 3 major groups: mineral corticoids, glucocorticoids, and sex steroids. Synthesis proceeds from cholesterol along 3 parallel pathways, corresponding to these 3 major groups of steroids, through successive side-chain cleavage and hydroxylation reactions. At various levels of each pathway, intermediate products can move into the respective adjacent pathways via additional, enzymatically catalyzed reactions (see Steroid Pathways in Special Instructions).


Corticosterone is the first intermediate in the corticoid pathway with significant mineral corticoid activity. Its synthesis from 11-deoxycorticosterone is catalyzed by 11 beta-hydroxylase 2 (CYP11B2) or by 11 beta-hydroxylase 1 (CYP11B1). Corticosterone is in turn converted to 18-hydroxycorticosterone and finally to aldosterone, the most active mineral corticoid. Both of these reactions are catalyzed by CYP11B2, which, unlike its sister enzyme CYP11B1, also possesses 18-hydroxylase and 18-methyloxidase (also known as aldosterone synthase) activity.


The major diagnostic utility of measurements of steroid synthesis intermediates lies in the diagnosis of disorders of steroid synthesis, in particular congenital adrenal hyperplasia (CAH). All types of CAH are associated with cortisol deficiency with the exception of CYP11B2 deficiency and isolated impairments of the 17-lyase activity of CYP17A1 (this enzyme also has 17 alpha-hydroxylase activity). In cases of severe illness or trauma, CAH predisposes patients to poor recovery or death. Patients with the most common form of CAH (21-hydroxylase deficiency, >90% of cases), with the third most common form of CAH (3-beta-steroid dehydrogenase deficiency, <3% of cases) and those with the extremely rare StAR (steroidogenic acute regulatory protein) or 20,22 desmolase deficiencies might also suffer mineral corticoid deficiency, as the enzyme blocks in these disorders are proximal to potent mineral corticoids. These patients might suffer salt-wasting crises in infancy. By contrast, patients with the second most common form of CAH, 11-hydroxylase deficiency (<5% of cases) are normotensive or hypertensive, as the block affects either CYP11B1 or CYP11B2, but rarely both, thus ensuring that at least corticosterone is still produced. In addition, patients with all forms of CAH might suffer the effects of substrate accumulation proximal to the enzyme block. In the 3 most common forms of CAH, the accumulating precursors spill over into the sex steroid pathway, resulting in virilization of females or, in milder cases, hirsutism, polycystic ovarian syndrome or infertility, as well as in possible premature adrenarche and pubarche in both genders.

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This assay is useful for diagnosis of Acute Hepatitis B infection. It identifies Acute HBV infection in the core window period when HBsAg and Anti HBs are negative. It also differentiates between acute and chronic HBV infection in the presence of positive Anti HBc

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Blood typing is a screening test to determine blood groups and Rh antigen for blood transfusion and pregnancy. The four blood groups A, B, O, and AB are determined by the presence of antigens A and B or their absence (O) on a patient's red blood cells. In addition to ABO grouping, most immunohematology testing includes evaluation of Rh typing tests for Rh(D) antigen. Blood cells that express Rh(D) antigen are Rh positive. Red blood cells found lacking Rh(D) are considered Rh negative. Rh typing is also important during pregnancy because of the potential for mother and fetus Rh incompatiblity. If the mother is Rh negative but the father is Rh positive, the fetus may be positive for the Rh antigen. As a result, the mother’s body could develop antibodies against the Rh antigen. These antibodies may cross the placenta and cause destruction of the baby’s red blood cells, resulting in a condition known as hemolytic disease of the fetus and newborn.


Blood typing is performed by agglutination testing. The patient's red cells are tested with anti-A and anti-B antibodies for the presence or absence of agglutination (forward type, aka cell type), and patient's serum or plasma is tested against known A and B cells (reverse type, aka serum type, aka back type). Rh typing is done by testing patient red blood cells with anti-D antibody.


Transfusion of blood components of the correct blood type is necessary in order to prevent an adverse immunologic reaction. These reactions can range from very mild and sub-clinical to very severe or fatal, depending upon the components involved and condition of the recipient. Therefore, accurate assessment of both blood component and recipient ABO and Rh status is mandatory. The results of this testing will determine what blood group types a recipient may receive safely. For plasma components such as fresh frozen plasma (FFP) and platelets, it is important that the plasma be compatible with the recipient's red blood cells. This is always true for FFP which must be transfused in adequate volume to replace essential components in the recipient. For platelets, they can be concentrated if the ABO types are incompatible such that the amount of plasma given to the recipient is reduced to a minimum and the resulting hemolysis, if any, is reduced accordingly.

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C-peptide is a substance, a short chain of amino acids, that is released into the blood as a byproduct of the formation of insulin by the pancreas. This test measures the amount of C-peptide in a blood or urine sample.


In the pancreas, within specialized cells called beta cells, proinsulin, a biologically inactive molecule, splits apart to form one molecule of C-peptide and one molecule of insulin. Insulin is vital for the transport of glucose into the body's cells and is required on a daily basis. When insulin is required and released from the beta cells into the blood in response to increased levels of glucose, equal amounts of C-peptide are also released. Since C-peptide is produced at the same rate as insulin, it is useful as a marker of insulin production.


In particular, C-peptide testing can be used to help evaluate the production of insulin made by the body (endogenous) and to help differentiate it from insulin that is not produced by the body but is taken in as diabetic medication (exogenous) and so does not generate C-peptide. This test may be done in conjunction with an insulin test.





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The human epidermal growth factor receptor 2 (HER2) gene is responsible for producing HER2 proteins. HER2 proteins are receptors that are present on some breast cancer cells. When they’re activated, these receptors signal breast cancer cells to divide and multiply. Normally, HER2 receptors regulate and control the growth of breast cells, keeping them at a healthy level.

However, the HER2 gene is overexpressed in about one in every five cases of breast cancer. This means that instead of having one copy of the gene from each parent, you have multiple HER2 genes. When this occurs, it’s known as HER2 gene amplification

These additional genes then make too many HER2 receptors. This is known as HER2 protein receptor overexpression. Too many genes and too many receptors cause breast cells to grow and divide in an uncontrolled manner. This can lead to aggressive tumor growth.


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Herpes simplex virus or HSV (family Herpesviridae) is a transmittable and infectous virus usually triggered by two strains of the herpes simplex virus, type 1 (HSV-1) and type 2 (HSV-2). HSV-1 normally affects the mouth and lips in the form of cold sores, whereas HSV-2 is more common and usually perceptible in the genital and anal area. HSV is very easily transmittable and infectous and is transmitted through contact with an infected person who produces it and sheds the virus. It could spread by direct contact with sores or occassionally by contact with the oral and genital areas of people with chronic HSV infection, who are between episodes of sores.Contamination with the herpes virus is classified by clearly distinguished disorders based on where the infection is like infection of the face, throat, and mouth, hands, eye, the central nervous system, brain, buttocks or anal area and the genitals. Ressurection of a latent oral or genital HSV contamination could set off by a fever, menstruation, emotional stress, or suppression of the immune system (for example, by a drug taken to prevent rejection of an organ transplant). An episode of the HSV infection could break out after physical trauma, like a dental procedure or overexposure of the lips to sunlight. Often, the set off is unknown. Once infected, the virus remains in the body for life and can keep recurring.


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Creatine kinase-MB (CK-MB) is a form of an enzyme found primarily in heart muscle cells. This test measures CK-MB in the blood.


CK-MB is one of three forms (isoenzymes) of the enzyme creatine kinase (CK). These isoenzymes include:


CK-MM (found in skeletal muscles and the heart)

CK-MB (found mostly in the heart, but small amounts found in skeletal muscles)

CK-BB (found mostly in the brain and smooth muscle, such as the intestines and uterus)

CK is released from muscle cells and is detectable in the blood whenever there is muscle damage. The small amount of CK that is normally in the blood is primarily CK-MM. CK-BB almost never gets into the blood, and CK-MB will typically only be present in significant amounts when the heart is damaged. A CK test measures the total level but does not distinguish between the three isoenzymes. When there is an increased amount of CK present in the blood, the CK-MB test can be used to determine whether it is due to heart damage or is more likely to be related to skeletal muscle injury.

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Creatine Kinase Total test is performed on a sample of blood to measure level of Creatine Kinase in blood.It is performed to confirm Myocardial Infraction, Myocardial Injury and Skeletal Muscle Injury and also during treatment and after treatment of Myocardial Infraction, Myocardial Injury and Skeletal Muscle Injury.

Also known as

CK - Total Spectrophotometric method Blood, CPK - Total, Creatine Phosphokinase Total Spectrophotometric method Blood, Serum CPK Test, CK - Total, Creatine Kinase Total, Creatine Phosphokinase Total, Serum CPK.

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Creatinine is a waste product produced by muscles from the breakdown of a compound called creatine. Creatinine is filtered from the blood by the kidneys and released into the urine. A creatinine clearance test measures creatinine levels in both a sample of blood and a sample of urine from a 24-hour urine collection. The results are used to calculate the amount of creatinine that has been cleared from the blood and passed into the urine. This calculation allows for a general evaluation of the amount of blood that is being filtered by the kidneys in a 24-hour time period.


The amount of creatinine produced in the body is dependent on muscle mass and is relatively constant for an individual. The amount of creatinine removed from the blood depends on both the filtering ability of the kidneys and the rate at which blood is carried to the kidneys.


The amount of blood filtered per minute by the kidneys is known as the glomerular filtration rate (GFR). If the kidneys are damaged or diseased, or if blood circulation is slowed, then less creatinine will be removed from the blood and released into the urine and the GFR will be decreased.


GFR is difficult to measure directly. Therefore, it is recommended to estimate GFR by measuring the creatinine level in the blood and using the results in an equation to calculate estimated GFR. The calculation that takes into account several factors, such as age, gender and race of the person tested (see the article on Estimated Glomerular Filtration Rate).


Another, less common way to estimate GFR is to calculate creatinine clearance. There are several versions of the creatinine clearance calculation. All of them include the measurement of the amount of creatinine in a blood sample collected just before or after the urine collection, the amount of creatinine in a 24-hour urine sample, and the 24-hour urine volume. Since the amount of creatinine produced depends on muscle mass, some calculations also use a correction factor that takes into account a person's body surface area (using their height and weight).

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Histamine is an important neurotransmitter and immune messenger molecule.  It is involved in processes involving hydrochloric acid secretion for digestion, triaging water reserves to key areas of the body and the inflammatory response One of the major effects of histamine is causing the blood vessels to swell and dilate.  When the body senses that it is threatened it will secrete higher amounts of histamine.   This allows the white blood cells to quickly move through the blood stream and find the potential threat or infection.  This is an important component to a healthy immune response. 

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Creatinine is a waste product produced by muscles from the breakdown of a compound called creatine. Creatinine is removed from the body by the kidneys, which filter almost all of it from the blood and release it into the urine. This test measures the amount of creatinine in the blood and/or urine.


Creatine is part of the cycle that produces energy needed to contract muscles. Both creatine and creatinine are produced by the body at a relatively constant rate. Since almost all creatinine is filtered from the blood by the kidneys and released into the urine, blood levels are usually a good indicator of how well the kidneys are working. The quantity produced depends on the size of the person and their muscle mass. For this reason, creatinine concentrations will be slightly higher in men than in women and children.


Results from a blood creatinine test may be used in combination with results from other tests, such as a 24-hour urine creatinine test, to perform calculations that are used to evaluate kidney function. See the "How is it used?" section for more on these.

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C-reactive protein (CRP) is an acute phase reactant, a protein made by the liver and released into the blood within a few hours after tissue injury, the start of an infection, or other cause of inflammation. Markedly increased levels are observed, for example, after trauma or a heart attack, with active or uncontrolled autoimmune disorders, and with serious bacterial infections like sepsis. The level of CRP can jump as much as a thousand-fold in response to inflammatory conditions, and its rise in the blood can precede pain, fever, or other clinical indicators. The test measures the amount of CRP in the blood and can be valuable in detecting inflammation due to acute conditions or in monitoring disease activity in chronic conditions.


The CRP test is not diagnostic, but it provides information to a health practitioner as to whether inflammation is present. This information can be used in conjunction with other factors such as signs and symptoms, physical exam, and other tests to determine if someone has an acute inflammatory condition or is experiencing a flare-up of a chronic inflammatory disease. The health practitioner may then follow up with further testing and treatment.


This standard CRP test is not to be confused with an hs-CRP test. These are two different tests that measure CRP and each test measures a different range of CRP level in the blood for different purposes:


The standard CRP test measures markedly high levels of the protein to detect diseases that cause significant inflammation. It measures CRP in the range from 10 to 1000 mg/L.

The hs-CRP test accurately detects lower levels of the protein than the standard CRP test and is used to evaluate individuals for risk of cardiovascular disease. It measures CRP in the range from 0.5 to 10 mg/L.

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Histones are proteins present in the nucleus. The genetic material, chromatin, is wrapped around histones. Anti-histone antibodies are a type of antinuclear antibodies, which are autoimmune antibodies. The production of anti-histone antibodies can be stimulated by certain drugs such as isoniazid, quinidine, anticonvulsants, thyroid medications and hydralazine. This may lead to an autoimmune disorder called drug induced lupus erythematous. The test for anti-histone antibodies is used to distinguish this form of lupus from systemic lupus erythematous. 


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Infection with Histoplasma capsulatum occurs commonly in areas in the Midwestern United States and Central America, but symptomatic disease requiring medical care is manifest in very few patients. The extent of disease depends on the number of conidia inhaled and the function of the host's cellular immune system. Pulmonary infection is the primary manifestation of histoplasmosis, varying from mild pneumonitis to severe acute respiratory distress syndrome. In those with emphysema, a chronic progressive form of histoplasmosis can ensue. Dissemination of H. capsulatum within macrophages is common and becomes symptomatic primarily in patients with defects in cellular immunity. The spectrum of disseminated infection includes acute, severe, life-threatening sepsis and chronic, slowly progressive infection. Diagnostic accuracy has improved greatly with the use of an assay for Histoplasma antigen in the urine; serology remains useful for certain forms of histoplasmosis, and culture is the ultimate confirming diagnostic test. Classically, histoplasmosis has been treated with long courses of amphotericin B. Today, amphotericin B is rarely used except for severe infection and then only for a few weeks, followed by azole therapy. Itraconazole is the azole of choice following initial amphotericin B treatment and for primary treatment of mild to moderate histoplasmosis.


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Cryptococcosis is an invasive fungal infection caused by Cryptococcus neoformans or Cryptococcus gattii. C. neoformans has been isolated from several sites in nature, particularly weathered pigeon droppings. C. gatti was previously only associated with tropical and subtropical regions; however, more recently this organism has also been found to be endemic in British Columbia and among the pacific northwest United States, and is associated with several different trees species.


Infection is usually acquired via the pulmonary route. Patients are often unaware of any exposure history. Approximately half of the patients with symptomatic disease have a predisposing immunosuppressive condition such as AIDS, steroid therapy, lymphoma, or sarcoidosis. Symptoms may include fever, headache, dizziness, ataxia, somnolence, and cough. While the majority of C. neoformans infections occur in immunocompromised patient populations, C.gattii is has a higher predilection for infection of healthy hosts.(1,2)


In addition to the lungs, cryptococcal infections frequently involve the central nervous system (CNS), particularly in patients infected with HIV. Mortality among patients with CNS cryptococcosis may approach 25% despite antibiotic therapy. Untreated CNS cryptococcosis is invariably fatal. Disseminated disease may affect any organ system and usually occurs in immunosuppressed individuals.

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As part of your HIV care, your provider will order several laboratory tests. The results of these lab tests, along with your physical exam and other information you provide, will help you and your provider work together to develop the best plan to manage your HIV care so that you can get the virus under control, protect your health, and reduce the chance that you will pass the virus to others.Your healthcare provider will repeat some of these tests as part of your ongoing HIV care to continue to assess your health and how well your HIV treatment is working.


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Cerebrospinal fluid (CSF) analysis is a set of laboratory tests that examine a sample of the fluid surrounding the brain and spinal cord. This fluid is an ultrafiltrate of plasma. It is clear and colorless. It contains glucose, electrolytes, amino acids, and other small molecules found in plasma, but has very little protein and few cells. CSF protects the central nervous system from injury, cushions it from the surrounding bone structure, provides it with nutrients, and removes waste products by returning them to the blood. CSF is withdrawn from the subarachnoid space through a needle by a procedure called a lumbar puncture or spinal tap. CSF analysis includes tests in clinical chemistry, hematology, immunology, and microbiology. Usually three or four tubes are collected. The first tube is used for chemical and/or serological analysis and the last two tubes are used for hematology and microbiology tests. This reduces the chances of a falsely elevated white cell count caused by a traumatic tap (bleeding into the subarachnoid space at the puncture site), and contamination of the bacterial culture by skin germs or flora.




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The HLA gene products can be grouped into three classes. Class I consists of the products of the genes located on the HLA-A, HLA-B, and HLA-C loci. These HLA antigens are found on all nucleated cells. Class II molecules consist of antigens inherited as genes from the HLA-DR, HLA-DQ, and HLA-DP loci. These HLA antigens are normally found only on B-lymphocytes, macrophages, monocytes, dendritic cells, endothelial cells, and activated T-lymphocytes. Class III molecules are not evaluated in histocompatibility testing.Because the HLA loci are closely linked, the HLA antigens are inherited as a group of six antigens is called a haplotype. The probability of siblings having identical haplotypes is one in four. Therefore, siblings provide the opportunity for the best matches. They can donate bone marrow, a kidney, and a section of their livers, but they cannot donate other solid organs. Approximately 85% of transplants are organs from cadavers, and because the HLA antigens are so highly polymorphic, the chance of identical haplotypes decreases quickly.

Histocompatibility testing consists of three tests, HLA antigen typing (tissue typing), screening of the recipient for anti-HLA antibodies (antibody screen), and the lymphocyte crossmatch (compatibility test). HLA antigen typing may be performed by serological or DNA methodsA laboratory will perform HLA typing by either the serological (blood fluid) or DNA method. In either case, HLA typing of HLA-A, HLA-B, HLA-DR, and HLADQ antigens is performed for solid organ transplants. HLA typing of HLA-C antigens is also included when tissue typing is performed for bone marrow transplantsThe antibody screen is performed in order to detect antibodies in the recipient's serum that react with HLA antigens. The most commonly used method of HLA antibody screening is the microcytotoxicity test. If an antibody against an HLA antigen is present, it will bind to the cells. The higher the number of different HLA antibodies, the lower the probability of finding a compatible matchThe third component of a histocompatibility study is the crossmatch test. In this test peripheral blood lymphocytes from the donor are separated into B and T lymphocyte populations. In the crossmatch, serum from the recipient is mixed with T-cells or B-cells from the donor. A positive finding indicates the presence of preformed antibodies in the recipient that are reactive against the donor tissues. An incompatible T-cell crossmatch contraindicates transplantation of a tissue from the T-cell donor.


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Human leukocyte antigen B27 (HLA-B27) is a protein located on the surface of your white blood cells. An HLA-B27 test is a blood test that identifies HLA-B27 proteins.Human leukocyte antigens (HLAs) are proteins commonly found on white blood cells. These antigens help your immune system identify the differences between healthy body tissue and foreign substances that may cause infection

Although most HLAs protect your body from harm, HLA-B27 is a specific type of protein that contributes to immune system dysfunction. The presence of HLA-B27 on your white blood cells can cause your immune system to attack those otherwise healthy cells. When this occurs, it can result in an autoimmune disease or immune-mediated disease, such as juvenile rheumatoid arthritis or ankylosing spondylitis.


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You will lie on a narrow table that slides into the center of the CT scanner. Most often, you will lie on your back with your arms raised above your head.

Once you are inside the scanner, the machine's x-ray beam rotates around you. Modern "spiral" scanners can perform the exam without stopping.

A computer creates separate images of the belly area, called slices. These images can be stored, viewed on a monitor, or printed on film. Three-dimensional models of the belly area can be made by stacking the slices together.

You must be still during the exam, because movement causes blurred images. You may be told to hold your breath for short periods of time.

The scan should take less than 30 minutes.

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An angiogram of the head and neck is an X-ray test that uses a special dye and camera (fluoroscopy) to take pictures of the blood flow in the blood vessels of the head and neck camera.gif. An angiogram of the neck (carotid angiogram) can be used to look at the large arteries in the neck that lead to the brain. An angiogram of the head (cerebral angiogram) can be used to look at the veins or the four arteries (four-vessel study) carrying blood to the brain.


During an angiogram, a thin, soft tube called a catheter is placed camera.gif into a blood vessel in the groin (femoral artery or vein) or just above the elbow (brachial artery or vein). The catheter is guided to the head and neck area. Then an iodine dye (contrast material) is injected into the vessel to make the area show clearly on the X-ray pictures. The angiogram pictures can be made into regular X-ray films or stored as digital pictures in a computer.


An angiogram can find a bulge in a blood vessel (aneurysm). It can also show narrowing or a blockage in a blood vessel that slows or stops blood flow. An abnormal pattern of blood vessels (arteriovenous [AV] malformation) or abnormal vessels near a tumor can be seen.


A magnetic resonance angiogram (MRA) or computed tomography angiogram (CTA) may be an option instead of a standard angiogram. Each of these tests is less invasive than an angiogram. Some MRA tests and all CTA tests require an injection of dye. A CTA also involves radiation exposure.


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Homocysteine is an amino acid that is produced by the body by chemically altering adenosine. Amino acids are naturally made products, which are the building blocks of all the proteins in the body. In 1969, Dr. Kilmer S. McCully reported that children born with a genetic disorder called homocystinuria, which causes the homocysteine levels to be very high, sometimes died at a very young age with advanced atherosclerosis in their arteries. Homocysteine levels in the blood may be elevated for many reasons. More specifically, these reasons can be divided into severe genetic causes and other milder causes.


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This is a procedure used to evaluate the blood flow of the arteries in the arms or legs. Using image-guidance, doctors can determine if there is damage to or a blockage of blood flow in an artery. This is helpful in diagnosing certain conditions such as atherosclerosis (hardening of the blood vessel) or damage caused by trauma. This helps doctors in planning for future interventions, including vascular procedures (such as stent placement) or surgery.

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Hysterosalpingography is a procedure where x rays are taken of a woman's reproductive tract after a dye is injected.Hystero means uterus and salpingo means tubes, so hysterosalpingography literally means to take pictures of the uterusand fallopian tubes. This procedure may also be called hysterography (or HSG).As with other types of pelvic examinations, the woman will lie on her back on an examination table with her legssometimes raised in stirrups. The x-ray equipment is placed above the abdomen.A speculum is inserted into the vagina and a catheter (a thin tube) is inserted into the uterus through the cervix (theopening to the uterus). A small balloon in the catheter is inflated to hold it in place. A liquid water-based or oil-based dyeis then injected through the catheter into the uterus. This process can cause cramping, pain, and uterine spasms.As the dye spreads through the reproductive tract, the doctor may watch for blockages or abnormalities on an x-raymonitor. Several x rays will also be taken. The procedure takes approximately 15-30 minutes. The x rays will bedeveloped while the patient waits, but the final reading and interpretation of the x rays by a radiologist (a doctor whospecializes in x rays) may not be available for a few days.Interestingly, sometimes the hysterosalpingography procedure itself can be considered a treatment. The dye used cansometimes open up small blockages in the fallopian tubes. The need for additional test procedures or surgical treatmentsto deal with infertility should be discussed with the doctor.


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You will be asked to lie on a narrow table that slides into the center of the CT scanner.


While inside the scanner, the machine's x-ray beam rotates around you.


A computer creates many separate images of the body area, called slices. These images can be stored, viewed on a monitor, or printed on film. Three-dimensional models of the head and neck area can be created by stacking the slices together.


You must be still during the exam, because movement causes blurred images. You may be told to hold your breath for short periods of time.


Complete scans usually take only a few seconds. The newest scanners can image your entire body, head to toe, in less than 30 seconds.

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A computerized tomography (CT) coronary angiogram is an imaging test that looks at the arteries that supply blood to your heart. It might be used to diagnose the cause of chest pain or other symptoms.


A CT coronary angiogram relies on a powerful X-ray machine to produce images of your heart and its blood vessels. These tests are noninvasive and don't require recovery time. Coronary CT angiograms are increasingly an option for people with a variety of heart conditions.


A traditional (not CT-based) coronary angiogram requires that a flexible tube (catheter) be threaded through your groin or arm to your heart or coronary arteries. If you have known coronary artery disease, your doctor might recommend a traditional coronary angiogram because you can also receive treatment during that procedure.

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This test looks for antibodies which the body develops in response to infection with the Human T-Cell Lymphotropic Virus (HTLV).  HTLV infects white blood cells which are important to the body’s immune system.  HTLV infection can be responsible for the development of a number of conditions including Leukemia, Lymphoma, and nervous system disorders.  The HTLV 1&2 Abs test detects and differentiates both type 1 and type 2 HTLV infections. An estimated 15-20 million people worldwide suffer from HTLV infections.  HTLV is typically spread through sexual contact and exposure to infected blood, especially through intravenous drug use.  Infected mothers can spread the infection to their infants during pregnancy or breast feeding.  After infection, HTLV will remain in the body for life.  Some people will develop HTLV related illnesses months or years after their initial exposure.  Most HTLV infections show no symptoms.  An infected person can spread the virus to others even if they are asymptomatic. 


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The first reported case of the use of computed tomography (CT) to guide biopsy was published in 1975 (1). By 1976, CT was heralded as the single most accurate method for guiding biopsy (2). With the increasing availability of CT and the development of percutaneous techniques, this statement has proved true: CT is now the imaging modality of choice for guiding percutaneous procedures. Over the following 20 years, CT-guided procedures were performed by obtaining a planning image of the region of interest and using cutaneous markers to specify a percutaneous access point. Needle advancement was documented by leaving the scanning room and obtaining one to three contiguous images at the level of the needle plane and repeating the process with each subsequent manipulation of the needle. The advent of CT fluoroscopy in the early 1990s allowed the needle to be visualized in real time, expediting the procedure and markedly reducing its overall length, partly because participants did not leave the scanning room (3). However, the use of real-time CT fluoroscopy potentially increased patient radiation dose and, for the first time, exposed physicians, nurses, and technologists to radiation.


Because CT fluoroscopy–guided procedures have become more common, they account for an important portion of the radiation dose delivered to our patient population. It has been shown that radiation dose may be significantly reduced in diagnostic CT examinations with no loss of diagnostic image quality (4). Likewise, dose should be taken into account when planning interventional procedures, and the radiation dose used should be as low as reasonably achievable to complete the procedure successfully. In this article, we discuss how patient dose is estimated and how knowledge of how a radiation dose is distributed over the course of a procedure is essential in developing low-dose protocols. If certain straightforward steps are followed, it is possible to significantly reduce radiation exposure for both patients and physicians

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Despite the morbidity associated with anogenital condylomas and the mortality associated with anal, penile, and cervical carcinoma as a direct consequence of human papillomavirus (HPV), the US Centers for Disease Control and Prevention currently does not recommend routine screening for HPV in immuno competent men. However, findings of emerging research focusing on the high-risk populations of men who have sex with men and men who test positive for human immunodeficiency virus, in whom HPV infection is pervasive and persistent, suggest that these populations may benefit from screening. Therefore, HPV screening, including anal cytology, should be considered for these men in settings where appropriate follow-up, including high-resolution anoscopy, is available.

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Bronchoscopy is a procedure that looks inside the lung airways. It involves inserting a bronchoscope tube, with its light and small camera, through your nose or mouth, down your throat into your trachea, or windpipe, and to the bronchi and bronchioles of your lungs. This procedure is used to find the cause of a lung problem. It can detect tumors, signs of infection, excess mucus in the airways, bleeding, or blockages in the lungs. It also can allow your doctor to take samples of mucus or tissue for other laboratory tests, as well as to insert airway stents, or small tubes, to keep your airway open to treat some lung problems.


The procedure is performed using a flexible bronchoscope or a rigid bronchoscope. Flexible bronchoscopy is more common than rigid bronchoscopy, and flexible bronchoscopy usually does not require general anesthesia. Before the procedure, you will be given medicine to relax you. A liquid medicine also will be given to numb your nose and throat. If you have low blood oxygen levels during the procedure, you will be treated with oxygen therapy. If you have a lot of bleeding in your lungs or a large object is stuck in your airway, you may require rigid bronchoscopy in a hospital operating room under general anesthesia.


After the procedure, you will be monitored to make sure you don’t have complications. You may experience a sore throat, cough, or hoarseness that will go away with time. If you had the procedure as an outpatient, you likely will be able to go home after a few hours, but you will need a ride home because of the medicines or anesthesia you received. You will need to follow up with your doctor after the procedure to get your results.


Bronchoscopy is usually safe, but there is a small risk for fever, minor bleeding, or pneumonia. Pneumothorax, or collapsed lung, is a rare but serious side effect that can be treated. Your doctor may do a chest x ray after the procedure to check for lung problems.

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Visual Evoked Potential/ Response (VEP/VER) measures the electrical signal generated at visual cortex in response to visual stimulation. The visual cortex is primarily activated by the central visual field and there is a large presentation of the macula at occipital cortex. VEP depends on integrity of visual pathway including eye, optic nerve, chiasma, optic tract, optic radiation and cerebral cortex. Standard International Society for Clinical Electrophysiology of Vision (ISCEV) protocols[1] assess the anterior visual pathway (eye, optic nerve anterior to the optic chiasma). For dysfunctions of posterior visual pathway extended multi-channel protocols are needed.


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Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside of the body.


The cross-sectional images generated during a CT scan can be reformatted in multiple planes, and can even generate three-dimensional images. These images can be viewed on a computer monitor, printed on film or transferred to a CD or DVD.


CT images of internal organs, bones, soft tissue and blood vessels provide greater detail than traditional x-rays, particularly of soft tissues and blood vessels.


A cardiac CT scan for coronary calcium is a non-invasive way of obtaining information about the presence, location and extent of calcified plaque in the coronary arteries—the vessels that supply oxygen-containing blood to the heart muscle. Calcified plaque results when there is a build-up of fat and other substances under the inner layer of the artery. This material can calcify which signals the presence of atherosclerosis, a disease of the vessel wall, also called coronary artery disease (CAD). People with this disease have an increased risk for heart attacks. In addition, over time, progression of plaque build up (CAD) can narrow the arteries or even close off blood flow to the heart. The result may be chest pain, sometimes called "angina," or a heart attack.


Because calcium is a marker of CAD, the amount of calcium detected on a cardiac CT scan is a helpful prognostic tool. The findings on cardiac CT are expressed as a calcium score. Another name for this test is coronary artery calcium scoring.

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There are several serological tests used to diagnose Hydatiddisease.Routine tests include indirect hemagglutination (IHA)andImmunoelectrophoresis (IEP). The sensitivity of IHA in calcified or lunglesions is 60%, and 88% in peritoneal or liver disease, with a specificityof 90-95% (1-2).IEP is regarded as an highly specific test, but crossreactivity could be with other infections such as Taenia SoliumCysticercosis )or rarely in liver cirrhosis or cancer (cross reactivitywith P1 antigen)(3).Our practice is to combine the tests, because of itslow sensitivity. IEP test will be positive for Antigen 5 (arc 5)usualywith a titer of 1:512 in IHA test. Inlower titer, IEP will be positiveonly in 13% of patients (3).Recently, more advanced serological tests are used. ELISA test withsensitivity and specificity of 84% and 96.6% respectively,or Westernblotting (IB-Immunoblot). There are several diagnostic antigens in IBtest. The first antigen was of 8 kDa , with a described sensitivity andspecificity of 91% and 100% respectively (4). Since this report, manyother antigens were described using the IB test. Basicly, the two majorantigens are the thermolabile Antigen A ( antigen 5)which is composed oftwo subunits of 38-40 and 20 kDa, and the thermostable Antigen B whichis composed of 3 antigens of 8-12, 16 and 23-24 kDa (5). The cellularImuune response can also be tested by a lymphoproliferative assay (blasttransformation) which is a very sensitive test used to diagnose thedisease in seronegative patients (5).


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Ultrasound imaging also called as sonography uses a transducer or a probe to generate sound waves and produce pictures of the body's internal structures. It is often used to help diagnose unexplained pain, swelling or infection. It is also used to see internal body structures such as tendons, muscles, joints, vessels and internal organs. Ultrasound abdomen is primarily used for evaluating the kidneys, liver, pancreas, gall bladder etc.It may also be used to provide imaging guidance to needle biopsies or to see and evaluate conditions related to blood flow. It does not use ionizing radiation, has no known harmful effects, and provides a clear picture of soft tissues that don't show up well on x-ray images. It is a painless, safe and non invasive procedure.
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This test measures the amount of immunoglobulins A, G, and M in the blood and, in certain circumstances, in cerebrospinal fluid (CSF) . There are numerous conditions and diseases that can cause increased or decreased production of immunoglobulins (Igs).Immunoglobulins play a key role in the body's immune system. They are proteins produced by specific immune cells (plasma cells and B-cells) in response to bacteria, viruses, and other microorganisms as well as substances that are recognized as "non-self" and harmful antigens. The first time a person is infected or otherwise exposed to a foreign substance (antigen), their immune system recognises the microorganism or substance as "non-self" and stimulates cells to produce specific immunoglobulin(s) or antibodies that can bind to and neutralise the threat. With subsequent exposures, the immune system "remembers" the antigen that was encountered, which allows for the rapid production of more antibodies and helps prevent re-infection.There are five classes of immunoglobulins and several subclasses. Each class represents a group of antibodies and has a slightly different role. Classes of immunoglobulins include:


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An IgA test measures the blood level of immunoglobulin A, one of the most common antibodies in the body. Antibodies are proteins made by the immune system to fight bacteria, viruses, and toxins.IgA is found in high concentrations in the body's mucous membranes, particularly the respiratory passages and gastrointestinal tract, as well as in saliva and tears. IgA also plays a role in allergic reactions. IgA levels also may be high in autoimmune conditions, disorders in which the body mistakenly makes antibodies against healthy tissues.

 

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This test measures the amount of Immunoglobulin E (IgE) in the blood.   Immunoglobulin E is a type of antibody produced by the body during an allergic reaction.  IgE levels are normally very low.  During exposure to an allergen, the immune system of the allergic person creates IgE which triggers typical allergy symptoms such as red itchy skin, runny nose, itchy eyes and difficulty breathing.  Measuring IgE levels can help determine if a person may have an allergic disease including asthma although it cannot identify a specific allergen.  IgE can also be elevated when a person has a parasitic infection.   


A Total IgE test is typically ordered when a person is experiencing symptoms associated with a parasitic infection or allergic reaction, especially if they do not know what they may be allergic to.  The test is usually taken shortly after or while someone is experiencing symptoms such as persistent itching, hives, itchy eyes, nausea, vomiting, diarrhea, sneezing, coughing, congestion or difficulty breathing.  This test is usually accompanied by or followed with testing for specific allergens. 

 

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 This test measures the level of Immunoglobulin G (IgG) Antibodies in the blood.  IgG are the smallest and most common type of antibody making up 75-80% of all antibodies in the body.  IgG antibodies are found in all body fluids and play a key role in fighting infections from bacteria and viruses. High IgG levels may indicate that a person has a chronic infection such as HIV or Hepatitis.  They can also be high due to conditions such as Multiple Sclerosis, some types of cancer and autoimmune disorders.  Low IgG levels can be found in people with kidney damage, leukemia and conditions which weaken the immune system leaving them more susceptible to infections. IgG test results cannot indicate the specific type or source of an infection.  More specific testing may be needed as a follow up to abnormal results.  An IgG test may be ordered when someone is suffering from frequent infections to see if they have a condition which is impairing their immune system. 


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The gamma-globulin band as seen in conventional serum protein electrophoresis consists of 5 immunoglobulins. In normal serum, about 5% is immunoglobulin M (IgM)Elevations of IgM may be due to polyclonal immunoglobulin production. Monoclonal elevations of IgM occur in macroglobulinemia.Monoclonal gammopathies of all types may lead to a spike in the gamma-globulin zone seen on serum protein electrophoresis.Decreased immunoglobulin levels are found in patients with congenital deficiencies.


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The inhibin A test is done to measure the amount of this hormone in a pregnant woman's blood to see if the baby may have Down syndrome. Inhibin A is made by the placenta during pregnancy. The level of inhibin A in the blood is used in a maternal serum quadruple screening test. Generally done between 15 and 20 weeks, this test checks the levels of four substances in a pregnant woman's blood. The quad screen checks alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), a type of estrogen (unconjugated estriol, or uE3), and 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.


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Virtual colonoscopy is a minimally invasive exam to screen for cancer of the large intestine (colon cancer). Virtual colonoscopy is also known as a screening CT colonography.


Unlike traditional colonoscopy, which requires a scope to be inserted into your rectum and advanced through your colon, virtual colonoscopy uses a CT scan to produce hundreds of cross-sectional images of your abdominal organs. The images are combined and digitally manipulated to provide a detailed view of the inside of the colon and rectum.


Virtual colonoscopy is one option used to screen for colon cancer. Discuss your colon cancer screening options with your doctor to determine whether virtual colonoscopy is the right option for you.

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The spinal cord is made up of three bones: lumbar, dorsal, and cervical. The dorsal spine, the middle portion of the cord, comprises 12 vertebrae and forms the largest portion. A CT scan with a Virtualscopy test of the dorsal spine gives a 3D scanned image of the spine. It is useful in getting a clear picture of the condition of the bones and helps in detecting any abnormalities in the same. Back pain and multiple sclerosis are the most common symptoms that call for a CT scan test of the dorsal spine. It is a relatively painless procedure.

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noninvasive X-ray test that is used to diagnose a variety of medical conditions.


It provides detailed cross sectional images of the body part in question to provide more clarity and detailed images than traditional X-rays.


A CT scan of the facial area produces images of a patient’s sinus cavity.

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A CT of the head is an exam which takes thin slice images of the brain, brain stem and skull. This is very useful to diagnose stroke, trauma, congenital defects, bleeding and possible masses. A CT of the orbit is an exam which takes thin slice images of the eye and orbital socket at three different angles. This helps in the diagnosis of things such as injury, diseases and congenital effects.

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The advent of high-resolution computed tomography (CT) scanning in the 1980s has revolutionized diagnostic imaging of the temporal bone. CT scanning offers the greatest structural definition of any currently available imaging modality. [1, 2] The purpose of this article is to familiarize the reader with the normal anatomy of the temporal bone depicted by CT scanning. The article reviews the anatomy of the middle ear space and surrounding bone and presents radiographic imaging in both axial and coronal views, with labeled salient features and relevant text.


An axial view through the superior portion of the temporal bone can be seen below.


A study by Visvanathan and Morrissey used high-resolution CT scanning to determine that temporal bone variations are not uncommon. Evaluating 339 temporal bones, the investigators found that the incidences of deep sinus tympani, anteriorly located sigmoid sinus, high dehiscent jugular bulb, enlarged internal auditory meatus, and enlarged cochlear aqueduct were 5.01%, 2.94%, 2.76%, 1.76%, and 0.58%, respectively.

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A doctor or physician may order a CT scan of the leg to make detailed pictures and analyze the internal structure. Computerized tomography (CT) scanning is useful to get a very detailed 3D image of certain parts of legs.


The process begins by taking many different X-ray views at various different angles, which are then combined with the use of computer processing to create cross-sectional images of the bones and soft tissue inside of your body, including tissues inside of solid organ. Ordinary X-ray testing does not show clear images of soft tissue, so doctors often request CT scanning to get a good image of soft tissue including organs, muscles, blood vessels, nerves, and the brain. Sometimes a contrast dye is used as it shows up clearer on the screen.


A quality CT scan of the leg will use multiple x-rays to make cross sectional pictures of the leg.

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Computed tomography (CT) of the abdomen and pelvis is a diagnostic imaging test used to help detect diseases of the small bowel, colon and other internal organs and is often used to determine the cause of unexplained pain. CT scanning is fast, painless, noninvasive and accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives.


Tell your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking, and allergies. You will be instructed not to eat or drink anything for a few hours beforehand. If you have a known allergy to contrast material, your doctor may prescribe medications to reduce the risk of an allergic reaction. These medications must be taken 12 hours prior to your exam. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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A CT scan, commonly referred to as a CAT scan, is a type of X-ray that produces cross-sectional images of a specific part of the body. In the case of a lumbar spine CT scan, your doctor can see a cross-section of your lower back. The scanning machine circles the body and sends images to a computer monitor, where they are reviewed by a technician.


The lumbar portion of the spine is a common area where back problems occur. The lumbar spine is the lowest portion of your spine. It’s made up of five vertebral bones. Below the lumbar spine is the sacrum and below the sacrum is the coccyx (tailbone). Large blood vessels, nerves, tendons, ligaments, and cartilage are also part of the lumbar spine.

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As an ancillary test for congenital adrenal hyperplasia (CAH), particularly in situations in which a diagnosis of 21-hydroxylase and 11-hydroxylase deficiency have been ruled out


Confirming a diagnosis of 3-beta-hydroxy dehydrogenase (3-beta-HSD) deficiency


Analysis for 17-hydroxypregnenolone is also useful as part of a battery of tests to evaluate females with hirsutism or infertility; both can result from adult-onset CAH

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The hormone 17-hydroxyprogesterone is a building block for producing the hormone cortisol. Cortisol is produced mainly by the adrenal cortex (the outer part of the two adrenal glands, located above the kidneys). Cortisol is called the "stress hormone" because it's secreted in larger amounts as part of the body's response to physical or emotional stress.


Cortisol levels normally vary throughout the day. They're highest in the morning, just before waking up, and lowest at night.


Some people, however, can't make enough cortisol because they lack an enzyme in the adrenal glands that's needed to make it. They'll have a buildup of 17-hydroxyprogesterone in the blood because it's not being converted to cortisol.


In kids, the most common cause of cortisol deficiency, and consequently high levels of 17-hydroxyprogesterone, is one of the forms of the genetic disorder congenital adrenal hyperplasia (CAH).


CAH can affect both boys and girls. It causes the adrenal glands to make excess androgens (male steroid hormones) and, in some cases, not enough of the hormones that regulate the body's salt balance.


Though treatable, undetected CAH can sometimes lead to more serious symptoms such as dehydration and shock in infants.

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CT scanning-sometimes called CAT scanning-is a noninvasive medical test that helps physicians diagnose and treat medical conditions.


CT scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body. These cross-sectional images of the area being studied can then be examined on a computer monitor, printed or transferred to a CD.


CT scans of internal organs, bones, soft tissue and blood vessels provide greater clarity and reveal more details than regular x-ray exams.


Using specialized equipment and expertise to create and interpret CT scans of the body, radiologists can more easily diagnose problems such as cancers, cardiovascular disease, infectious disease, appendicitis, trauma and musculoskeletal disorders.

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Direct examination via endoscopy remains the criterion standard for evaluation of laryngotracheobronchial pathologic conditions. Endoscopy allows for easy visualization and accurate diagnosis of mucosal and superficial submucosal lesions. However, the evaluation of deeper structures is capable only through CT imaging or MRI. CT imaging has become the most commonly used technique for general laryngeal imaging. It is readily available at most hospitals and even at some outpatient centers. The acquisition time for a CT image is extremely short (within a matter of seconds), which is quite useful for the laryngeal examination, as patients are generally required to hold their breath to reduce movement. [1, 2]


Nevertheless, small lesions may still be difficult to visualize. In these cases, active techniques such as the Valsalva maneuver and phonation can better delineate masses of the hypoglottis and vocal cords, respectively.


MRI has also become more widely available in the past decade, although it has not surpassed CT scanning for conventional laryngeal imaging. Both techniques have advantages and disadvantages. For example, CT and MRI appear to be comparable in efficacy for defining the site and extent of disease in fat and muscle. MRI, however, is more sensitive for detecting pathologic involvement of cartilage (Glastonbury). CT imaging is best for evaluation of occult fractures and dislocations during laryngeal trauma. Furthermore, MRI seems to be the optimal method for examining cooperative patients, especially for preoperative larynx evaluation when partial laryngectomy is considered. CT imaging is more useful in patients who cannot lie still for the study (eg, inebriated, combative). The imaging study performed usually depends on the experience of the radiologist. Additionally, MRI avoids radiation exposure. For more information, please see the Medscape Reference articleMR Imaging of the Larynx.

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Primary aldosteronism should be suspected whenever a patient has the triad of hypertension, hypokalemia, and inappropriate renal potassium wasting. The biggest challenge is the differential diagnosis between the more common adrenal adenoma and bilateral hyperplasia. Because adrenal adenomas increase the circulating levels of 18-hydroxycorticosterone (18-OH B), serum levels of 18-OH B may be useful to differentiate them from bilateral adrenal hyperplasia. The cutoff point appears to be about 50 ng/dL of serum. Most values are around 100 ng/dL. The higher the level of this precursor, the greater the possibility that an adrenal adenoma is present. J Clin Endocrinol Metab.

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Albumin commonly exists in the blood and is filtered by the kidneys. The presence or absence of albumin determines the functionality of the kidneys. It is said that small quantities of albumin leak into the urine when the kidneys do not function properly. This condition is known as microalbuminuria. A microalbumin test diagnosis urine for the presence of albumin.

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3D movies, 3D books, 3D printing and now 3D dental scans? Do I have to wear those funny looking glasses? Will I get motion sickness or up close and personal with all sorts of creatures? Don’t get yourself into dental distress! 3D dental scans are the newest advancement in technology that your dentist can use to get a good idea of what’s really going on with your chompers — no silly glasses needed.

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A computed tomography (CT) scan of the orbit is an imaging method. It uses x-rays to create detailed pictures of the eye sockets (orbits), eyes and surrounding bones.

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Testosterone plays a central role in male development and health. Likewise, androgen deficiency, or hypogonadism, is associated with a variety of symptoms including decreased energy, diminished libido and erectile dysfunction, among others. Male androgen levels steadily decline with age, and, in a subset of symptomatic older men, can result in late-onset hypogonadism (LOH). Over the last decade, increased awareness of hypogonadism among patients and providers has led to a significant rise in the use of testosterone replacement therapy (TRT) for hypogonadism, and especially in LOH. Accompanying the rise in TRT are concerns of potential adverse effects, including cardiovascular risks and the promotion of prostate cancer. The ‘androgen hypothesis’ asserts that prostate cancer development and progression is driven by androgens, and thus TRT has the theoretical potential to drive prostate cancer development and progression. In this review, we examine existing data surrounding testosterone and prostate cancer. There is significant evidence that androgens promote prostate cancer in experimental systems. However, there is no clear evidence that elevations in endogenous testosterone levels promote the development of prostate cancer in humans. As a result of experimental and historical data on the progression of prostate cancer following TRT, there has been widespread belief that TRT will promote disease progression in prostate cancer patients. Despite these fears, there are a growing number of studies demonstrating no increase in prostate cancer incidence among men on TRT. Furthermore, in studies involving a small number of patients, there has been no discernable increase in disease progression in prostate cancer patients on TRT. While data from large, prospective, randomized, controlled trials are absent, TRT in select prostate cancer patients is likely safe. In the end, the use of TRT in prostate cancer patients is still considered experimental and should only be offered after well-informed shared decision making and with close monitoring.

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This test finds out how much 5-hydroxyindoleacetic acid (5-HIAA) is in your urine.


Your liver breaks down the hormone serotonin into 5-HIAA. This waste product is normally sent from your body in your urine. Tumors called functioning carcinoids secrete serotonin. Carcinoid tumors are found in the intestinal tract, lungs, appendix, and other body tissues. Because serotonin in the blood is broken down very quickly, the amount of 5-hydroxyindoleacetic acid collected in the urine over a full day more accurately reflects the rate at which serotonin is being made than the blood level at one particular time. 

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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.

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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.

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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.

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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.

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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:

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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.

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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.

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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.

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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.

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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

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PNS is the full form of Para Nasal Sinuses. A Computed Tomography (CT) Scan of the PNS is an imaging test of sinuses which uses X-Rays to bring out in-depth images of air-filled spaces within the bones of the face, surrounding the nasal cavity. It usually includes the upper area of the throat, behind the nose. Some doctors refer to CT Scan PNS as Sinus CT Scan also. 

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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.

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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.”


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A CT scan uses X-rays to make detailed pictures camera.gif of the spine and vertebrae camera.gif.


During the test, you will lie on a table that is attached to the CT scanner, which is a large doughnut-shaped machine. The CT scanner sends X-rays through the body. Each rotation of the scanner takes a second and provides a picture of a thin slice of the organ or area being studied. One part of the scanning machine can tilt to follow the curve of your spine. All of the pictures are saved as a group on a computer. They also can be printed.


In some cases, a dye called contrast material may be put in a vein (IV) in your arm or into the spinal canal. The dye makes structures and organs easier to see on the CT pictures. The dye may be used to check blood flow and look for tumors, areas of inflammation, or nerve damage.

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An ultrasound test uses high-frequency sound waves to create images of your internal organs. Imaging tests can identify abnormalities and help doctors diagnose conditions. A transvaginal ultrasound, also called an endovaginal ultrasound, is a type of pelvic ultrasound used by doctors to examine female reproductive organs. This includes the uterus, fallopian tubes, ovaries, cervix, and vagina.

“Transvaginal” means “through the vagina.” This is an internal examination. Unlike a regular abdominal or pelvic ultrasound, where the ultrasound wand, or transducer, rests on the outside of the pelvis, this procedure involves your doctor or a technician inserting an ultrasound probe about two or three inches into your vaginal canal.


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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.

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Abdominal and Pelvic CT scan shows the abdominal and pelvic organs of our body (such as the pancreas, liver, kidneys, spleen, and adrenal glands) and the gastrointestinal tract. A doctor usually orders this test to check for a cause of abnormal pain and sometimes to follow-up on an abnormality seen on another test such as an ultrasound.

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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


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A CT (computed tomography) scan, which is also called a CAT scan, is a type of specialized X-ray. The scan can show cross-sectional images of a specific area of the body. With a CT scan, the machine circles the body and sends the images to a computer, where they’re viewed by a technician.


An abdominal CT scan helps your doctor see the organs, blood vessels, and bones in your abdominal cavity. The multiple images provided give your doctor many different views of your body.


Keep reading to learn why your doctor may order an abdominal CT scan, how to prepare for your procedure, and any possible risks and complications.

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Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside of the body.


The cross-sectional images generated during a CT scan can be reformatted in multiple planes, and can even generate three-dimensional images. These images can be viewed on a computer monitor, printed on film or transferred to a CD or DVD.


CT images of internal organs, bones, soft tissue and blood vessels provide greater detail than traditional x-rays, particularly of soft tissues and blood vessels.


Using specialized equipment and expertise to create and interpret CT scans of the body, radiologists can more easily diagnose problems such as cancer, cardiovascular disease, infectious disease, appendicitis, trauma and musculoskeletal disorders.

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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

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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.

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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%.

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Blood typing is a screening test to determine blood groups and Rh antigen for blood transfusion and pregnancy. The four blood groups A, B, O, and AB are determined by the presence of antigens A and B or their absence (O) on a patient's red blood cells. In addition to ABO grouping, most immunohematology testing includes evaluation of Rh typing tests for Rh(D) antigen. Blood cells that express Rh(D) antigen are Rh positive. Red blood cells found lacking Rh(D) are considered Rh negative. Rh typing is also important during pregnancy because of the potential for mother and fetus Rh incompatiblity. If the mother is Rh negative but the father is Rh positive, the fetus may be positive for the Rh antigen. As a result, the mother’s body could develop antibodies against the Rh antigen. These antibodies may cross the placenta and cause destruction of the baby’s red blood cells, resulting in a condition known as hemolytic disease of the fetus and newborn.


Blood typing is performed by agglutination testing. The patient's red cells are tested with anti-A and anti-B antibodies for the presence or absence of agglutination (forward type, aka cell type), and patient's serum or plasma is tested against known A and B cells (reverse type, aka serum type, aka back type). Rh typing is done by testing patient red blood cells with anti-D antibody.


Transfusion of blood components of the correct blood type is necessary in order to prevent an adverse immunologic reaction. These reactions can range from very mild and sub-clinical to very severe or fatal, depending upon the components involved and condition of the recipient. Therefore, accurate assessment of both blood component and recipient ABO and Rh status is mandatory. The results of this testing will determine what blood group types a recipient may receive safely. For plasma components such as fresh frozen plasma (FFP) and platelets, it is important that the plasma be compatible with the recipient's red blood cells. This is always true for FFP which must be transfused in adequate volume to replace essential components in the recipient. For platelets, they can be concentrated if the ABO types are incompatible such that the amount of plasma given to the recipient is reduced to a minimum and the resulting hemolysis, if any, is reduced accordingly.

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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.

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Cystic Fibrosis (CF) is an inherited condition that mainly affects the lungs, pancreas, and sweat glands. It causes the production of thick, sticky mucus that leads to recurrent respiratory infections and blocks the release of pancreatic enzymes, inhibiting the digestion of protein and fat.


CF is one of the most common recessive genetic disorders in the U.S. A recessive disorder occurs when each of the two copies of a gene (one inherited from each parent) is abnormal. According to Cystic Fibrosis Foundation, it is estimated that 30,000 Americans are living with CF and approximately 1,000 new cases are diagnosed every year. Most people with CF are diagnosed in early childhood.


CF is caused by mutations (disease-causing variations in the DNA) in a gene called CFTR located on chromosome seven. More than 2,000 different CF mutations have been identified so far, but only a few are common. The majority of cystic fibrosis cases in the U.S. are caused by a mutation called deltaF508 (F508).


The CFTR gene is responsible for the normal production of a protein called cystic fibrosis transmembrane conductance regulator (CFTR). In CF, the CFTR protein may be dysfunctional or totally absent. With dysfunctional or absent CFTR, chloride does not move out of the ducts into surrounding fluid, resulting in the production of thick, sticky mucus. Since CFTR levels are usually highest in the epithelial cells lining the internal surfaces of the bronchi of the lungs, pancreas, sweat glands, salivary glands, intestine, and reproductive organs, these are the areas most affected by CF.


Most people with CF develop respiratory and pancreatic symptoms early in life, although the severity of signs and symptoms varies from person to person, even in those carrying the exact same mutations. The majority of adult men with CF are also infertile due to missing or underdeveloped vas deferens, the tubules that transport sperm from the testicles.


An individual with one normal CFTR gene copy and one abnormal gene copy is a CF carrier. Carriers do not generally have symptoms, but they may pass a copy of their abnormal gene on to their children. Both biological parents must either be carriers or have CF in order for their child to have CF.


The risk associated with carrying an abnormal CF gene can be generally associated with a person's ethnic background. Caucasians from Northern Europe and Ashkenazi Jews have the highest incidence of CF with about 1 in 25 individuals being CF carriers.

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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.

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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.


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A transrectal ultrasound (TRUS) may also be called prostate sonogram or endorectal ultrasound. It is used to look at the prostate and tissues around it. An ultrasound transducer (also called a probe) sends sound waves through the wall of the rectum and into the prostate and surrounding tissue. A computer analyzes the wave patterns (called echoes) as they bounce off the organs and converts them into an image that doctors view on a video screen.

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Thyroid ultrasound uses sound waves to produce pictures of the thyroid gland within the neck. It does not use ionizing radiation and is commonly used to evaluate lumps or nodules found during a routine physical or other imaging exam.This procedure requires little to no special preparation. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels





 

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Ultrasound imaging of the scrotum uses sound waves to produce pictures of a man’s testicles and surrounding tissues. It is the primary method used to help evaluate disorders of the testicles, epididymis (a tube immediately next to a testicle that collects sperm) and scrotum. Ultrasound is safe, noninvasive, and does not use ionizing radiation.

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Cytomegalovirus (CMV) is a common virus that occurs widely throughout the population but rarely causes symptoms. In the United States, as many as 50-85% of adults have been infected with CMV. Most people are infected as children or as young adults and do not experience any significant symptoms or health problems.


CMV testing involves either a measurement of CMV antibodies, immune proteins produced in response to CMV exposure, or the detection of the virus itself. The virus can be identified during an active infection by culturing CMV or by detecting the virus's genetic material (its DNA) in a fluid or tissue sample.


CMV is found in many body fluids during an active infection, including saliva, urine, blood, breast milk, semen, vaginal secretions, and cerebrospinal fluid. It is easily transmitted to others through close physical contact or by contact with infected objects, such as diapers or toys. After the initial "primary" infection has resolved, CMV becomes dormant or latent, like other members of the herpes family. Cytomegalovirus remains in a person for the rest of the person's life without causing any symptoms unless the person's immune system is significantly weakened. If this happens, the virus can reactivate.


CMV can cause notable health problems in three situations:


In young adults, primary CMV infection may cause a flu-like or mononucleosis-type illness. This condition, which causes symptoms such as extreme fatigue, fever, chills, body aches and/or headaches, usually resolves within a few weeks. 

In infants, primary CMV infection may cause serious physical and developmental problems. This occurs when a woman is infected for the first time (primary infection) during pregnancy and then passes the infection to her developing baby across the placenta. Most newborns (about 90%) who are infected appear healthy at birth but may develop hearing or vision problems, pneumonia, seizures, and/or delayed mental development a few months later. A few babies may be stillborn, while others may have symptoms at birth such as jaundice, anemia, an enlarged spleen or liver, and a small head.

In those with weakened immune systems, CMV could cause serious illness and death. This includes those with HIV/AIDS, those who have had organ or bone marrow transplants, and those undergoing chemotherapy treatment for cancer. People with compromised immune systems who become infected for the first time (primary infection) might experience the most severe symptoms and their CMV infection may remain active. Those who have been exposed to CMV previously may reactivate their infection. This could affect their eyes (causing inflammation of the retina, which can lead to blindness), digestive tract (causing bloody diarrhea and abdominal pain), lungs (causing pneumonia with a non-productive cough and shortness of breath), and brain (causing encephalitis). There can also be spleen and liver involvement, and those who have had organ or bone marrow transplants may experience some degree of rejection. Active CMV also further depresses the immune system, allowing other secondary infections such as fungal infections, to occur.

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Dehydroepiandrosterone (DHEA) is the principal human C-19 steroid. DHEA has very low androgenic potency, but serves as the major direct or indirect precursor for most sex steroids. DHEA is secreted by the adrenal gland and production is at least partly controlled by adrenocorticotropic hormone (ACTH). The bulk of DHEA is secreted as a 3-sulfoconjugate dehydroepiandrosterone sulfate (DHEAS). Both hormones are albumin bound, but DHEAS binding is much tighter. As a result, circulating concentrations of DHEAS are much higher (>100-fold) compared to DHEA. In most clinical situations, DHEA and DHEAS results can be used interchangeably. In gonads and several other tissues, most notably skin, steroid sulfatases can convert DHEAS back to DHEA, which can then be metabolized to stronger androgens and to estrogens.


 


During pregnancy, DHEA/DHEAS and their 16-hydroxylated metabolites are secreted by the fetal adrenal gland in large quantities. They serve as precursors for placental production of the dominant pregnancy estrogen, estriol. Within weeks after birth, DHEA/DHEAS levels fall by 80% or more and remain low until the onset of adrenarche at age 7 or 8 in girls and age 8 or 9 in boys. Adrenarche is a poorly understood phenomenon, peculiar to higher primates, that is characterized by a gradual rise in adrenal androgen production. It precedes puberty, but is not casually linked to it. Early adrenarche is not associated with early puberty or with any reduction in final height or overt androgenization. However, girls with early adrenarche may be at increased risk of polycystic ovarian syndrome as adults and some boys may develop early penile enlargement.


 


Following adrenarche, DHEA/DHEAS levels increase until the age of 20 to a maximum roughly comparable to that observed at birth. Levels then decline over the next 40 to 60 years to around 20% of peak levels. The clinical significance of this age-related drop is unknown and trials of DHEA/DHEAS replacement in the elderly have not produced convincing benefits. However, in young and old patients with primary adrenal failure, the addition of DHEA/DHEAS to corticosteroid replacement has been shown in some studies to improve mood, energy, and sex drive.

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Ultrasound is a high-frequency sound that you cannot hear but it travels through fluid and soft tissues. However, it bounces back, or echoes, when it hits a more solid, dense surface such as a valve or bile in the gallbladder etc. So, when ultrasound 'hits' structures of different densities in our bodies, it echoes differently with each hit. 


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Dehydroepiandrosterone sulfate (DHEAS) is a male sex hormone (androgen) that is present in both men and women. This test measures the level of DHEAS in the blood.


DHEAS:


Plays a role in developing male secondary sexual characteristics at puberty

Can be converted by the body into more potent androgens, such as testosterone and androstenedione

Can be converted into the female hormone estrogen

 

DHEAS is produced almost exclusively by the adrenal glands, with smaller amounts being produced by a woman's ovaries and a man's testicles.


It is useful as a marker for adrenal gland function. Adrenal tumors (cancerous and non-cancerous) and adrenal hyperplasia can lead to the overproduction of DHEAS. Rarely, an ovarian tumor may produce DHEAS.

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Dengue fever is a viral infection transmitted to humans by mosquitoes that live in tropical and subtropical climates and carry the virus. Blood testing detects the dengue virus or antibodies produced in response to dengue infection.


According to the Centers for Disease Control and Prevention (CDC), dengue infections have been reported in more than 100 countries from parts of Africa, the Americas, the Caribbean, the Eastern Mediterranean, Southeast Asia, and the Western Pacific. It is a fast emerging infectious disease, according to the World Health Organization (WHO), with an increasing number of cases and countries affected throughout the world. The actual number is not known because about 75% of cases are asymptomatic, but a recent estimate put the number of annual dengue infections as high as 390 million. Approximately 50 to 100 million symptomatic cases occur annually worldwide.


In the U.S., the majority of dengue cases occur in travelers returning from areas where dengue is endemic. Most dengue cases in U.S. citizens occur in people who live in Puerto Rico, the U.S. Virgin Islands, Samoa and Guam. Outbreaks where a large number of cases occur in a defined area are rare in the U.S. In recent years, there have been small outbreaks in Texas and Hawaii and a few cases diagnosed in southern Florida.

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The overnight dexamethasone suppression test checks to see how taking a steroid medicine called dexamethasone changes the levels of the hormone cortisol in the blood. This test checks for a condition in which large amounts of cortisol are produced by the adrenal glands (Cushing's syndrome).


Normally, when the pituitary gland camera.gif makes less adrenocorticotropic hormone (ACTH), the adrenal glands camera.gif make less cortisol. Dexamethasone, which is like cortisol, lowers the amount of ACTH released by the pituitary gland. This in turn lowers the amount of cortisol released by the adrenal glands.


After a dose of dexamethasone, cortisol levels often stay very high in people who have Cushing's syndrome. Sometimes other conditions can keep cortisol levels high during this test. Examples include major depression, alcoholism, stress, obesity, kidney failure, pregnancy, and uncontrolled diabetes.


The night before the blood test, you will take a dexamethasone pill. The next morning, the cortisol level in your blood will be measured. If your cortisol level stays high, Cushing's syndrome may be the cause.


An ACTH test is sometimes done at the same time as the cortisol test.

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A dexamethasone suppression test is primarily used to help diagnose Cushing syndrome. Cushing syndrome indicates that you have an abnormally high level of cortisol. Cortisol is a steroid hormone produced by the body during high levels of stress. (Abnormally low cortisol levels can be a sign of Addison’s disease, which is not diagnosed by this test.)

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X-ray imaging, also called radiography, is a fast and easy way to identify and diagnose bone injuries and disorders such as arthritis, cancer, osteoporosis, fractures and infections. It is also used in conjunction with orthopedic surgery to ensure that a fracture or other injury has been properly aligned, and it can aid in the detection and diagnosis of abnormalities in the chest organs, including the heart and lungs. X-rays may be followed up with MRI, PET, CT, or ultrasound imaging if further testing is needed.

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Dihydrotestosterone (DHT) is a potent form of testosterone required for male sexual development. However, aging men tend to have higher levels of DHT that could lead to problems such as hair loss and prostate dysfunction.


Additionally, men and women on testosterone therapy should always check their testosterone blood level to make sure that it stays within an optimal range. Remember, women with higher levels of DHT can also lose their hair.

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A DLC blood test is one which measures the percentage of every single type of WBCs in the body. There are five types of normal WBCs in the blood. Their respective normal range in adults is as follows:


Neutrophils or Polymorphs: 40 - 60%


Lymphocytes (B and T cells): 20 - 40%


Monocytes: 2 - 8%


Eosinophils: 1 - 4%


Basophils: 0.5 - 1%


Band or young neutrophils: 0 - 3%


Speaking on the relevance of TLC and DLC blood tests, our expert Dr Gita Prakash, says, "These are one of the most common blood tests that we do. It tells us if there is any fever, urine infection, cough, etc." 


She goes on to add, "TLC and DLC blood tests are tests done at a primary level for a patient, because they give you a basic idea about the kind of disease you are suffering from. It also gives you an idea if there is anything more serious. I would say that TLC and DLC are good tests to get done if you are suffering from any kind of problem." 


So, how often should one get a TLC and DLC test done? "Anyone who comes to me with a problem, TLC and DLC are the basic tests that I suggest them to get done. In the report, if TLC is high, it means that there is some kind of infection. If the TLC is lower than normal, it could be a typhoid, dengue, viral fever, etc. The same goes with DLC. So these tests tell you everything about the kind of illness you are looking at," says Dr. Gita while further mentioning that by correlating the symptoms with the test results, one can diagnose the particular disease  that a patient is suffering from.

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Drugs of abuse testing is the detection of one or more illegal and/or prescribed substances in the urine, blood, saliva, hair, or sweat. Testing detects substances not normally found in the body, with the exception of some hormones and steroids measured as part of sports testing.


Drug abuse testing usually involves an initial screening test followed by a second test that identifies and/or confirms the presence of a drug or drugs. Most laboratories use commercially available tests that have been developed and optimized to screen urine for the "major drugs of abuse."


For most drugs of abuse testing, laboratories compare results of initial screening with a predetermined cut-off. Anything below that cut-off is considered negative; anything above is considered a positive screening result. In addition, labs might perform testing for masking agents (adulterants). These may either interfere with testing or dilute a urine sample.


Among drugs of abuse, each class of drug may contain a variety of chemically similar substances. Legal substances that are chemically similar to illegal ones can produce a positive screening result. Positive screening tests are considered presumptive. Therefore, screening tests that are positive for one or more classes of drugs are frequently confirmed with a secondary test that identifies the exact substance present using a very sensitive and specific method, such as gas chromatography/mass spectrometry (GC/MS) or liquid chromatography-tandem mass spectrometry (LC-MS/MS).

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Culture and Sensitivity Aerobic test is performed on a sample of ear swab to measure the level of Culture of the pathogenic organism in the ear swab.It is performed to confirm Ear infection and also during the treatment and after the treatment of Ear infection.

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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)

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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.

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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.

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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).

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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

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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.

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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.

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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.

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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.

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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


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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.

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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.

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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.

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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).

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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.

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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.

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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.

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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.

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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

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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.


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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.

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An ECG (electrocardiogram) records the electrical activity of your heart at rest. It provides information about your heart rate and rhythm, and shows if there is enlargement of the heart due to high blood pressure (hypertension) or evidence of a previous heart attack (myocardial infarction). However, it does not show whether you have asymptomatic blockages in your heart arteries or predict your risk of a future heart attack. The resting ECG is different from a stress or exercise ECG or cardiac imaging test. You may need an ECG test if you have risk factors for heart disease such as high blood pressure, or symptoms such as palpitations or chest pain. Or you may need it if you already have heart disease. But in other cases, you may think twice about having this test.

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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.

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An echocardiogram (echo) is a graphic outline of the heart's movement. During an echo test, ultrasound (high-frequency sound waves) from a hand-held wand placed on your chest provides pictures of the heart's valves and chambers and helps the sonographer evaluate the pumping action of the heart. Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart's valves.

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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.

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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.

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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.

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Fetal echocardiography is a test similar to an ultrasound. This exam allows your doctor to better see the structure and function of your unborn child’s heart. It’s typically done in the second trimester, between weeks 18 to 24.


The exam uses sound waves that “echo” off of the structures of the fetus’ heart. A machine analyzes these sound waves and creates a picture, or echocardiogram, of their heart’s interior. This image provides information on how your baby’s heart has formed and whether it’s working properly.


It also allows your doctor to see the blood flow through their heart. This in-depth look allows your doctor to find any defects or abnormalities in the baby’s blood flow or heartbeat.

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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.

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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


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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.

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Inhibin is a hormone secreted by granulosa cells in the ovarian follicles and by Sertoli cells in the testis. Its physiological role is to suppress secretion of follicle stimulating hormone (FSH) by the pituitary.Inhibin exists as two different isoforms, inhibin A and inhibin B. Both isoforms are comprised of 2 subunits, the alpha and beta subunits. The alpha subunit is the same for both inhibin A and B, but the beta subunit differs. Inhibin A contains a beta-A subunit and inhibin B contains a beta-B subunit. Plasma levels of inhibin A and B fluctuate during the menstrual cycle. At menopause, serum inhibin A and B decrease to very low or undetectable levels.


Ninety five percent of ovarian cancers are derived from epithelial cells. The remaining 5% are germ cell and sex cord-stromal tumors. Inhibin A is elevated up to 6 times the upper limit of the reference range in approximately 70% of granulosa cell tumors. Inhibin A is also elevated in about 20% of patients with epithelial tumors of the mucinous type. Inhibin is a better tumor marker for these two types of ovarian cancer than cancer antigen 125 (CA 125). Inhibin A is most useful as a tumor marker in postmenopausal women, because plasma levels are normally very low. Inhibin A levels are much harder to interpret in premenopausal women, because plasma levels are higher and fluctuate throughout the menstrual cycle. Because of its low sensitivity, a normal inhibin A level does not rule-out a mucinous or granulosa ovarian cell tumor. Inhibin B might be elevated in these cases.


Inhibin A level decreases shortly after surgery for ovarian cancer. Patients in remission have normal levels of inhibin A. Elevations of inhibin A after treatment are suggestive of residual or recurrent disease. Inhibin A may become elevated prior to onset of clinical symptoms. Inhibin A levels are increased in normal pregnancy, preeclampsia and Down syndrome.Specimen requirement is blood collected into a red top tube. Reference range using a Beckman Coulter Unicel chemiluminescent assay is <2.1 pg/mL for males, <97.5 pg/mL for premenopausal females and <6.9 pg/mL for postmenopausal females. 


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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.

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The child will lie down tilted slightly on his / her side on a hospital bed in our child-friendly examination room, not an operating room. Many exam rooms are equipped with a television to keep a child entertained and alleviate boredom. The child must be undressed from the waist up and can choose to wear a short gown.


To improve the quality of the pictures, a colorless, warm gel is applied to the skin on the area of the chest where the heart is located. A transducer, a small microphone-like device, is placed on top of the gel and against the skin. The transducer uses sound waves, which bounce off the different parts of a child's heart, creating a picture.


The transducer is moved over the chest, abdominal area, and neck in order to obtain the images.


The sounds you may hear from the echo machine are the sounds of the blood flowing from one chamber to another and the valves opening or closing as the blood moves through the heart.


The colors you see on the screen are not the colors of the blood. The colors tell us what direction the blood is flowing. The red color shows the blood is flowing towards the transducer and the blue color shows blood is flowing away. A child may feel some discomfort from the pressure of the transducer. Pediatric echosonographers are trained to complete scans in as pain-free and patient-sensitive manner as possible. 


A computer interprets the information from the transducer to make an image of the heart appear on the screen. This image is recorded into a digital storage system for the cardiologist to measure and review. 

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Vitamin B12 and folate deficiencies are a lack of these two B complex vitamins that the body needs for several important functions. They are required to make normal red blood cells (RBCs), repair tissues and cells, synthesize DNA (the genetic material in cells). B12 is also important for normal nerve cell function. B12 and folate (also known as folic acid or vitamin B9) are nutrients that cannot be produced in the body and must be...

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Babesiosis is a zoonotic infection caused by the protozoan parasite Babesia microti. The infection is acquired by contact with Ixodes ticks carrying the parasite. The deer mouse is the animal reservoir and, overall, the epidemiology of this infection is much like that of Lyme disease. Babesiosis is most prevalent in the Northeast, Upper Midwest, and Pacific Coast of the United States.


Infectious forms (sporozoites) are injected during tick bites and the organism enters the vascular system where it infects RBCs. In this intraerythrocytic stage it becomes disseminated throughout the reticuloendothelial system. Asexual reproduction occurs in RBCs, and daughter cells (merozoites) are formed which are liberated on rupture (hemolysis) of the RBC.


Most cases of babesiosis are probably subclinical or mild, but the infection can be severe and life threatening, especially in older or asplenic patients. Fever, fatigue, malaise, headache, and other flu-like symptoms occur most commonly. In the most severe cases, hemolysis, acute respiratory distress syndrome, and shock may develop. Patients may have hepatomegaly and splenomegaly.


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A stress echocardiography, also called an echocardiography stress test or stress echo, is a procedure that determines how well your heart and blood vessels are working.


During a stress echocardiography, you’ll exercise on a treadmill or stationary bike while your doctor monitors your blood pressure and heart rhythm. When your heart rate reaches peak levels, your doctor will take ultrasound images of your heart to determine whether your heart muscles are getting enough blood and oxygen while you exercise.


Your doctor may order a stress echocardiography test if you have chest pain that they think is due to coronary artery disease or a myocardial infarction, which is a heart attack. This test also determines how much exercise you can safely tolerate if you’re in cardiac rehabilitation. The test can also tell your doctor how well treatments such as bypass grafting, angioplasty, and anti-anginal or antiarrhythmic medications are working.

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A brainstem auditory evoked response (BAER) test measures how your brain processes the sounds you hear. The BAER test records your brainwaves in response to clicks or other audio tones that are played for you. The test is also called a brainstem auditory evoked potentials (BAEP) or auditory brainstem response (ABR) test.


A BAER test can help to diagnose hearing loss and nervous system disorders, especially in newborns, young children, and others who may not be able to participate in a standard hearing test.


BAER tests are often administered to canines and are the only scientifically reliable way to test a dog’s ability to hear with one or both ears.

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Context: Autoantibodies to glutamate decarboxylase, islet antigen-2, insulin, and zinc transporter-8 are characteristic of type 1 diabetes. They are detectable before clinical onset and define the subgroup of patients with latent autoimmune diabetes in adults. Autoantibody assays are increasingly available to clinicians. This article reviews the prognostic significance of autoantibodies and considers the utility of diabetes antibody testing in routine clinical practice.Evidence Acquisition: The medical literature to May 2009 was reviewed for key articles and consensus statements covering use of islet autoantibody testing for prediction and classification of diabetes and implications for therapy.Evidence Synthesis: Sensitive and specific glutamate decarboxylase and islet antigen-2 antibody assays are widely available, although to insulin autoantibody assays remain variable. Islet autoantibodies appear early in life, and testing for multiple antibodies identifies unaffected individuals at very high risk of type 1 diabetes with high sensitivity. This is important for research, but currently no intervention prevents or delays diabetes, and evidence of benefit from awareness of risk is weak. In non-insulin-treated diabetes, patients with autoantibodies progress to insulin requirement more rapidly, but evidence that testing benefits the individual patient is limited. Antibody testing is useful in classifying diabetes of other types.Conclusions: Islet autoantibody testing allows prediction of type 1 diabetes and definition of the latent autoimmune diabetes in adults subgroup of non-insulin-treated patients. Although useful for research, until therapies modulating the disease process become available, the benefit to individual patients is generally questionable. With a few exceptions, diabetes antibody testing does not yet have a role in routine clinical care.


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A barium enema is a type of X-ray imaging test that allows doctors to examine your lower intestinal tract. It involves delivering a contrast solution that contains the metallic element barium into your rectum while a technician takes X-ray images of the area. The barium solution will be delivered using an enema — a process in which your doctor pushes a liquid into your rectum through your anus.


The barium solution helps to improve the quality of the X-ray images by highlighting certain areas of tissue. The X-ray used in this procedure is known as fluoroscopy. It allows the radiologist to see your internal organs in motion by tracking the flow of the barium solution through your intestinal tract.


The test doesn’t require painkillers or sedation, but there may be moments of slight discomfort.

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A barium meal is a diagnostic test used to detect abnormalities of the esophagus, stomach and small bowel using X-ray imaging. X-rays can only highlight bone and other radio-opaque tissues and would not usually enable visualization of soft tissue. However, infusion of the contrast medium barium sulfate, a radioopaque salt, coats the lining of the digestive tract, allowing accurate X-ray imaging of this part of the abdomen.

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Insulin is produced by the pancreas and used by the body to transport and convert glucose throughout the body into usable energy. Issues with the pancreas including diabetes or a pancreatic tumor can prevent the pancreas from producing the correct amount of insulin to maintain proper glucose levels. Too much insulin causes hypoglycemia, or low glucose levels, while too little, or resistance to, insulin, which is often caused by type 2 diabetes, leads to extremely high levels of glucose. Either situation can lead to severe health issues.Excess insulin production may be due to an insulin producing tumor (insulinoma) and can cause low glucose levels leading to convulsions or loss of consciousness. Acute or chronic symptoms of low blood sugar include sweating, confusion, blurred vision, hunger, fainting or heart palpitations.


Insulin resistance, which is associated with type 2 diabetes, metabolic syndrome, prediabetes, heart disease and polycystic ovarian syndrome (POCS), can lead to extremely high glucose levels in the body. Long term blood sugar levels that are too high cause severe health problems associated with both type 1 and type 2 diabetes including blindness, neuropathy that can lead to foot and leg amputations and cardiovascular disease. The pancreatic system in those with prediabetes or type 2 diabetes becomes damaged over time and is unable to utilize insulin properly. Known as insulin resistance, this condition can be improved with diet and lifestyle changes but may ultimately require injectable insulin.


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A barium swallow is an imaging test that uses X-rays to look at your upper gastrointestinal (GI) tract. Your upper GI tract includes the back of your mouth and throat (pharynx) and your esophagus.


You may have just a barium swallow. Or this test may be done as part of an upper GI series. This series looks at your esophagus, stomach, and the first part of the small intestine (duodenum).


X-rays use a small amount of radiation to create images of your bones and internal organs. X-rays are most often used to find bone or joint problems, or to check the heart and lungs. A barium swallow is one type of X-ray.


Fluoroscopy is often used during a barium swallow. Fluoroscopy is a kind of X-ray “movie.”


The test also uses barium. Barium is a substance that makes certain area of the body show up more clearly on an X-ray. The radiologist will be able to see size and shape of the pharynx and esophagus. He or she will also be able see how you swallow. These details might not be seen on a standard X-ray. Barium is used only for imaging tests for the GI tract.

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The cobalamins, also referred to as vitamin B12, are a group of closely related enzymatic cofactors involved in the conversion of methylmalonyl-coenzyme A to succinyl-coenzyme A and in the synthesis of methionine from homocysteine. Vitamin B12 deficiency can lead to megaloblastic anemia and neurological deficits. The latter may exist without anemia, or precede it. Adequate replacement therapy will generally improve or cure cobalamin deficiency. Unfortunately, many other conditions, which require different interventions, can mimic the symptoms and signs of vitamin B12 deficiency. Moreover, even when cobalamin deficiency has been established, clinical improvement may require different dosages or routes of vitamin B12 replacement, depending on the underlying cause. In particular, patients with pernicious anemia (PA), possibly the commonest type of cobalamin deficiency in developed countries, require either massive doses of oral vitamin B12 or parenteral replacement therapy. The reason is that in PA patients suffer from gastric mucosal atrophy, most likely caused by a destructive autoimmune process. This results in diminished or absent gastric acid, pepsin and intrinsic factor (IF) production. Gastric acid and pepsin are required for liberation of cobalamin from binding proteins, while IF binds the free vitamin B12, carries it to receptors on the ileal mucosa, and facilitates its absorption. Most PA patients have autoantibodies against gastric parietal cells or intrinsic factor, with the latter being very specific but only present in approximately 50% of cases. By contrast, parietal cell antibodies are found in approximately 90% of PA patients, but are also found in a significant proportion of patients with other autoimmune diseases, and in approximately 2.5% (4th decade of life) to approximately 10% (8th decade of life) of healthy individuals.


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The Bence-Jones protein (BJP) test measures the level of BJP in your urine. Bence-Jones proteins are named for Henry Bence-Jones, a physician and chemist who first isolated them in 1847. These proteins are not present in healthy urine samples and are usually a sign of multiple myeloma. Multiple myeloma is a type of bone marrow cancer that is most common in people who are older than 60 years.


Your bone marrow is found in the center of your larger bones. It makes red and white blood cells as well as platelets. Multiple myeloma is a condition where your bone marrow makes too much of a type of white blood cell.


Normally, white blood cells make many different types of antibodies. They play an important role in your immune system. However, when you have multiple myeloma, one white blood cell line grows out of control. It produces only one type of antibody. These cells then crowd out the normal cells. Your body is then vulnerable to illness.

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Electrolytes are minerals that are found in body tissues and blood in the form of dissolved salts. As electrically charged particles, electrolytes help move nutrients into and wastes out of the body's cells, maintain a healthy water balance, and help stabilize the body's acid/base (pH) level.


The electrolyte panel measures the blood levels of the main electrolytes in the body: sodium (Na+), potassium (K+), chloride (Cl-), and bicarbonate (HCO3-; sometimes reported as total CO2).


A person's diet provides sodium, potassium, and chloride. The kidneys help maintain proper levels by reabsorption or by elimination into the urine. The lungs provide oxygen and regulate CO2. The CO2 is produced by the body and is in balance with bicarbonate. The overall balance of these chemicals is an indication of the functional well-being of several basic body functions. They are important in maintaining a wide range of body functions, including cardiac and skeletal muscle contraction and nerve impulse conduction.


Any disease or condition that affects the amount of fluid in the body, such as dehydration, or affects the lungs, kidneys, metabolism, or breathing has the potential to cause a fluid, electrolyte, or pH imbalance (acidosis or alkalosis). Normal pH must be maintained within a narrow range of 7.35-7.45 and electrolytes must be in balance to ensure the proper functioning of metabolic processes and the delivery of the right amount of oxygen to tissues. (For more on this, see the condition article on Acidosis and Alkalosis and also on Dehydration.)

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You can do a lot to take care of yourself and give your body what it needs. Still, as you get older, your body changes in ways you can’t always control. For most men, one of those changes is that the prostate gets bigger.


It’s a natural part of aging, but at some point, it can lead to a condition called BPH, or benign prostatic hyperplasia.


Your prostate surrounds part of your urethra, the tube that carries urine and semen out of your penis. When you have BPH, your prostate is larger than usual, which squeezes the urethra. This can cause a weak stream when you pee and cause you to wake up a lot at night to go to the bathroom.


BPH isn’t prostate cancer and doesn’t make you more likely to get it.


It’s a common condition, especially in older men, and there are a lot of treatments for it, from lifestyle changes to surgery. Your doctor can help you choose the best care based on your age, health, and how the condition affects you.

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The quantitative human chorionic gonadotropin (hCG) blood test measures the level of hCG hormone present in a sample of your blood. HCG is a hormone that is produced during pregnancy. Your doctor may refer to the hCG quantitative test by another name, including:


quantitative serial beta-hCG test

repeat quantitative beta-hCG test

beta-hCG blood test

quantitative blood pregnancy test

In some cases, the hCG quantitative blood test may also be used to evaluate and manage certain types of cancer.

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An electromyogram (EMG) measures the electrical activity of muscles when they're at rest and when they're being used. Nerve conduction studies measure how well and how fast the nerves can send electrical signals.


Nerves control the muscles in the body with electrical signals called impulses. These impulses make the muscles react in certain ways. Nerve and muscle problems cause the muscles to react in ways that aren't normal.


If you have leg pain or numbness, you may have these tests to find out which nerves are being affected and how much they are affected. These tests check how well your spinal nerves are working. They also check the nerves in your arms and legs.

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We reviewed the records of 52 amyotrophic lateral sclerosis (ALS) patients examined between 1995 and 2000 who had needle electromyography (EMG) of their respiratory muscles, including the diaphragm, at or near the time of their diagnosis. With respiratory function testing, patients with abnormal diaphragmatic EMG at diagnosis (Group 1, n=23) had significantly lower forced vital capacity (FVC), lower daytime arterial PO(2) and higher PCO(2) measurements (p<0.05) than patients with normal diaphragmatic EMG (Group 2, n=29). Twenty-eight percent of the patients without symptoms or signs of respiratory insufficiency at the time they were examined had an abnormal diaphragm EMG. Mean survival of Groups 1 and 2 were similar. However, sub-analysis of patients within each group, comparing those treated with non-invasive positive pressure ventilation (NIPPV) with those not treated, showed that treated patients in Group 1 (abnormal diaphragm EMG) survived significantly longer (p<0.05) than untreated patients. They also started NIPPV earlier than treated patients in Group 2. We conclude that respiratory muscle EMG was simply and safely performed on ALS patients at or around the time of diagnosis. The procedure can detect sub-clinical respiratory muscle dysfunction. The technique used for EMG of the respiratory muscles, its pitfalls and contraindications are also reviewed.

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Autoimmune diseases cause the body to attack itself, which leads to inflammation and results in damage to muscles, tissues, and organs. The inflammation produces antibodies in the blood that can be measured and the levels used to diagnose specific autoimmune diseases. Type I diabetes mellitus (DM) is an autoimmune disease, where the body attacks the pancreatic cells that produce insulin (islet cells). High ICA levels can be measured a number of years before clinical signs of diabetes are seen, and this test is a very helpful tool your doctor may use to prevent the disease or to better manage the onset, as well as to provide a proper diet and treatment. ICA testing must be done before any insulin therapy is started, since this will cause elevations in this antibody in the blood.ICA tests are ordered to diagnose Type I diabetes mellitus (DM), insulin allergy, insulin resistance; or to monitor your condition after a pancreas transplant.


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Intravenous pyelogram (IVP) is an x-ray exam that uses an injection of contrast material to evaluate your kidneys, ureters and bladder and help diagnose blood in the urine or pain in your side or lower back. An IVP may provide enough information to allow your doctor to treat you with medication and avoid surgery.Inform your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking and allergies, especially to iodine-based contrast materials. Your doctor may instruct you to take a mild laxative the evening before the exam and to not eat or drink anything after midnight. Wear loose, comfortable clothing and leave jewelry at home. You may be asked to wear a gown.


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Electromyography (EMG) is a diagnostic procedure that evaluates the health condition of muscles and the nerve cells that control them. These nerve cells are known as motor neurons. They transmit electrical signals that cause muscles to contract and relax. An EMG translates these signals into graphs or numbers, helping doctors to make a diagnosis.


A doctor will usually order an EMG when someone is showing symptoms of a muscle or nerve disorder. These symptoms may include tingling, numbness, or unexplained weakness in the limbs. EMG results can help the doctor diagnose muscle disorders, nerve disorders, and disorders affecting the connection between nerves and muscles.


There are two components to an EMG test: the nerve conduction study and needle EMG. The nerve conduction study is the first part of the procedure. It involves placing small sensors called surface electrodes on the skin to assess the ability of the motor neurons to send electrical signals. The second part of the EMG procedure, known as needle EMG, also uses sensors to evaluate electrical signals. The sensors are called needle electrodes, and they are directly inserted into muscle tissue to evaluate muscle activity when at rest and when contracted.


During each part of the EMG procedure, one electrode releases a very mild electrical signal while the other electrodes measure how long it takes for the signal to reach them. This mimics the natural electrical signals sent by the nerves to the muscles. The distance between the electrodes and time it takes for a signal to reach them is used to determine the speed at which the nerves are able to send and receive signals. An abnormal speed usually indicates a muscle or nerve disorder.

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Hypoperfusion is the most common cause of lactic acidosis and hyperlactacidemia may be the only marker of tissue hypoperfusion.1 Suspect lactic acidosis when unexplained anion gap metabolic acidosis is encountered, especially if azotemia or ketoacidosis are not present. Evaluate metabolic acidosis, regional or diffuse tissue hypoperfusion, hypoxia, shock,2 congestive heart failure, dehydration, complicated postoperative state, ketoacidosis or nonketotic acidosis in diabetes mellitus, patients with infections, inflammatory states, postictal state, certain myopathies, acute leukemia and other neoplasia, enzyme defects, glycogen storage disease (type I), thiamine deficiency, and hepatic failure. A spontaneous form of lactic acidosis occurs. It is a prognostic index in particular clinical settings, especially in critically ill patients in shock.3 A relationship to renal disease also exists. With skin rash, seizures, alopecia, ataxia, keratoconjunctivitis, and lactic acidosis in children, consider defective biotin metabolism.4 Phenformin, ethanol, methanol, and salicylate poisoning and ethylene glycol may cause lactic acidosis. Acetaminophen toxicity causes lactic acidosis, sometimes with hypoglycemia. Cyanide, isoniazid, and propylene glycol are among the causes of lactic acidosis.1 Lactic acidosis may be due to inborn errors of metabolism.

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This course shows you videos of the commonly studied muscles in the upper extremity, insertional activity and muscle activation and motor unit analysis techniques to help you gain a working understanding of the technical skills you need to perform needle EMG examinations. The video will focus on muscle localization and needle insertion techniques, what results you should expect, how to study the shape, amplitude and duration of motor unit waveforms, pitfalls and common errors you should watch for. Muscles studied include the First Dorsal Interosseous (FDI), the Abductor Pollicis Brevis (APB), the Flexor Carpi Radialis (FCR) the Brachio-Radialis (BR), the Triceps (TRI), the Deltoid (DEL) and the Cervical Paraspinals.

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The lactate dehydrogenase (LDH) test looks for signs of damage to the body’s tissues. LDH is an enzyme found in almost every cell of your body, including your blood, muscles, brain, kidneys, and pancreas.The enzyme turns sugar into energy.  The LDH test measures the amount of LDH in your blood or other body fluid.When cells are damaged or destroyed, this enzyme is released into the fluid portion of blood. Doctors call this “serum” or “plasma.” LDH can also be released into other body fluid, including cerebrospinal fluid, which surrounds your brain and spinal cord.


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This test measures the integrity of nerve tracts which conduct the electric impulses. It is used to assess the nature, severity and duration of the nerve lesion and in combination with EMG helps in predicting the chances of recovery after a nerve lesion.The nerves of interest are stimulated with a very low voltage electric current which causes mild tingling over the area stimulated. The test takes 20 min to 1 hour depending upon the number of nerves to be tested. It is very useful, in cases of carpal tunnel syndrome, diabetic neuropathy, traumatic neuropathy, plexopathy, varius vitamin deficiencies.

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Cholesterol is a soft, wax-like substance found in all parts of the body. Your body needs a little bit of cholesterol to work properly. But too much cholesterol can clog your arteries and lead to heart diseaseCholesterol blood tests are done to help you and your health care provider better understand your risk for heart disease, stroke, and other problems caused by narrowed or blocked arteries. The ideal values for all cholesterol results depend on whether you have heart disease, diabetes, or other risk factors. Your provider can tell you what your goal should be  Some cholesterol is considered good and some is considered bad. Different blood tests can be done to measure each type of cholesterol. Your provider may order only a total cholesterol level as the first test. It measures all types of cholesterol in your blood.

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Circulating IgA endomysial antibodies are present in 70% to 80% of patients with dermatitis herpetiformis or celiac disease, and in nearly all such patients who have high grade gluten-sensitive enteropathy and are not adhering to a gluten-free diet.


 


For your convenience, we recommend utilizing cascade testing for celiac disease. Cascade testing ensures that testing proceeds in an algorithmic fashion. The following cascades are available; select the appropriate one for your specific patient situation. Algorithms for the cascade tests are available in Special Instructions.


-CDCOM / Celiac Disease Comprehensive Cascade: complete testing including HLA DQ


-CDSP / Celiac Disease Serology Cascade: complete testing excluding HLA DQ


-CDGF / Celiac Disease Gluten-Free Cascade: for patients already adhering to a gluten-free diet

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Lupus erythematosus (LE) cell testing was once performed to diagnose systemic lupus erythematous but has been replaced for this purpose by antinuclear antibody testing.

Negative findings on LE cell testing exclude a diagnosis of systemic lupus erythematosus (SLE).

The presence of LE cells indicates lupus.

A smear is considered positive when 10 or more characteristic LE cells are seen during a 15-minute search, associated with the presence of extracellular, amorphous, nuclear masses.

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Endothelin-1 (ET-1), a peptide of 21 amino acid residues, is the most potent vasoconstrictor substance known. Originally isolated from porcine aortic endothelial cells1, ET-1 is now known to be one of a family of three mammalian vasoactive peptides that also includes endothelin-2 (ET-2) and endothelin-3 (ET-3).2 These related peptides differ from ET-1 at the two and six amino acid residue positions, respectively. A fourth peptide, vasoactive intestinal contractor (VIC), is sometimes classified as rat ET-2.3

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The Lead Blood (Adult) test is used to monitor exposure to Lead in people age 16 and older. Lead and organic lead compounds are found in a number of industrial products including paints, plastics, storage batteries, bearing alloys, insecticides, and ceramics. Exposure may also occur through the inhalation of dust containing lead emitted by automobile exhaust and the discharging of firearms. This test is commonly ordered when someone is concerned about occupational or environmental lead exposure.  It is frequently used by people who work for or patronize shooting ranges.  This test is not appropriate for people under the age of 16.


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Lead poisoning through chronic exposure is characterized by gastrointestinal disturbance, anemia, insomnia, weight loss, motor weakness, muscle paralysis, and neuropathy. Ingestion of large quantities may produce death Increased urinary lead excretion indicates excessive lead exposure, regardless of clinical presentation. Erythrocyte protoporphyrin and whole blood lead levels are probably more sensitive indicators of excessive lead exposure. In cases of borderline blood levels, an EDTA lead mobilization test may be considered. Chelation therapy monitoring may be indicated. Lead and organic lead compounds have numerous commercial and industrial applications, use in paints, plastics, storage batteries, bearing alloys, insecticides, and ceramics. Exposure may also occur through the inhalation of dust containing lead emitted by automobile exhausts. A common source of lead exposure among children is derived through the mouthing of inanimate objects, specifically objects with paint and paint chips that contain lead. Acute lead exposure is rare; however, toxicity may occur through acute ingestion of a lead salt or acetate. Urine is suggested specimen in which chronic lead poisoning may be monitored.  BEI® are reference values intended as guidelines for evaluation of occupational exposure. BEI® represent biological levels of chemicals that correspond to workers with inhalation exposure equivalent to the threshold limit value (TLV®) of the chemicals. TLVs refer to the airborne concentrations of substances and represent conditions under which it is believed that nearly all workers may be repeatedly exposed, day after day, without adverse health effects.


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Visceral leishmaniasis (kala azar) is a disseminated intracellular protozoal infection that targets primarily the reticuloendothelial system (liver, spleen, bone marrow) and is caused by Leishmania donovani, Leishmania chagasi, or Leishmania infantum (Leishmania donovani complex).  Transmission is by the bite of sandflies. Clinical symptoms include fever, weight loss, and splenomegaly; pancytopenia and hypergammaglobulinemia are often present. Most (90%) new cases each year arise in rural areas of India, Nepal, Bangladesh, Sudan, and Brazil but the disease has a worldwide distribution, including the Middle East.  Definitive diagnosis has required the microscopic documentation of characteristic intracellular amastigotes in stained smears from culture of aspirates of tissue (spleen, lymph node) or bone marrow. The detection of serum antibodies to the recombinant K39 antigen of Leishmania donovani is an alternative noninvasive sensitive (95%-100%) method for the diagnosis of active, visceral leishmaniasis.


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The pemphigus   Pemphigus foliaceus  and pemphigoid   Skin: bullous pemphigoid  autoimmune skin diseases   Immune-mediated disease: overview   are mediated by autoantibodies that target antigens within the interkeratinocyte desmosomes (pemphigus) or the basement membrane zone hemidesmosomes (pemphigoid).

A range of laboratory methods may be used to demonstrate the presence of these autoantibodies. These tests have not been used widely in equine pemphigus or pemphigoid diseases and, in those report available, have shown variable sensitivity and specifity.

Autoantibodies may be detected either in situ(within lesional skin biopsies), or circulating with the serum of affected animals.

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Leptin is a hormone produced by fat cells in the body. It is the gatekeeper of fat metabolism, monitoring how much energy a person takes in. Leptin acts to maintain energy balance in the body by regulating metabolism and hunger. The level of leptin circulating in your body is directly proportional to the total amount of fat you have. That means the more fat you have, the greater the amount of leptin you have. When present in high levels, it signals our brain that we’re full and can stop eating. When low, we feel hungry and crave food. Most people don't have a leptin deficiency, rather they have lost sensitivity to their leptin. Much like insulin resistance, it's possible to have enough leptin in your blood, but because your body doesn't use it effectively, you still feel hungry. In these cases, the leptin is not getting into the brain effectively and it is important to take measures to improve your body’s leptin sensitivity. This improvement can help you maintain a stable body weight.

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Leptospirosis is a zoonotic disease transmitted through soil, food or water contaminated by urine of infected animal. Illness may be self limiting or cause Hepatorenal failure (Weil syndrome. IgM antibodies appear within 1-2 weeks after onset of illness and peak at 2-4 weeks.Leptospirosis is a zoonotic disease transmitted through soil, food or water contaminated by urine of infected animal. Illness may be self limiting or cause Hepatorenal failure (Weil syndrome. IgM antibodies appear within 1-2 weeks after onset of illness and peak at 2-4 weeks.

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Epstein-Barr virus (EBV) is a virus that typically causes a mild to moderate illness. Blood tests for Epstein-Barr virus detect antibodies to EBV in the blood and help establish a diagnosis of EBV infection.


Epstein-Barr virus causes an infection that is very common. According to the Centers for Disease Control and Prevention (CDC), most people in the United States are infected by EBV at some point in their lives. The virus is very contagious and easily passed from person to person. It is present in the saliva of infected individuals and can be spread through close contact such as kissing and through sharing utensils or cups.


After initial exposure to EBV, there is a period of several weeks before associated symptoms may appear, called the incubation period. During the acute primary infection, the virus multiplies in number. This is followed by a decrease in viral numbers and resolution of symptoms, but the virus never completely goes away. Latent EBV remains in the person's body for the rest of that person's life and may reactivate but usually causes few problems unless the person's immune system is significantly weakened.


Most people are infected by EBV in childhood and experience few or no symptoms. However, when the initial infection occurs in adolescence, it can cause infectious mononucleosis, commonly called mono, a condition associated with fatigue, fever, sore throat, swollen lymph nodes, an enlarged spleen, and sometimes an enlarged liver. These symptoms occur in about 25% of infected teens and young adults and usually resolve within a month or two.


People with mono are typically diagnosed by their symptoms and the findings from a complete blood count (CBC) and a mono test (which tests for a heterophile antibody). About 25% of those with mono do not produce heterophile antibodies and will have a negative mono test; this is especially true with children. Tests for EBV antibodies can be used to determine whether or not the symptoms these people are experiencing are due to a current infection with the EBV virus.


EBV is the most common cause of mono. According to the CDC, examples of other causes of mono include cytomegalovirus (CMV), hepatitis A, hepatitis B or hepatitis C, rubella, and toxoplasmosis. Sometimes, it can be important to distinguish EBV from these other illnesses. For instance, it may be important to diagnose the cause of symptoms of a viral illness in a pregnant woman. Testing can help to distinguish a primary EBV infection, which has not been shown to affect a developing baby, from a CMV, herpes simplex virus, or toxoplasmosis infection, as these illnesses can cause complications during the pregnancy and may harm the fetus.


It can also be important to rule out EBV infection and to look for other causes of the symptoms. Those with strep throat, an infection caused by group A streptococcus, for instance, need to be identified and treated with antibiotics. A person may have strep throat instead of mono or may have both conditions at the same time.


Several tests for different types and classes of EBV antibodies are available. The antibodies are proteins produced by the body in an immune response to several different Epstein-Barr virus antigens. During a primary EBV infection, the level of each of these EBV antibodies rises and falls at various times as the infection progresses. Measurement of these antibodies in the blood can aid in diagnosis and typically provides the healthcare practitioner with information about the stage of infection and whether it is a current, recent, or past infection.

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A leukocyte alkaline phosphatase (LAP) test is a laboratory test that can be conducted on a sample of your blood. Your doctor can order it to measure the amount of alkaline phosphatase, a group of enzymes, in certain white blood cells. Before the advent of more advanced tests, the LAP test was commonly use to diagnose chronic myeloid leukemia (CML). This is a type of cancer than affects white blood cells. If you have CML, the level of alkaline phosphatase in your white blood cells will be lower than normal. Some doctors still order the LAP test to check for signs of CML. It can also help them rule out other disorders. But it’s now generally accepted that a cytogenetic test (a test of your cells and chromosomes) is needed to confirm a CML diagnosis. As a result, the LAP test is used less often now than in the past.


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Receptors are specialized proteins on the surface of or within cells that recognize and bind to other substances. The binding typically has a specific effect on the cells. Many, but not all, breast cancer cells have receptors that bind to the hormones estrogen and progesterone. Breast cancer tumors with estrogen receptors (ER) and progesterone receptors (PR) depend on the hormones to grow and divide. ER and PR testing of breast tumor tissue determines if one or both types of receptors are present.


Knowing if a tumor depends on hormones to grow helps a health practitioner determine a person's risk of breast cancer recurrence and whether it can be treated with hormone therapy to block estrogen and progesterone. About two-thirds of breast cancer tissues are positive for both ER and PR.


In 2010, the American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) jointly published guidelines that recommend that all tumors from individuals with newly diagnosed invasive breast cancer be evaluated for estrogen and progesterone receptors. The guidelines also state that all recurrent breast cancers should be tested and that the option of testing should be provided for patients who have non-invasive breast cancer.

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Erythropoietin (EPO) is a hormone produced primarily by the kidneys. It plays a key role in the production of red blood cells (RBCs), which carry oxygen from the lungs to the rest of the body. This test measures the amount of erythropoietin in the blood.


Erythropoietin is produced and released into the blood by the kidneys in response to low blood oxygen levels (hypoxemia). EPO is carried to the bone marrow, where it stimulates production of red blood cells. The hormone is active for a short period of time and then eliminated from the body in the urine.


The amount of erythropoietin released depends upon how low the oxygen level is and the ability of the kidneys to produce erythropoietin. Increased production and release of erythropoietin continues to occur until oxygen levels in the blood rise to normal or near normal concentrations, then production falls. The body uses this dynamic feedback system to help maintain sufficient oxygen levels and a relatively stable number of RBCs in the blood.


However, if a person's kidneys are damaged and do not produce sufficient erythropoietin, then too few RBCs are produced and the person typically becomes anemic. Similarly, if a person's bone marrow is unable to respond to the stimulation from EPO, then the person may become anemic. This can occur with some bone marrow disorders or with chronic diseases, such as rheumatoid arthritis. (Read Anemia of Chronic Diseases to learn more.)


Individuals who have conditions that affect the amount of oxygen they breathe in, such as lung diseases, may produce more EPO to try to compensate for the low oxygen level. People who live at high altitudes may also have higher levels of EPO and so do chronic tobacco smokers.


If too much erythropoietin is produced, as occurs with some benign or malignant kidney tumors and with a variety of other cancers, too many RBCs may be produced (polycythemia or erythrocytosis). This can lead to an increase in the blood's thickness (viscosity) and sometimes to high blood pressure (hypertension), blood clots (thrombosis), heart attack, or stroke. Rarely, polycythemia is caused by a bone marrow disorder called polycythemia vera, not by increased erythropoietin.

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LH is a hormone that’s produced in the pituitary gland. The pituitary gland is located at the base of the brain, and it’s roughly the size of a pea. If you’re a woman, LH is an important part of your menstrual cycle. It works with follicle-stimulating hormone (FSH), which is another gonadotropin made in the pituitary gland. FSH stimulates the ovarian follicle, causing an egg to grow. It also triggers the production of estrogen in the follicle. The rise in estrogen tells your pituitary gland to stop producing FSH and to start making more LH. The shift to LH causes the egg to be released from the ovary, a process called ovulation. In the empty follicle, cells proliferate, turning it into a corpus luteum. This structure releases progesterone, a hormone necessary to maintain pregnancy. If pregnancy doesn’t occur, the levels of progesterone drop off and the cycle begins again.If you’re a man, your pituitary gland also produces LH. The hormone binds to receptors in certain cells in your testes called Leydig cells. This leads to the release of testosterone, a hormone that’s necessary for producing sperm cells.

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Erythrocyte sedimentation rate (ESR or sed rate) is a test that indirectly measures the degree of inflammation present in the body. The test actually measures the rate of fall (sedimentation) of erythrocytes (red blood cells) in a sample of blood that has been placed into a tall, thin, vertical tube. Results are reported as the millimeters of clear fluid (plasma) that are present at the top portion of the tube after one hour.


When a sample of blood is placed in a tube, the red blood cells normally settle out relatively slowly, leaving little clear plasma. The red cells settle at a faster rate in the presence of an increased level of proteins, particularly proteins called acute phase reactants. The level of acute phase reactants such as C-reactive protein (CRP) and fibrinogen increases in the blood in response to inflammation.


Inflammation is part of the body's immune response. It can be acute, developing rapidly after trauma, injury or infection, for example, or can occur over an extended time (chronic) with conditions such as autoimmune diseases or cancer.


The ESR is not diagnostic; it is a non-specific test that may be elevated in a number of these different conditions. It provides general information about the presence or absence of an inflammatory condition.


There have been questions about the usefulness of the ESR in light of newer tests that have come into use that are more specific. However, ESR test is typically indicated for the diagnosis and monitoring of temporal arteritis, systemic vasculitis and polymyalgia rheumatica. Extremely elevated ESR is useful in developing a rheumatic disease differential diagnosis. In addition, ESR may still be a good option in some situations, when, for example, the newer tests are not available in areas with limited resources or when monitoring the course of a disease.

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Your pancreas makes an enzyme called lipase. When you eat, lipase is released into your digestive tract to help your intestines break down the fats in the food you’re eating. Lipase also allows cell nutrients and cell waste to move through the walls of the cells in your body. Certain levels of lipase are needed to maintain normal digestive and cell function. Abnormally high levels of the enzyme in your blood can be a sign of a health problem.The serum lipase test is used to measure the amount of lipase in the body. The lipase test is often ordered at the same time as the amylase test. An amylase test is used to diagnose diseases of the pancreas. The results from these tests are typically used to diagnose and monitor specific health conditions, including:


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An estradiol test measures the amount of the hormone estradiol in your blood. It’s also called an E2 test.


Estradiol is a form of the hormone estrogen. It’s also called 17 beta-estradiol. The ovaries, breasts, and adrenal glands make estradiol. During pregnancy, the placenta also makes estradiol.


Estradiol helps with the growth and development of female sex organs, including the:


uterus

fallopian tubes

vagina

breasts

Estradiol helps to control the way fat is distributed in the female body. It’s also essential for bone and joint health in females.


Males also have estradiol in their bodies. Their levels of estradiol are lower than the levels in females. In males, the adrenal glands and testes make estradiol. Estradiol has been shown in vitro to prevent destruction of sperm cells, but its clinical importance in sexual function and development in men is likely less significant than in women.

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This group of tests measures the amount of cholesterol and other fats in your blood. Cholesterol and triglycerides are lipids, or fats. These fats are important for cell health, but they can be harmful when they build up in the blood. Sometimes they can lead to clogged, inflamed arteries, a condition call atherosclerosis. This may keep your heart from working normally if the arteries of your heart muscle are affected. This panel of tests helps predict your risk for heart disease and stroke.


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The estrogen test measures the total amounts of the estrogen in the blood. Estrogens are the hormones responsible for female sexual development and function. Estrogens are secreted by the gonads, adrenal glands, and placenta.


Normal estrogen results depend upon the sex and age of the person being tested. With women, it also depends upon their menstrual cycle or whether they are pregnant.

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Reference ranges of lipoprotein (a) (Lp[a]) vary and depend on assay and reporting laboratories. They also differ by population and may differ regionally worldwide. Nonetheless, many US lipidologists generally consider an Lp(a) level of less than 10 mg/dL to indicate a lower cardiovascular risk. levels higher than 10 mg/dL are associated with an increase in cardiovascular risk (see Interpretation). The apolipoproteins have a primary responsibility for the transport of lipids and cholesterol. Apolipoprotein B (apoB) is a nonexchangeable lipoprotein that exists in two forms in humans, apoB-100 and apoB-48.


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Estrone (E1) is one of the three estrogens, which also includes estradiol (E2) and estriol (E3). Estrone is the least abundant of the three and is relevant to health and disease because it is considered the stronger acting estrogen.


In post-menopausal women, higher levels of E1 when compared to the other estrogens have been implicated in cardiovascular disease, stroke, and certain types of cancer.


If you are taking estrogen replacement therapy, it is important to follow the balance of the three main estrogens in your body. Imbalances in the relationship between E1 and the other two major estrogens are thought to increase the risk for many age-related diseases.

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Lipids are a group of fats and fat-like substances that are important constituents of cells and sources of energy. A lipid profile measures the level of specific lipids in the blood.


Two important lipids, cholesterol and triglycerides, are transported in the blood by lipoprotein particles. Each particle contains a combination of protein, cholesterol, triglyceride, and phospholipid molecules. The particles measured with a lipid profile are classified by their density into high-density lipoproteins (HDL), low-density lipoproteins (LDL), and very low-density lipoproteins (VLDL).


Monitoring and maintaining healthy levels of these lipids is important in staying healthy. While the body produces the cholesterol needed to function properly, the source for some cholesterol is the diet. Eating too much of foods that are high in saturated fats and trans unsaturated fats (trans fats) or having an inherited predisposition can result in a high level of cholesterol in the blood. The extra cholesterol may be deposited in plaques on the walls of blood vessels. Plaques can narrow or eventually block the opening of blood vessels, leading to hardening of the arteries (atherosclerosis) and increasing the risk of numerous health problems, including heart disease and stroke. A high level of triglycerides in the blood is also associated with an increased risk of developing cardiovascular disease (CVD), although the reason for this is not well understood.

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Histopathology (or histology) involves the examination of sampled whole tissues under the microscope. Three main types of specimen are received by the pathology laboratory.


Specimens received by the pathology laboratory require tissue preparation then are treated and analysed using techniques appropriate to the type of tissue and the investigation required. For immediate diagnosis during a surgical procedure a frozen section is performed


Larger specimens include whole organs or parts thereof, which are removed during surgical operations. Examples include a uterus after a hysterectomy, the large bowel after a colectomy or tonsils after a tonsillectomy.


Pieces of tissue rather than whole organs are removed as biopsies, which often require smaller surgical procedures that can be performed whilst the patient is still awake but sedated. Biopsies include excision biopsies, in which tissue is removed with a scalpel (e.g. a skin excision for a suspicious mole) or a core biopsy, in which a needle is inserted into a suspicious mass to remove a slither or core of tissue that can be examined under the microscope (e.g. to investigate a breast lump).


Fluid and very small pieces of tissue (individual cells rather than groups of cells, e.g. within fluid from around the lung) can be obtained via a fine needle aspiration (FNA). This is performed using a thinner needle than that used in a core biopsy, but with a similar technique. This type of material is usually liquid rather than solid, and is submitted for cytology rather than histology (see Cytopathology).

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Lithium has been the gold standard drug for treatment in bipolar disorder. It was administered as thrice daily with standard preparation; later twice daily with the availability of sustained release preparations. The efficacy of lithium is dose-dependent and reliably correlates with serum concentrations. Therapeutic efficacy of lithium demands maintenance of serum concentrations in the range of 0.8 and 1.2 mmol/L (trough level).[1] Lower levels are considered to be noneffective, and serum level above this range would lead to side-effects and toxicity. Amdisen[2] proposed the use of a standardized 12 h serum lithium concentration, which subsequently became the universally accepted mode of monitoring lithium levels in patients who have been taking the drug in two or more divided dosages with standard preparations where the last dose would be administered at bed time. It is convenient for the patient to provide a blood sample to check the trough levels before the next morning dose. However, in the current day, clinical practice once a day (OD) dose is being prescribed for reasons of better compliance.[3] The current practice is to measure serum lithium levels at 12 h after the last dosing, irrespective of BD/OD administration.

Now the clinical question is whether this standardized 12 h serum level estimation indicates true trough level when lithium is administered as OD dosage. If not, would it lead to misleading clinical decisions in estimating the correct dose of lithium and also erroneous interpretations of lithium nonresponse? The current study is undertaken to test this hypothesis! To the best of our knowledge, this would be the first study to be published in the literature to determine the appropriate time for serum lithium level estimation for OD administration of sustained release preparations of lithium


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Liver function tests help determine the health of your liver by measuring the levels of proteins, liver enzymes, or bilirubin in your blood.


A liver function test is often given in the following situations: to screen for liver infections, such as hepatitis C

to monitor the side effects of certain medications known to affect the liver

if you already have a liver disease, to monitor the disease and how well a particular treatment is working

to measure the degree of scarring (cirrhosis) on the liver

if you’re experiencing the symptoms of a liver disorder

if you’re planning on becoming pregnant

Many tests can be performed on the liver, but most of them don’t measure the overall function of the liver. Commonly used tests to check liver function are the alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), albumin, and bilirubin tests. The ALT and AST tests measure enzymes that your liver releases in response to damage or disease. The albumin and bilirubin tests measure how well the liver creates albumin, a protein, and how well it disposes of bilirubin, a waste product of the blood.

Having abnormal results on any of the liver function tests doesn’t necessarily mean you have liver disease or damage. Talk to your doctor about the results of your liver function test.

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Lupus anticoagulant (LAC) testing is important for evaluating patients with antiphospholipid syndromes and hypercoagulable states. We reviewed results of proficiency testing challenges (n = 5) distributed by the North American Specialized Coagulation Laboratory Association to examine LAC testing performed by participating laboratories. The activated partial thromboplastin time (APTT) and dilute Russell viper venom time (dRVVT) constituted major testing methods. In screening studies, LAC-sensitive APTT methods were more sensitive to weak LAC than dRVVT-based methods but less specific. In confirmatory testing, dRVVT methods performed better, but performance was LAC-dependent. The highest false-negative confirmatory test results were obtained for the platelet neutralization procedure. Noncompliance with recommendations for LAC testing by the International Society on Thrombosis and Haemostasis was high (8%–38%), with the majority of noncompliant laboratories failing to report results of mixing studies. These data provide new insights into LAC testing in North America and identify opportunities for standardization.


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Lyme disease is caused by a bacteria, Borrelia burgdorferi, that’s transmitted to humans through a bite from an infected black-legged or deer tick. Symptoms can occur anywhere from 3 to 30 days after the bite, and symptoms can be wide-ranging, depending on the stage of the infection. The chances you might get Lyme disease from a tick bite depend on the kind of tick, where you were when the bite occurred, and how long the tick was attached to you, according to the CDC. Black-legged ticks must be attached to you for at least 24 hours to transmit Lyme disease.


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Lysozyme is a bacteriolytic enzyme that is found in some hematopoietic cells. It is primarily present in granulocytes, monocytes, and histiocytes. The enzyme is present in only minute amounts in lymphocytes; and is not present in myeloblasts, eosinophils, and basophils. Lysozyme in the plasma comes chiefly from the degradation of granulocytes and monocytes and its concentration reflects the turnover of these cells. Increases are seen in benign (eg, infection, inflammation) and malignant processes(eg, some leukemias). Plasma lysozyme is elevated in patients with acute or chronic granulocytic or monocytic leukemias and falls with successful treatment. Conversely, patients with lymphocytic leukemia may have depressed plasma lysozyme levels. Patients with renal disorders (including rejection of transplanted kidneys) or Crohn’s disease (regional enteritis) also tend to have elevated levels of plasma lysozyme.


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Magnesium is important to the functioning of your body and can be found in many common foods. Rich magnesium sources include green vegetables, nuts, seeds, and beans. Your tap water may also contain magnesium. According to the National Institutes of Health (NIH), this mineral plays a role in more than 300 of your body’s biochemical reactions. For example, it helps regulate blood pressure and your heartbeat. It also helps maintain bone strength.Having too little magnesium in your body can negatively affect all of these functions. It’s possible to have too much magnesium as well.If your doctor suspects that your magnesium level is too low or too high, they may order a serum magnesium test. This test involves a basic blood draw. Your doctor will collect some of your blood into a vial or tube and send it to a lab for testing.


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Malaria antigen detection tests are a group of commercially available rapid diagnostic tests of the rapid antigen test type that allow quick diagnosis of malaria by people who are not otherwise skilled in traditional laboratory techniques for diagnosing malaria or in situations where such equipment is not available. There are currently over 20 such tests commercially available (WHO product testing 2008). The first malaria antigen suitable as target for such a test was a soluble glycolytic enzyme Glutamate dehydrogenase.[1][2][3] None of the rapid tests are currently as sensitive as a thick blood film, nor as cheap. A major drawback in the use of all current dipstick methods is that the result is essentially qualitative. In many endemic areas of tropical Africa, however, the quantitative assessment of parasitaemia is important, as a large percentage of the population will test positive in any qualitative assay.

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The mainstay of malaria diagnosis has been the microscopic examination of blood, utilizing blood films.[1] Although blood is the sample most frequently used to make a diagnosis, both saliva and urine have been investigated as alternative, less invasive specimens.[2] More recently, modern techniques utilizing antigen tests or polymerase chain reaction have been discovered, though these are not widely implemented in malaria endemic regions.[3][4] Areas that cannot afford laboratory diagnostic tests often use only a history of subjective fever as the indication to treat for malaria

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Mammography is a specific type of breast imaging that uses low-dose x-rays to detect cancer early – before women experience symptoms – when it is most treatable. Tell your doctor about any breast symptoms or problems, prior surgeries, hormone use, whether you have a family or personal history of breast cancer, and if there’s a possibility you are pregnant. If possible, obtain copies of your prior mammograms and make them available to your radiologist on the day of your exam. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. Don’t wear deodorant, talcum powder or lotion under your arms or on your breasts as these may appear on the mammogram and interfere with correct diagnosis.

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Coagulation factors are proteins circulating in the blood that are essential for proper blood clot formation. Coagulation factor tests measure the function of or sometimes the amount of these proteins in the blood.


Blood clotting is a complex process that involves numerous coagulation factors, which are produced by the liver and blood vessels. Each coagulation factor is evaluated with one or more tests. When factor levels are low, it can cause blood clotting to fail, leading to unexplained bleeding episodes. Measuring coagulation factors can help a healthcare practitioner determine the cause of the bleeding and the best treatment.


Coagulation factors are usually tested by measuring the factor's activity level in the blood. Activity assays can detect reduced levels of protein or proteins that don't function properly. Rarely, the amount (antigen level) of a coagulation factor may also be measured. Coagulation factor antigen tests can tell how much of the protein is present, but not whether its function is normal.


When someone bleeds (e.g., with an injury), the coagulation system is activated, plugging the leaking blood vessel with a clot. The coagulation system consists of a series of coagulation factors that activate in a step-by-step process called the coagulation cascade. The end result is the formation of insoluble fibrin threads that link together at the site of injury, along with aggregated cell fragments called platelets, to form a stable blood clot. The clot prevents additional blood loss and remains in place until the injured area has healed.


Blood clotting is dynamic; once a clot is formed, other factors are activated that slow clotting or dissolve the clot in a process called fibrinolysis. The clot is eventually removed after the injury site heals. In normal healthy individuals, this balance between clot formation and removal ensures that bleeding does not become excessive and that clots are removed once they are no longer needed.


For people with bleeding disorders, clotting does not work properly because they lack platelets or coagulation factors, or their platelets or factors don't work properly. There are a variety of bleeding disorders that may be passed through families (inherited) or acquired after birth. If a person has signs and symptoms of one of these disorders, coagulation factor testing may be ordered to help determine the diagnosis and treatment.


There are nine coagulation factor proteins that can be measured clinically (see table below). These factors are referred to by a name or Roman numeral or both in some cases. For example, coagulation factor II is also known as prothrombin. When one or more of these factors are produced in too small a quantity, or are not functioning correctly, they can cause excessive bleeding.

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Fibrin degradation products (FDP) are substances that remain in your bloodstream after your body dissolves a blood clot. Your fibrinolytic (clot-busting) system manages and regulates clot dissolving.


When you cut yourself, the injured blood vessel constricts to stop bleeding and promote healing. This process is called hemostasis. Platelets in your blood gather together and stick to the injury site to form a plug or clot. The formation of the plug or clot is called the clotting cascade.


Fibrin is a protein that aids in clotting. Clotting, also called coagulation, at the wound site produces a mass of fibrin threads called a net. The net remains in place until the cut is healed. As the cut heals, the clotting slows down. Eventually the clot breaks down and dissolves.


When the clot and fibrin net dissolve, fragments of protein are released into the body. These fragments are fibrin degradation products (FDPs). If your body is unable to dissolve a clot, you may have abnormal levels of FDPs.


Blood tests can measure your level of FDPs to see if you have a clotting disorder. The fibrin degradation products test is a specific test that determines the amount of FDPs in your blood. The test is also known as the fibrin split products (FSPs) test, or the fibrin breakdown products test.

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Ferritin is an iron-containing protein and is the primary form of iron stored inside of cells. The small quantity of ferritin that is released into the blood is a reflection of the amount of total iron stored in the body. This test measures the amount of ferritin in the blood.


In healthy people, about 70% of the iron absorbed by the body is incorporated into the hemoglobin of red blood cells. Most of the remaining 30% is stored as ferritin or as hemosiderin, a complex of iron, proteins, and other materials. Ferritin and hemosiderin are present primarily in the liver but also in the bone marrow, spleen, and skeletal muscles.


When available iron is insufficient to meet the body's needs, iron stores are depleted and ferritin levels decrease. This may occur because of insufficient iron intake, inadequate absorption, or increased need for iron such as during pregnancy or due to a condition that causes chronic blood loss. Significant depletion of iron stores may occur before any signs of iron deficiency develop.


Iron storage and ferritin levels increase when more iron is absorbed than the body needs. Chronic absorption of excess iron will lead to the progressive buildup of iron compounds in organs and may eventually cause their dysfunction and failure. This happens in hemochromatosis, a genetic disease in which the body absorbs too much iron, even on a normal diet.

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A fetal hemoglobin test is a blood test that checks the amount of fetal hemoglobin (Hb F) in the blood. Fetal hemoglobin is one of many types of hemoglobin. It is present in high levels in fetuses, but usually drops to trace amounts about six months after birth. If Hb F is at higher than normal levels, it can mean you have thalassemia, myeloid leukemia, or sickle cell anemia.

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Fibrinogen is a protein, a coagulation factor (factor I) that is essential for blood clot formation. Two types of tests are available to evaluate fibrinogen: a fibrinogen activity test evaluates how well fibrinogen functions in helping to form a blood clot while a fibrinogen antigen test measures the amount of fibrinogen in the blood.


Fibrinogen is produced by the liver and released into circulation along with several other coagulation factor proteins. Normally, when a body tissue or blood vessel wall is injured, a process called hemostasis begins to help stop the bleeding by forming a plug at the injury site. Small cell fragments called platelets adhere to and aggregate at the site, a coagulation cascade begins, and clotting factors are activated one after the other.


As the cascade nears completion, soluble fibrinogen is converted into insoluble fibrin threads. These threads crosslink together to form a fibrin net that stabilizes at the injury site. The fibrin net adheres to the site of injury along with the platelets to form a stable blood clot. This barrier prevents additional blood loss and remains in place until the injured area has healed.


For a stable clot to form there must be enough normally functioning platelets and coagulation factors. If there are dysfunctional factors or platelets, or too little or too much of them, it can lead to bleeding episodes and/or to formation of an in appropriate blood clot (thrombosis). Several laboratory tests, including fibrinogen tests, can be used to evaluate hemostasis.

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Lymphatic filariasis (LF) is a parasitic disease caused by nematodes (Wuchereria bancrofti, Brugia malayi and Brugia timori) whose preferred habitats are the lymphatic vessels and lymph nodes which induce the development of disfiguring and debilitating clinical symptoms. The infection, which is transmitted by various genera of mosquitoes (Sasa 1976), is considered to be one of the health problems of greatest social and economic impact in endemic areas (Ottesen et al. 1997).


Until the 1980s, the only direct way to confirm a diagnosis of infection by W. bancrofti was via the identification of microfilariae (MF) in peripheral blood using camera counting, polycarbonate membrane filtration, the thick smear method or Knott's technique (Knott 1939, Denham et al. 1971, Dennis & Kaen 1971, Eberhard & Lammie 1991). Apart from the low sensitivities of these methods arising from the fact that they only identify filarial infection by way of microfilaremia, they are also inconvenient in terms of the time of day the blood must be collected, namely when the MF are at a peak in peripheral blood, a parameter that varies from one endemic area to another. In Brazil, the peak for microfilaremia occurs between 11 pm-1 am (Dreyer et al. 1996).


In the 1990s, significant advances were made in the diagnosis of LF with the emergence of new diagnostic tools: (i) use of recombinant antigens to detect specific antibodies (Chandrasherkar et al. 1994); (ii) a PCR for the detection of filarial DNA (Zhong et al. 1996, Rocha et al. 2002); (iii) the visualisation of live adult worms (AW) using ultrasound (US) and (iv) circulating filarial antigen (CFA) detection (More & Copeman 1990, Weil et al. 1997). At present, the standard diagnostic tools are US (Amaral et al. 1994) and CFA detection, with the latter using the monoclonal antibodies (McAbs) Og4C3 and AD12. The CFA detection techniques are commercially available in the form of kits and have the advantage of allowing for diagnosis to be carried out using blood samples collected at any time of day (More & Copeman 1990, Amaral et al. 1994, Weil et al. 1997, Rocha 2002, 2004)

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For a palpable breast lump, a fine needle is inserted through the skin and directed towards the suspicious area. When this needle reaches the mass, the doctor suctions out a sample with the help of syringe, which is then sent to the laboratory for further analysis.

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A fistulogram is a special x-ray procedure. It uses a form of real-time x-ray called fluoroscopy and a barium-based contrast material to produce images of an abnormal passage within the body called a fistula. It looks at the blood flow in your fistula or graft (dialysis access). This procedure can check to see if it is blocked or if there is any narrowing (stenosis).

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The fluorescent treponemal antibody absorption (FTA-ABS) test is a blood test that checks for the presence of antibodies to Treponema pallidum bacteria. These bacteria cause syphilis.


Syphilis s a sexually transmitted infection (STI) that’s spread through direct contact with syphilitic sores. Sores are most often present on the penis, vagina, or rectum. These sores aren’t always noticeable. You may not even know that you’re infected.


The FTA-ABS test doesn’t actually check for the syphilis infection itself. However, it can determine whether you have antibodies to the bacteria that cause it. Antibodies are special proteins produced by the immune system when harmful substances are detected. These harmful substances, known as antigens, include viruses, fungi, and bacteria. This means that people who are infected with syphilis will have the corresponding antibodies.

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Fluoroscopy is a study of moving body structures. It’s much like an X-ray "movie" and is often done while a contrast dye moves through the part of the body being examined. A continuous X-ray beam is passed through the body part and sent to a video monitor so that the body part and its motion can be seen in detail. Fluoroscopy, as an imaging tool, allows healthcare providers to look at many body systems, including the skeletal, digestive, urinary, cardiovascular, respiratory, and reproductive systems.


Fluoroscopy may be used to evaluate specific areas of the body. These include the bones, bowel, muscles, heart vessels, and joints.

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Vitamin B12 (Cobalamin) and Folic Acid (Folate) both play key roles in DNA synthesis and creating red blood cells. This test is used to measure vitamin B12 and folic acid levels.


Deficiencies in vitamin B12 can lead to nerve damage and specific cases of anemia in which red blood cells are larger than average and the level of hemoglobin in the blood are deficient, called macrocyotic anemia. Deficiencies in folate can cause neural tube defects to occur to a fetus during pregnancy.


Malnutrition or conditions that can cause an individual to have poor absorption of nutrients like celiac disease, Crohn's disease, alcoholism or intestinal or gastrointestinal disorders may have low levels of B12 and folic acid.

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Prostate specific antigen (PSA) is a protein produced primarily by cells in the prostate, a small gland that encircles the urethra in males and produces a fluid that makes up part of semen. Most of the PSA that the prostate produces is released into this fluid, but small amounts of it are also released into the bloodstream. This test measures the amount of PSA in the blood.


The PSA test is used as a tumor marker to screen for and to monitor prostate cancer. It is a good tool but not a perfect one, and most experts agree that screening should be done on asymptomatic men only after thorough discussions with their healthcare providers on the benefits and risks and after informed decisions are made to undergo screening. Elevated levels of PSA are associated with prostate cancer, but they may also be seen with prostatitis and benign prostatic hyperplasia (BPH). PSA levels tend to increase in all men as they age, and men of African American heritage may have levels that are higher than other men, even at earlier ages.


PSA is not diagnostic of cancer. The gold standard for identifying prostate cancer is the prostate biopsy, collecting small samples of prostate tissue and identifying abnormal cells under the microscope. (Read the article on Anatomic Pathology for more information on biopsies.) The total PSA test and digital rectal exam (DRE) are used together to help determine the need for a prostate biopsy.


The goal of screening is to detect prostate cancer while it is still confined to the prostate. Once the presence of prostate cancer is confirmed by biopsy, another decision must be made with regard to treatment. Prostate cancer is relatively common in men as they age and many, if not most, of the tumors are very slow-growing. While prostate cancer is the number two cause of death in men, the slow-growing type is an uncommon cause of death. A pathologist may be able to help differentiate between slow-growing cases and cancers that are likely to grow aggressively and spread to other parts of the body (metastasize).

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Triiodothyronine (T3) is one of two major hormones produced by the thyroid gland, a small butterfly-shaped organ that lies flat across the windpipe at the base of the throat. The other major thyroid hormone is called thyroxine (T4) and together they help control the rate at which the body uses energy. Almost all of the T3 (and T4) found in the blood is bound to protein. The rest is free (unbound) and is the biologically active form of the hormone. Tests can measure the amount of free T3 or the total T3 (bound plus unbound) in the blood.


T3 and T4 production is regulated by a feedback system. When blood levels of thyroid hormones decline, the hypothalamus releases thyrotropin releasing hormone, which stimulates the pituitary gland to produce and release thyroid-stimulating hormone (TSH). TSH then stimulates the thyroid gland to produce and/or release more thyroid hormones. Most of the thyroid hormone produced is T4. This hormone is relatively inactive, but it is converted into the much more active T3 in the liver and other tissues.


If the thyroid gland produces excessive amounts of T4 and T3, then the person affected may have symptoms associated with hyperthyroidism, such as nervousness, tremors of the hands, weight loss, insomnia, and puffiness around dry, irritated eyes. In some cases, the person's eyes cannot move normally and they may appear to be staring. In other cases, the eyes may appear to bulge.


If the thyroid gland produces insufficient amounts of thyroid hormones, then the person may have signs and symptoms associated with hypothyroidism and a slowed metabolism, such as weight gain, dry skin, fatigue, and constipation. The blood levels of thyroid hormones may be low or high due to thyroid dysfunction or rarely due to insufficient or excessive TSH production related to a pituitary disorder.


The most common causes of thyroid dysfunction are related to autoimmune disorders. Graves disease causes hyperthyroidism, but it can also be caused by thyroiditis, thyroid cancer, and excessive production of TSH. The effect of these conditions on thyroid hormone production can be detected and monitored by measuring the free T3 or sometimes total T3.

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Thyroxine (T4) is one of two major hormones produced by the thyroid gland, a small butterfly-shaped organ that lies flat across the windpipe at the base of the throat. The other major thyroid hormone is called triiodothyronine (T3) and together they help control the rate at which the body uses energy. Almost all of the T4 (and T3) found in the blood is bound to protein. The rest is free (unbound) and is the biologically active form of the hormone. This test measures the amount of free T4 in the blood.


T4 production is regulated by a feedback system. When the level of T4 in the bloodstream decreases, the hypothalamus releases thyrotropin releasing hormone, which stimulates the pituitary gland to produce and release thyroid-stimulating hormone (TSH). TSH then stimulates the thyroid gland to make and/or release more T4. As the blood concentration of T4 increases, TSH release is inhibited.


T4 makes up about 90% of thyroid hormones. When the body requires thyroid hormone, the thyroid gland releases stored T4 into circulation. In the blood, T4 is either free (not bound) or bound to protein (primarily bound to thyroxine-binding globulin). The concentration of free T4 is only about 0.1% of that of total T4. T4 is converted into T3 in the liver or other tissues. T3, like T4, is also mostly bound to protein, but it is the free forms of T3 and T4 that are biologically active. Free T3 is 4 to 5 times more active than free T4 in circulation.


If the thyroid gland does not produce sufficient T4, due to thyroid dysfunction or to insufficient TSH, then the affected person experiences symptoms of hypothyroidism such as weight gain, dry skin, cold intolerance, irregular menstruation, and fatigue. Severe untreated hypothyroidism, called myxedema, can lead to heart failure, seizures, and coma. In children, hypothyroidism can stunt growth and delay sexual development.

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Testosterone is the main sex hormone (androgen) in men. It is responsible for male physical characteristics. Although it is considered to be a "male" sex hormone, it is present in the blood of both men and women. This test measures the level of testosterone in the blood.


Testosterone is mainly produced by special endocrine tissue (the Leydig cells) in the male testicles. It is also produced by the adrenal glands in both males and females and, in small amounts, by the ovaries in females.


In males, testosterone stimulates development of secondary sex characteristics, including enlargement of the penis, growth of body hair, muscle development, and a deepening voice. It is present in large amounts in males during puberty and in adult males to regulate the sex drive and maintain muscle mass. In women, testosterone is converted to estradiol, the main sex hormone in females.


Testosterone production is stimulated and controlled by luteinizing hormone (LH), which is manufactured by the pituitary gland. Testosterone works within a negative feedback mechanism: as the testosterone level increases, LH production decreases, which slows testosterone production; decreased testosterone causes increased production of LH, which in turn stimulates testosterone production.


Testosterone levels are diurnal, peaking in the early morning hours (about 4:00 to 8:00 am), with the lowest levels in the evening (about 4:00 to 8:00 pm). Levels also increase after exercise and also decrease with age.


About two-thirds of testosterone circulates in the blood bound to sex-hormone binding globulin (SHBG) and slightly less than one-third bound to albumin. A small percent (less than 4%) circulates as free testosterone. The free plus the albumin-bound testosterone is the bioavailable fraction, which can act on target tissues.

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Fructosamine is a glycated serum protein which is formed by the combination of glucose and protein in the blood. Higher the levels of blood glucose, higher will be the concentration of fructosamine. Hence, the blood fructosamine levels reflect the amount of glucose present. Glycation mainly involves albumin which is the principal blood protein. Other protein substance may also combine with glucose. These protein substances have a lifespan of about 2-3 weeks. By measuring the level of fructosamine, you get an idea of the level of blood glucose over the past 2-3 weeks. Fructosamine test is usually performed on a blood sample to measure the level of fructosamine in blood. The test is performed to confirm Diabetes and also useful in estimating the blood sugar trends in the diabetic patient.

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Beta-2-microglobulin (beta-2-M) is a small membrane protein (11,800 Dalton) associated with the heavy chains of class I major histocompatibility complex proteins and is, therefore, on the surface of all nucleated cells. The small size allows beta-2-M to pass through the glomerular membrane, but it is almost completely reabsorbed in the proximal tubules.


Serum beta-2-M levels are elevated in diseases associated with increased cell turnover. Levels are also elevated in several benign conditions such as chronic inflammation, liver disease, renal dysfunction, some acute viral infections, and a number of malignancies, especially hematologic malignancies associated with the B-lymphocyte lineage.


In multiple myeloma, beta-2-M is a powerful prognostic factor and values <4 mcg/mL are considered a good prognostic factor.


In renal tubular disease, serum levels are low and urine levels are high. Although urine beta-2-M has been used to assess tubular dysfunction, it is not stable in urine below pH 5.5.


See Laboratory Screening Tests for Suspected Multiple Myeloma in Special Instructions.

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This test looks for bilirubin in your blood or urine.

Bilirubin is a substance made when your body breaks down old red blood cells. This is a normal process. Bilirubin is also part of bile, which your liver makes to help digest the food you eat.


A small amount of bilirubin in your blood is normal. Healthy adults make 250 to 350 milligrams (mg) of bilirubin each day.

Bilirubin that is bound to a certain protein (albumin) in the blood is called unconjugated, or indirect, bilirubin. Conjugated, or direct, bilirubin travels from the liver into the small intestine. A very small amount passes into your kidneys and is excreted in your urine. This bilirubin also gives urine its distinctive yellow color.


This test is usually done to look for liver problems, such as hepatitis, or blockages, such as gallstones.

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Bilirubin is a yellow pigment that’s in everyone’s blood and stool. Sometimes the liver can’t process the bilirubin in the body. This can be due to an excess of bilirubin, an obstruction, or inflammation of the liver. When your body has too much bilirubin, your skin and the whites of your eyes will start to yellow. This condition is called jaundice. A bilirubin test will help determine if you have any of these conditions.


Bilirubin is made in the body when the hemoglobin protein in old red blood cells is broken down. The breakdown of old cells is a normal, healthy process. After circulating in your blood, bilirubin then travels to your liver. In the liver, bilirubin is conjugated, mixed into bile, and then excreted into the bile ducts and stored in your gallbladder. Eventually, the bile is released into the small intestine to help digest fats. It’s ultimately excreted within your stool.


Bilirubin attached by the liver to the glucose-derived acid, glucuronic acid, is called direct, or conjugated, bilirubin. Bilirubin not attached to glucuronic acid is called indirect, or unconjugated, bilirubin. All the bilirubin in your blood together is called total bilirubin.


A comprehensive bilirubin blood test will get an accurate count of all three bilirubin levels in your blood: direct, indirect, and total.


In both adults and children, symptoms related to high bilirubin can involve jaundice, a yellowing of the skin or eyes, fatigue, itchy skin, dark urine, and low appetite.

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A Liver Function Test, also known as LFT, refers to a series of tests carried out to gather information about a patient’s liver conditions. Certain diseases of the liver, which seem mild in their initial stages, can develop to become chronic later on. Hence, proper diagnosis of liver conditions is pretty crucial for the detection and control of these ailments in time.


Liver function tests are performed on blood samples of the patients, and check the levels of various enzymes and proteins present in it. There are enzymes that get released into the blood only when the liver has undergone some damage. While some of the tests are carried out for functionality, a few others may be performed to check the condition of the biliary tract. Cellular integrity tests are also included in the series.


Liver function tests (LFTs), are a group of blood tests that provide details about the liver and identify any inflammation, malfunctioning or damage to the liver. Liver tests may be done together in a panel or tested separately. The list of tests include: Total Protein Albumin Bilirubin (Total & Direct) Gamma-glutamyl transpeptidase (GGT) Alkaline phosphatase (ALP) Serum Glutamic Oxaloacetic Transaminase (SGOT) or AST Serum Glutamate Pyruvate Transaminase (SGPT) or ALT.

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The dimorphic fungus, Blastomyces dermatitidis, causes blastomycosis. When the organism is inhaled, it causes pulmonary disease-cough, pain, and hemoptysis, along with fever and night sweats. It commonly spreads to the skin, bone, or internal genitalia where suppuration and granulomas are typical. Occasionally, primary cutaneous lesions after trauma are encountered; however, this type of infection is uncommon.

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A bleeding time test determines how quickly your blood clots to stop bleeding. The test involves making small, superficial cuts on your skin. They’re similar to light scratches.


The test is a basic assessment of how well your blood platelets work -form clots. Platelets are tiny cell fragments that circulate in your blood. They’re the first cells to react to a blood vessel injury. They seal off the wound to prevent more blood from escaping.

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A blood culture is a test that checks for foreign invaders like bacteria, yeast, and other microorganisms in your blood. Having these pathogens in your bloodstream can be a sign of a blood infection, a condition known as bacteremia. A positive blood culture means that you have bacteria in your blood.

This type of infection involves the blood that circulates within your entire body. Bacteria that start on your skin or in your lungs, urine, or gastrointestinal tract are common sources of blood infections.

An infection can spread to your blood and become systemic if it’s severe or if your immune system isn’t able to keep it contained. A systemic infection is known as sepsis.

The test for a blood culture involves a simple blood draw. A laboratory tests the blood sample and forwards the results to your doctor, who will use the findings to help determine what’s needed to treat any infection.
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A blood gas test measures the amount of oxygen and carbon dioxide in the blood. It may also be used to determine the pH of the blood, or how acidic it is. The test is commonly known as a blood gas analysis or arterial blood gas (ABG) test.


Your red blood cells transport oxygen and carbon dioxide throughout your body. These are known as blood gases. As blood passes through your lungs, oxygen flows into the blood while carbon dioxide flows out of the blood into the lungs. The blood gas test can determine how well your lungs are able to move oxygen into the blood and remove carbon dioxide from the blood.


Imbalances in the oxygen, carbon dioxide, and pH levels of your blood can indicate the presence of certain medical conditions. These may include:


kidney failure

heart failure

uncontrolled diabetes

hemorrhage

chemical poisoning

a drug overdose

shock

Your doctor may order a blood gas test when you’re showing symptoms of any of these conditions. The test requires the collection of a small amount of blood from an artery. It’s a safe and simple procedure that only takes a few minutes to complete.

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Arterial blood gases (ABGs) are commonly used for estimating the acid-base status, oxygenation and carbon dioxide concentration of unwell patients. However, arterial blood can be difficult to obtain due to weak pulses or patient movement. Due to thicker, muscular and innervated walls, arteries are also more painful to puncture than veins. As such, a venous blood gas (VBG) is an alternative method of estimating pH and other variables.

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Blood typing is a test that determines a person’s blood type. The test is essential if you need a blood transfusion or are planning to donate blood. Not all blood types are compatible, so it’s important to know your blood group. Receiving blood that’s incompatible with your blood type could trigger a dangerous immune response.

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A bone density test is the only test that can diagnose osteoporosis before a broken bone occurs. This test helps to estimate the density of your bones and your chance of breaking a bone. NOF recommends a bone density test of the hip and spine by a central DXA machine to diagnose osteoporosis. DXA stands for dual energy x-ray absorptiometry.


You can find out whether you have osteoporosis or if you should be concerned about your bones by getting a bone density test. Some people also call it a bone mass measurement test. This test uses a machine to measure your bone density. It estimates the amount of bone in your hip, spine and sometimes other bones. Your test result will help your healthcare provider make recommendations to help you protect your bones.


Are you a postmenopausal woman or man age 50 and older? Have you recently broken a bone? If you answered “yes” to both questions, you should talk to your doctor or other healthcare provider about getting a bone density test if you’ve never had one.

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Sometimes a sample of bone marrow must be examined to determine why blood cells are abnormal or why there are too few or too many of a specific kind of blood cell. A doctor can take two different types of bone marrow samples:


Bone marrow aspirate: Removes fluid and cells by inserting a needle into the bone marrow and sucking out fluid and cells


Bone marrow core biopsy: Removes an intact piece of bone marrow using a coring device (similar to a larger diameter needle)

The bone marrow aspirate shows what cells, normal and abnormal, are present in the bone marrow. The core biopsy shows how full the bone marrow is with cells and where the cells are located within the marrow. Both types of samples are usually taken from the hipbone (iliac crest), although aspirates are rarely taken from the breastbone (sternum). In very young children, bone marrow samples are occasionally taken from one of the bones in the lower leg (tibia).

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Bronchial washing is part of a procedure called a bronchoscopy, in which a physician looks into the lungs with a fiber-optic bronchoscope to check for irregularities and take tissue samples. The physician injects saline through the bronchoscope into the lung and then suctions it back out. By checking the wash return fluid, the doctor can diagnose bleeding, pneumonia, industrial pollutants, fungal infections and different kinds of lung cancer. Patients undergoing bronchial washing usually receive topical anesthesia with sedation. Most side effects of bronchial washing are mild and include coughing, sore throat and a sleepy feeling from being sedated.

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This is a blood test for brucellosis. Brucellosis is an infectious disease usually caused by handling animals or milk products infected with the brucella bacteria. If you have brucellosis, your body will make certain antibodies to fight the brucella bacteria. This test looks for those antibodies in your blood.


The brucella bacteria can infect dogs and livestock, including cows, sheep, camels, goats, and pigs. Recently brucella bacteria have also been found in ocean mammals, including seals.


The disease is rare in the U.S. Fewer than 200 cases are reported here each year. It's more commonly found in Latin America, the Middle East, and the Mediterranean. This is why it's often called Mediterranean or Malta fever. It's also called Undulant fever, Bang's disease, and Gibraltar fever.


If you are exposed to brucella bacteria, you may develop brucellosis. Your symptoms may not show up right away. But if the disease isn't treated after a few months, you may start to feel unusually weak. You may get a fever and chills, headaches, backache, muscle and joint pain, and sweats. You may lose your appetite and appear anorexic. If untreated, the bacteria can sometimes damage the heart, joints, or central nervous system. They can also cause infections that keep coming back. If you are pregnant and have brucellosis, it may cause a miscarriage or infect your unborn child. 

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B-type natriuretic peptide (BNP) is a hormone produced by your heart. N-terminal (NT)-pro hormone BNP (NT-proBNP) is a non-active prohormone that is released from the same molecule that produces BNP. Both BNP and NT-proBNP are released in response to changes in pressure inside the heart. These changes can be related to heart failure and other cardiac problems. Levels goes up when heart failure develops or gets worse, and levels goes down when heart failure is stable. In most cases, BNP and NT-proBNP levels are higher in patients with heart failure than people who have normal heart function.

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Mammography plays a central part in early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them. Current guidelines from the U.S. Department of Health and Human Services (HHS), the American Cancer Society (ACS), the American Medical Association (AMA) and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 40. Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and breast-conservation therapies are available.


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The test is a simple method to identifying a person’s gender and establish sexual identity in newborns and in adults. Earlier the method was popularly employed in competitive sports to identify males masquerading as females. 


The mouth has to be rinsed and washed before the test. A spatula is used to gently scrape the inside of the person’s cheek. This can be done by a health care provider or by self. A smear of this buccal sample is made on a slide, stained and observed under the microscope.

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A BUN, or blood urea nitrogen test, can provide important information about your kidney function. The main job of your kidneys is to remove waste and extra fluid from your body. If you have kidney disease, this waste material can build up in your blood and may lead to serious health problems, including high blood pressure, anemia, and heart disease.


The test measures the amount of urea nitrogen in your blood. Urea nitrogen is one of the waste products removed from your blood by your kidneys. Higher than normal BUN levels may be a sign that your kidneys aren't working efficiently.


People with early kidney disease may not have any symptoms. A BUN test can help uncover kidney problems at an early stage when treatment can be more effective.


Other names for a BUN test: Urea nitrogen test, serum BUN

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A micturating cysto-urethrogram (or MCU) is a study using X-rays that shows the bladder and urethra (the tube that carries urine from the bladder and out of the body) while passing urine (see children’s X-ray examination). The test is performed to find out if the urine goes from the bladder back up to the kidneys instead of out through the urethra, known as vesico-ureteric reflux (VUR). This can be the cause of recurrent urinary tract (in the bladder or kidneys) infection and kidney damage. The test also shows how the bladder empties and what the urethra looks like.This test is most commonly performed on children under six months of age, but can be used less commonly as an investigation for older children and adults with multiple recurrent urinary tract infections.


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In horses there are 7 blood group systems (A,C,D,K,P,Q,U) with greater than 30 red blood cell factors. Of these, Ca seems to be one of the most immunogenic antigens (causing allo-immunization).


Transfusion reactions

Blood typing before transfusion minimizes the risk of transfusion reactions and prevent immunization of the recepient against incompatible RBC antigens. Ca, Aa and Qa antigens are clinically important for their role in transfusion reactions.


Neonatal isoerythrolysis (NI)


NI is a potentially fatal condition in new foals that result from an incompatibility of blood types between the mare and the foal. It is caused when the mare produces antibodies against the foal RBC and transfers those antibodies through colostrum.

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Red blood cell (RBC) indices are individual components of a routine blood test called the complete blood count (CBC). The CBC is used to measure the quantity and physical characteristics of different types of cells found in your blood.

Blood consists of RBCs, white blood cells (WBCs), and platelets that are suspended in your plasma. Platelets are cells that enable clot formation. RBCs contain hemoglobin, which carries oxygen throughout your body to all of your tissues and organs. An RBC is pale red and gets its color from hemoglobin. It’s shaped like a doughnut, but it has a thinner area in the middle instead of a hole. Your RBCs are normally all the same color, size, and shape. However, certain conditions can cause variations that impair their ability to function properly.  The RBC indices measure the size, shape, and physical characteristics of the RBCs. Your doctor can use RBC indices to help diagnose the cause of anemia. Anemia is a common blood disorder in which you have too few, misshapen, or poorly functional RBCs.





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The toxicity of cadmium resembles the other heavy metals (arsenic, mercury, and lead) in that it attacks the kidney; renal dysfunction with proteinuria with slow onset (over a period of years) is the typical presentation.


Breathing the fumes of cadmium vapors leads to nasal epithelial deterioration and pulmonary congestion resembling chronic emphysema.


The most common source of chronic exposure comes from spray painting of organic-based paints without use of a protective breathing apparatus; aut

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The reference intervals are dependent on the method used for assessment.


Reference intervals based on sex and thyroid status have been established in healthy, unstimulated (eg, pentagastrin provocative test or post-calcium infusion) individuals and in stimulated individuals, as follows:


Basal reference ranges for some calcitonin chemiluminescent assays: Less than 8.8 pg/mL (ng/L) in males; less than 5.8 pg/mL (ng/L) in females; less than 0.5 pg/ml (ng/L) in athyroidal individuals

Peak calcium infusion (IMMULITE 2000 calcitonin assay): Less than or equal to 130 pg/mL in males; less than or equal to 90 pg/mL in females

Age, pregnancy, lactation, and ingestion of food have been reported to influence calcitonin concentration in healthy individuals, but specific reference intervals have not been established. 

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MCH stands for Mean Corpuscular Hemoglobin, and is a calculation of the average amount of hemoglobin contained within each of a person's red blood cells. Hemoglobin is the substance that carries oxygen from the lungs to the cells of the body through the bloodstream. Abnormally high or low levels of MCH, as determined by blood testing, can be an indication of a number of problems within the body, ranging from nutrient deficiencies to chronic diseases.The MCH blood test is done as a component of a blood test called a Complete Blood Count (CBC), which evaluates the composition of the blood, checking hematocrit, white blood cells (WBC) and platelets as well as hemoglobin and red blood cells (RBC). It is usually ordered to get an overview of general health. MCH is not measured directly, but calculated based on the hemoglobin value (Hgb), which is the total measure of hemoglobin in the blood, and the RBC, which is the number of red blood cells in the blood. To calculate MCH, the Hgb is divided by RCB, yielding an average amount of hemoglobin per red blood cell. Normal levels of MCH are between 26 and 33 picograms (pg) of hemoglobin per RBC.


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Calcium is an important mineral that your body uses in many ways. It increases the strength of your bones and teeth and helps your muscles and nerves function.


A serum calcium blood test measures the total calcium in your blood. There are several different forms of calcium in your blood. These include ionized calcium, calcium bound to other minerals called anions, and calcium bound to proteins like albumin. Ionized calcium, also known as free calcium, is the most active form.

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A calcium blood test measures the amount of calcium in your blood. Calcium is one of the most important minerals in your body. You need calcium for healthy bones and teeth. Calcium is also essential for proper functioning of your nerves, muscles, and heart. About 99% of your body's calcium is stored in your bones. The remaining 1% circulates in the blood. If there is too much or too little calcium in the blood, it may be a sign of bone disease, thyroid disease, kidney disease, or other medical conditions.

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Medullary thyroid cancer can be highly aggressive, especially if the diagnosis is done in advanced stages. Early diagnosis is based on RET genetic testing, for familial forms, and on the routine measurement of calcitonin (Ct). Nevertheless, since false-positive results can be obtained with the basal measurement of Ct, a provocative test to evaluate stimulated Ct is often needed. Pentagastrin which has been widely used to stimulate basal Ct, especially in European countries, is now hardly available. Thus, the stimulation with calcium (Ca), used in the 1970s-1980s and then abandoned for around 30 years, has recently elicited more interest. In the past 3 years, studies in patients and normal controls have demonstrated that the stimulation with Ca (2.3-2.5 mg/kg of elemental Ca, corresponding to 25 mg/kg of Ca gluconate) is highly potent and accurate. Novel gender-related cut-offs have been proposed for the Ca test, though the analysis of additional large series is predicted to modify these preliminary data. Finally, Ca seems to be the test of choice to stimulate Ct for the diagnosis and follow-up of medullary thyroid cancer, also because it is widely available, has a low cost and it is associated with a low number and intensity of side effects. In the present review the different methods to stimulate Ct and the cut-offs for the identification of the hyperplastic/neoplastic transformation of the C cells will be reported and discussed.

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The mean corpuscular hemoglobin concentration (MCHC) is the average concentration of hemoglobin in your red blood cells. Hemoglobin is the protein molecule that allows red blood cells to carry oxygen to tissues within your body. Your MCHC can fall into low, normal, and high ranges even if your red blood cell count is normal.


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Carcinoembryonic antigen (CEA) is a glycoprotein normally found in embryonic entodermal epithelium.


Increased levels may be found in patients with primary colorectal cancer or other malignancies including medullary thyroid carcinoma and breast, gastrointestinal tract, liver, lung, ovarian, pancreatic, and prostatic cancers.


Serial monitoring of CEA should begin prior to therapy to verify post therapy decrease in concentration and to establish a baseline for evaluating possible recurrence. Levels generally return to normal within 1 to 4 months after removal of cancerous tissue.

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Evaluation of carnitine in serum, plasma, tissue, and urine screens patients for suspected primary disorders of the carnitine cycle, or secondary disturbances in carnitine levels as a result of organic acidemias and fatty acid oxidation disorders. In the latter disorders, acyl-CoA groups accumulate and are excreted into the urine and bile as carnitine derivatives, resulting in a secondary carnitine deficiency. More than 100 such primary and secondary disorders have been described. Individually, the incidence of these disorders varies from less than 1 in 10,000 to more than 1 in 1,000,000 live births. Collectively, their incidence is approximately 1 in 1,000 live births. Primary carnitine deficiency has an incidence of approximately 1 in 21,000 live births based on Minnesota newborn screening data.


Other conditions which could cause an abnormal carnitine level are neuromuscular diseases, gastrointestinal disorders, familial cardiomyopathy, renal tubulopathies and chronic renal failure (dialysis), and prolonged treatment with steroids, antibiotics (pivalic acid), anticonvulsants (valproic acid), and total parenteral nutrition.

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Vitamin A, also known as retinol, plays an important role in the formation of rhodopsin, a photoreceptor pigment in the retina of the eye. Vitamin A helps to maintain epithelial tissues. Vitamin A is a group of unsaturated nutritional organic compounds, including beta-carotene.


Typically the liver stores 80%-90% of the body's vitamin A. Primary Vitamin A deficiency is usually caused by dietary deprivation for a long period of time, but it can also stem from fat malabsorption or liver disorders.


In children with complicated measles, vitamin A can shorten the duration of the disorder and reduce the severity of symptoms and risk of death. The younger the patient, the more severe the effects of vitamin A deficiency are. Mortality rate can exceed 50% in children with severe vitamin A deficiency.

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MCV stands for mean corpuscular volume. There are three main types of corpuscles (blood cells) in your blood–red blood cells, white blood cells, and platelets. An MCV blood test measures the average size of your red blood cells, also known as erythrocytes. Red blood cells move oxygen from your lungs to every cell in your body. Your cells need oxygen to grow, reproduce, and stay healthy. If your red blood cells are too small or too large, it could be a sign of a blood disorder such as anemia, a vitamin deficiency, or other medical condition.


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A test for catecholamines measures the amount of the hormones epinephrine, norepinephrine, and dopamine in the blood. These catecholamines are made by nerve tissue camera.gif, the brain, and the adrenal glands. Catecholamines help the body respond to stress or fright and prepare the body for "fight-or-flight" reactions.


The adrenal glands make large amounts of catecholamines as a reaction to stress. The main catecholamines are epinephrine (adrenaline), norepinephrine (noradrenaline), and dopamine. They break down into vanillylmandelic acid (VMA), metanephrine, and normetanephrine. Metanephrine and normetanephrine also may be measured during a catecholamine test.


Catecholamines increase heart rate, blood pressure, breathing rate, muscle strength, and mental alertness. They also lower the amount of blood going to the skin and intestines and increase blood going to the major organs, such as the brain, heart, and kidneys.


Certain rare tumors (such as a pheochromocytoma) can increase the amount of catecholamines in the blood. This causes high blood pressure, excessive sweating, headaches, fast heartbeats (palpitations), and tremors.


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Ceruloplasmin, a glycoprotein produced in the liver, carries or transports more than 95 percent of the copper in blood plasma.


Copper plays an important role in the body by aiding crucial bodily processes. These include producing energy, forming connective tissue, and helping your central nervous system function.


A ceruloplasmin test can determine the levels of ceruloplasmin in your body. It’s most often used in the diagnosis of Wilson’s disease, a genetic disorder.

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A rubella blood test detects antibodies that are made by the immune system to help kill the rubella virus. These antibodies remain in the bloodstream for years. The presence of certain antibodies means a recent infection, a past infection, or that you have been vaccinated against the disease. Rubella (also called German measles or 3-day measles) usually does not cause long-term problems. But a woman infected with the rubella virus during pregnancy can transmit the disease to her baby (fetus). And serious birth defects called congenital rubella syndrome (CRS) could develop, especially during the first trimester. Birth defects of CRS include cataracts and other eye problems, hearing impairment, and heart disease. Miscarriage and stillbirth are also possible consequences for pregnant women. The vaccination to prevent rubella protects against these complications.A rubella test is usually done for a woman who is or wants to become pregnant to determine whether she is at risk for rubella. Several laboratory methods can be used to detect rubella antibodies in the blood. The most commonly used method is the enzyme-linked immunosorbent assay (ELISA, EIA).


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Filariasis is a disease resulting from parasitization by thread like of filiform worms called filariae. The embryos circulate in lymphatic tissues and blood as microfilaria leading to Lymphangitis, Lymphadenitis, Elephantiasis and Tropical eosinophilia


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The mitochondria create energy for the cells in your body to use. They’re critical to the normal functioning of all cells.Antimitochondrial antibodies (AMAs) are an example of an autoimmune response that occurs when the body turns against its own cells, tissues, and organs. When this happens, the immune system attacks the body as though it were an infection. The AMA test identifies elevated levels of these antibodies in your blood. The test is most often used to detect an autoimmune condition known as primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis.


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Follicle-stimulating hormone (FSH) is an important part of the reproductive system. It’s responsible for the growth of ovarian follicles. Follicles produce estrogen and progesterone in the ovaries and help maintain the menstrual cycles in women. In men, FSH is a part of the development of the gonads as well as sperm production.


The FSH test measures the level of FSH found in your blood. Your doctor will order an FSH test to find the underlying cause of symptoms affecting the reproductive system.

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Mononucleosis is a viral infection caused by the Epstein Barr virus and is common in adolescents and young adults. Often times, there are no symptoms, but others feel tired, feverish, have a sore throat, etc. The Mononucleosis Test (Qualitative) will detect what’s called ‘heterophil antibodies’ in your blood (related to mono). Keep in mind, if you’ve had mononucleosis in the past, you will always test positive for it.


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Fungi are microbes that exist in nature as one-celled yeasts or as branching filamentous molds (also may be spelled "moulds"). Only about 20 to 25 species of fungi are common causes of infection. Fungal tests detect infections and sometimes identify the fungus and help guide treatment. 


Fungal infections range from superficial skin infections to serious deep tissue, blood, lung, or systemic diseases.


Superficial fungal infections are very common. They may cause nail infections or itchy, red, scaly skin infections such as those commonly known as athlete's foot, jock itch, and ringworm, or yeast infections that cause white patches in the mouth (thrush) or vaginal itching and discharge. According to the Centers for Disease Control and Prevention (CDC), almost 75% of women will have at least one yeast infection in their lifetime.

Lung, blood, and systemic infections: less commonly, fungi cause serious lung infections, blood infections (septicemia), or systemic infections that can affect any organ in the body. Fungal lung infections typically start with the accidental inhalation of microscopic fungal spores. While anyone can get a serious lung or systemic fungal infection, most affected people will only experience mild to moderate flu-like symptoms. However, people who are immunocompromised, such as those with HIV/AIDS, organ transplant recipients, and people with an underlying condition such as diabetes or lung disease are at an increased risk of having a severe fungal infection, a systemic infection, and/or recurrent infections.

Fungal tests are used to detect and identify fungi in order to diagnose infections and help guide treatment. Fungal testing typically includes a microscopic examination of the sample on a slide, sometimes using a preparation or stain to aid in detection of fungal elements. This may be sufficient to determine that the infection is due to a fungus and, with superficial infections, no further testing may be required.


However, in cases of persistent, deep, or systemic infections when a more definitive diagnosis is needed, the microscopic exam may be followed by additional tests, such as culture and susceptibility testing, antigen or antibody tests, or molecular tests that detect fungal genetic material.

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Tuberculin is a glycerol extract of the tubercle bacillus. Purified protein derivative (PPD) tuberculin is a precipitate of species-nonspecific molecules obtained from filtrates of sterilized, concentrated cultures. The tuberculin reaction was first described by Robert Koch in 1890. The test was first developed and described by the German physician Felix Mendel in 1908 [1] It is named after Charles Mantoux, a French physician who built on the work of Koch and Clemens von Pirquet to create his test in 1907. However, the test was unreliable due to impurities in tuberculin which tended to cause false results.[2] Esmond R. Long and Florence B. Seibert identified the active agent in tuberculin as a protein. Seibert then spent a number of years developing methods for separating and purifying the protein from Mycobacterium tuberculosis, obtaining purified protein derivative (PPD) and enabling the creation of a reliable test for tuberculosis.[2] Her first publication on the purification of tuberculin appeared in 1934.[3] By the 1940s, Seibert's PPD was the international standard for tuberculin tests.[4] In 1939, M. A. Linnikova in the USSR created a modified version of PPD. In 1954, the Soviet Union started mass production of PPD-L, named after Linnikova.[c


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Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme involved in energy production. It is found in all cells, including red blood cells (RBCs) and helps protect them from certain toxic by-products of cellular metabolism. A deficiency in G6PD causes RBCs to become more vulnerable to breaking apart (hemolysis) under certain conditions. This test measures the amount of G6PD in RBCs to help diagnose a deficiency.


G6PD deficiency is a genetic disorder. When individuals who have inherited this condition are exposed to a trigger such as stress, an infection, certain drugs or other substance(s), significant changes occur in the structure of the outer layer (cell membrane) of their red blood cells. Hemoglobin, the life-sustaining, oxygen-transporting protein within RBCs, forms deposits (precipitates) called Heinz bodies. Some individuals may experience these reactions when exposed to fava beans, a condition called "favism." With these changes, RBCs can break apart more readily, causing a decrease in the number of RBCs. When the body cannot produce sufficient RBCs to replace those destroyed, hemolytic anemia results and the individual may develop jaundice, weakness, fatigue, and/or shortness of breath.


G6PD deficiency is the most common enzyme deficiency in the world, affecting more than 400 million people. It may be seen in up to 10% of African-American males and 20% of African males. It is also commonly found in people from the Mediterranean and Southeast Asia.


G6PD deficiency is inherited, passed from parent to child, due to mutations or changes in the G6PD gene that cause decreased enzyme activity. There are over 440 variants of G6PD deficiency. The G6PD gene is located on the sex-linked X chromosome. Since men have one X and one Y sex chromosome, their single X chromosome carries the G6PD gene. This may result in a G6PD deficiency if a male inherits the single X chromosome with an altered gene.


Since women have two X sex chromosomes, they inherit two copies of the G6PD gene. Women with only one mutated gene (heterozygous) produce enough G6PD that they usually do not experience any symptoms (i.e., asymptomatic), but under situations of stress, they may demonstrate a mild form of the deficiency. In addition, a mother may pass the single mutated gene to any male children. Rarely do women have two mutated gene copies (homozygous), which could result in G6PD deficiency.

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MR angiography (MRA) uses a powerful magnetic field, radio waves and a computer to evaluate blood vessels and help identify abnormalities or diagnose atherosclerotic (plaque) disease. This exam does not use ionizing radiation and may require an injection of a contrast material called gadolinium, which is less likely to cause an allergic reaction than iodinated contrast material. Tell your doctor about any health problems, recent surgeries or allergies and whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should always tell the technologist if you have any devices or metal in your body. In some instances, your doctor will provide you with a card that includes information about your implant to give to the technologist. Guidelines about eating and drinking before your exam vary between facilities. Unless you are told otherwise, take your regular medications as usual. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. If you have claustrophobia or anxiety, you may want to ask your doctor for a mild sedative prior to the exam.


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Galactose is a sugar that is part of the lactose found in milk and milk products. A galactosemia test is a blood or urine test that checks for enzymes that are needed to change galactose into glucose, a sugar that your body uses for energy. A person with galactosemia doesn't have one of these enzymes, so high levels of galactose build up in the blood or urine.


When galactose builds up in a baby's blood, it can cause liver damage, problems with eating, and intellectual disabilities. The damage caused by galactosemia can begin within weeks after the baby has started drinking breast milk or formula. Babies with galactosemia need foods low in galactose in order to gain weight and to prevent brain damage, liver problems, infection, and cataracts.


Galactosemia is a rare disease that is passed from parents to children (inherited genetic disorder). A galactosemia test is usually done to determine whether a newborn has the disease. In a family with a member who has galactosemia, a genetic test can be done on adults to find out whether they have an increased chance of having a child with the disease.

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Constipation has a high prevalence in the general population and is a cause for significant morbidity. It has been estimated that approximately 10% of the Indian population suffers from constipation. [1] Chronic constipation leads to approximately 2.5 million visits to the physicians in the United States annually. [2] Various definitions have been used for chronic constipation. However, recently, the Rome II criteria were developed to promote consistency in the diagnosis. [3] Constipation may be primary or secondary. Primary constipation may be due to slow transit disorder or anorectal expulsion disorder (obstructive defecation) or a combination of these. According to the National Institute for health and Clinical Excellence (NICE) guidelines issued in 2010, obstructed defecation syndrome (ODS) is characterized by the urge to defecate but an impaired ability to expel the fecal bolus. Symptoms include unsuccessful fecal evacuation attempts, excessive straining, pain, bleeding after defecation, and a sense of incomplete fecal evacuation. [4] Patients may also resort to digital rectal evacuation. Evaluation and treatment of these patients has been difficult. Magnetic resonance defecography (MRD) has been shown to demonstrate the structural abnormalities associated with ODS, and patients with significant structural abnormalities may benefit from surgical interventions like stapled transanal resection of rectum (STARR). Patients who do not demonstrate significant structural abnormalities can be referred for biofeedback techniques. We present our experience in a large series of patients with suspected ODS who underwent MRD at our tertiary care center.


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A ganglioside is a molecule of a glycosphingolipid with one other sialic salts  sialic acids (e.g. n-acetylneuraminic acid, NANA) linked on the sugar chain. NeuNAc, an acetylated derivative of the carbohydrate sialic acid, makes the head groups of gangliosides anionic at pH 7, which distinguishes them from globosides.


The name ganglioside was first applied by the German scientist Ernst Klenk in 1942 to lipids newly isolated from ganglion cells of the brain. More than 60 gangliosides are known, which differ from each other mainly in the position and number of NANA residues. It is a component of the cell plasma membrane that modulates cell signal transduction events, and appears to concentrate in lipid rafts

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You can have peace of mind that we place you first with a focus on giving you comprehensive benefits, value for money and services to improve the quality of care available to you. As a Discovery Health Medical Scheme member you have access to the broadest and best level of healthcare cover in the market based on your medical condition needs. Depending on your medical aid plan, we cover for in- and out-hospital tests and screening, including investigations, radiology and blood tests, vaccinations for adults and children and blood tests


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Mammography is a screening tool for breast cancer. At NM Medical we employ advanced digital imaging technology for the dual benefits of optimum diagnostic quality and maximum patient comfort. Mammography is important because in its earliest stages breast cancer may not be palpable; it may be too small to feel as a lump or tissue change. Mammography can help detect these changes two years or more before you would feel them. Physical examination is also important because pre-menopausal breast tissue is often dense and fibrous, which may decrease the reliability of mammography for young women.

  

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MR spectroscopy (MRS) allows tissue to be interrogated for the presence and concentration of various metabolites. Grossman and Yousem said "If you need this to help you, go back to page 1; everything except Canavan has low NAA, high Choline". This is perhaps a little harsh, however it is fair to say that MRS often does not add a great deal to an overall MR study but does increase specificity, and may help in improving our ability to predict histological grade.


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Diffusion tensor imaging tractography, or DTI tractography, is an MRI (magnetic resonance imaging) technique that measures the rate of water diffusion between cells to understand and create a map of the body’s internal structures; it is most commonly used to provide imaging of the brain. This advanced imaging technique, which provides much more detailed images of the brain than a conventional MRI, may also be used in the diagnosis of stroke, acute ischemia, brain tumors and multiple sclerosis, as well as pre-operative planning.  Using MRI technology, DTI tractography is non-invasive and uses radio waves and a magnetic field to produce images of the brain, tissues and skull. MRI technology provides detailed images showing small changes in body tissue and blood flow, which makes it an extremely reliable tool for the detection of disease, injury, bleeding and swelling.  Loyola offers state-of-the-art imaging and diagnostic techniques in order to provide timely and accurate diagnosis for our patients. Our expert radiologists are recognized nationally for clinical excellence, innovative diagnostic and therapeutic methods and skilled use of the latest technology. Our experienced technologists provide testing in a caring and compassionate environment where we want you to feel comfortable asking any questions you may have about your test or procedure. 


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Magnetic resonance cholangiopancreatography or MRCP uses a powerful magnetic field, radio waves and a computer to evaluate the liver, gallbladder, bile ducts, pancreas and pancreatic duct for disease. It is noninvasive and does not use ionizing radiation. Tell your doctor about any health problems, recent surgeries or allergies and whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should always tell the technologist if you have any devices or metal in your body. Guidelines about eating and drinking before your exam vary between facilities. Unless you are told otherwise, take your regular medications as usual. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. If you have claustrophobia or anxiety, you may want to ask your doctor for a mild sedative prior to the exam


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A magnetic resonance angiogram (MRA) is a type of magnetic resonance imaging (MRI) scan that uses a magnetic field and pulses of radio wave energy to provide pictures of blood vessels inside the body. In many cases MRA can provide information that can't be obtained from an X-ray, ultrasound, or computed tomography (CT) scan. MRA can find problems with the blood vessels that may be causing reduced blood flow. With MRA, both the blood flow and the condition of the blood vessel walls can be seen. The test is often used to look at the blood vessels that go to the brain, kidneys, and legs. Information from an MRA can be saved and stored on a computer for further study. Photographs of selected views can also be made.During MRA, the area of the body being studied is placed inside an MRI machine. Contrast material is often used during MRA to make blood vessels show up more clearly.


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Ankle pain and ankle injuries are common. Physicians must carefully eliminate other conditions before making an ankle arthritis diagnosis. Physicians use a comprehensive approach that is verified by diagnostic imaging to arrive at a clinical diagnosis.Below is a description of the process physicians use to determine if a patient’s symptoms are caused by ankle osteoarthritis.

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Gastrin is a hormone produced by "G-cells" in the part of the stomach called the antrum. It regulates the production of acid in the body of the stomach during the digestive process. This test measures the amount of gastrin in the blood to help evaluate an individual with recurrent peptic ulcers and/or other serious abdominal symptoms.


When food is eaten, the antrum of the stomach becomes distended and the presence of food stimulates the release of gastrin. Gastrin in turn stimulates parietal cells to produce gastric acid. Acidity helps to digest food and the rise in acidity eventually suppresses gastrin release. This feedback system normally results in low concentrations of gastrin in the blood, especially in the fasting state. Rare conditions such as G-cell hyperplasia and gastrinomas, including Zollinger-Ellison (ZE) syndrome, can cause an overproduction of gastrin and gastric acid. This can lead to aggressive peptic ulcers that can be difficult to treat.


Gastrinomas are gastrin-producing tumors. ZE syndrome is a condition caused by the presence of one or more gastrinomas and is characterized by high gastrin levels, greatly increased gastric acid production, and by peptic ulcers. Gastrinomas usually form in the pancreas, even though the endocrine cells of the pancreas do not normally make gastrin. More than half of them are malignant, causing cancer that can spread to other parts of the body, such as the liver. Even tiny tumors can produce large quantities of gastrin.

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GCT test is used to help diagnose gestational diabetes and type 2 diabetes. A glucose tolerance test measures how well your body’s cells are able to absorb glucose, or sugar, after you ingest a given amount of sugar.

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Gamma-glutamyl transferase (GGT) is an enzyme that is found in many organs throughout the body, with the highest concentrations found in the liver. GGT is elevated in the blood in most diseases that cause damage to the liver or bile ducts. This test measures the level of GGT in a blood sample.


Normally, GGT is present in low levels, but when the liver is injured, the GGT level can rise. GGT is usually the first liver enzyme to rise in the blood when any of the bile ducts that carry bile from the liver to the intestines become obstructed, for example, by tumors or stones. This makes it the most sensitive liver enzyme test for detecting bile duct problems.


However, the GGT test is not very specific and is not useful in differentiating between various causes of liver damage because it can be elevated with many types of liver diseases, such as liver cancer and viral hepatitis, as well as other non-hepatic conditions, such as acute coronary syndrome. For this reason, the GGT test is not recommended for routine use by itself. However, it can be useful in conjunction with other tests and in determining the cause of a high alkaline phosphatase (ALP) level, another enzyme found in the liver.


Both GGT and ALP are increased in liver diseases, but only ALP will be increased with diseases affecting bone tissue. Therefore, GGT can be used as a follow up to an elevated ALP to help determine if the high ALP result is due to liver or bone disease.


GGT levels are sometimes increased with consumption of even small amounts of alcohol. Higher levels are found more commonly in chronic heavy drinkers than in people who consume less than 2 to 3 drinks per day or who only drink heavily on occasion (binge drinkers). The GGT test may be used in evaluating someone for acute or chronic alcohol abuse.

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A glucagon blood test measures the amount of a hormone called glucagon in your blood. Glucagon is produced by cells in the pancreas. It helps control your blood sugar level by increasing blood sugar when it is too low.

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C-peptide is a substance, a short chain of amino acids, that is released into the blood as a byproduct of the formation of insulin by the pancreas. This test measures the amount of C-peptide in a blood or urine sample.


In the pancreas, within specialized cells called beta cells, proinsulin, a biologically inactive molecule, splits apart to form one molecule of C-peptide and one molecule of insulin. Insulin is vital for the transport of glucose into the body's cells and is required on a daily basis. When insulin is required and released from the beta cells into the blood in response to increased levels of glucose, equal amounts of C-peptide are also released. Since C-peptide is produced at the same rate as insulin, it is useful as a marker of insulin production.


In particular, C-peptide testing can be used to help evaluate the production of insulin made by the body (endogenous) and to help differentiate it from insulin that is not produced by the body but is taken in as diabetic medication (exogenous) and so does not generate C-peptide. This test may be done in conjunction with an insulin test.

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Blood sugar (glucose) is usually present in the urine at very low levels or not at all. Abnormally high amounts of sugar in the urine, known as glycosuria, are usually the result of high blood sugar levels. High blood sugar usually occurs in diabetes, especially when untreated. It serves as the main source of energy used by the body. Insulin is a hormone that helps the body's cells to use the glucose. Excess or shortage of insulin in the body causes an imbalance of the blood glucose in the body, leading to its severe drop or drastic increase in the blood. Blood glucose levels that remain high over time can cause damage to the eyes, kidneys, nerves and blood vessels. Chronic low glucose levels can lead to brain and nerve damage.


Fasting blood sugar is a test for glucose content in a person’s blood that, as the name suggests, is conducted after fasting. The test is generally carried out in the morning, after an overnight fasting. As a part of the test, a sample of the patient’s blood is collected and then sent to the lab for testing.


A fasting blood sugar test offers information about how the body is managing the blood sugar levels. Normally, the range of glucose in a person’s blood is between 70 to 100 mg/dl. Fasting blood sugar levels between 100 to 126 mg/dl are considered as pre-diabetic or impaired fasting glucose and blood sugar levels of 126 mg/dl or higher are diagnosed as diabetes.

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This is a blood test to check for diabetes. If you have diabetes, your body doesn't make enough insulin to keep your blood sugar in check. This means your blood sugar levels are too high, and over time this can lead to serious health problems including nerve and eye damage.


This test is done to see how your body responds to sugar and starch after you eat a meal. As you digest the food in your stomach, blood glucose, or blood sugar, levels rise sharply. In response, your pancreas releases insulin to help move these sugars from the blood into the cells of muscles and other tissues to be used for fuel. Within two hours of eating, your insulin and blood glucose levels should return to normal. If your blood glucose levels remain high, you may have diabetes.

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Blood sugar (glucose) is usually present in the urine at very low levels or not at all. Abnormally high amounts of sugar in the urine, known as glycosuria, are usually the result of high blood sugar levels. High blood sugar usually occurs in diabetes, especially when untreated. It serves as the main source of energy used by the body. Insulin is a hormone that helps the body's cells to use the glucose. Excess or shortage of insulin in the body causes an imbalance of the blood glucose in the body, leading to its severe drop or drastic increase in the blood. Blood glucose levels that remain high over time can cause damage to the eyes, kidneys, nerves and blood vessels. Chronic low glucose levels can lead to brain and nerve damage.

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The term HbA1c refers to glycated haemoglobin. It develops when haemoglobin, a protein within red blood cells that carries oxygen throughout your body, joins with glucose in the blood, becoming 'glycated'.


By measuring glycated haemoglobin (HbA1c), clinicians are able to get an overall picture of what our average blood sugar levels have been over a period of weeks/months.


For people with diabetes this is important as the higher the HbA1c, the greater the risk of developing diabetes-related complications. 


HbA1c is also referred to as haemoglobin A1c or simply A1c.

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A vaginal swab test involves taking a sample of vaginal secretions with a device that looks like a cotton bud. The swab, with secretions attached, is then placed in a special container and sent to the microbiology laboratory for further analysis. When it reaches the laboratory the sample is then plated on a Petrie dish, which is a flat dish containing a special jelly. The dish is then placed in a special incubator that maintains a particular level of heat and humidity, which facilitates the growth of any bacteria that may be contained in the sample. The jelly in the Petrie dish is a nutrient material that allows any bacteria in the sample to colonise the surface of the jelly. This is the process that is referred to when we send a swab for culture. In other words the lab technician is attempting to make the bacteria reproduce and multiply by creating a favourable yet artificial environment. Having succeeded in creating the bacterial colonies on the Petrie dish various antibiotics are then added to the dish to determine which antibiotics are the most effective in eliminating the bacterial colonies from the dish. Therefore culture and sensitivity simply refers to the process whereby the bacteria in the sample are identified and then tested to determine which antibiotics are needed to eliminate them. “Culture and sensitivity” testing is widely used in microbiology for testing such diverse samples as various bodily discharges to urine samples.

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Chikungunya virus (ChikV) is a single-stranded RNA alphavirus and a member of the Togaviridae family of viruses. The name Chikungunya is derived from the language of the Makonde ethnic groups in southeast Africa and means "that which bends" or "stooped walk." This is in reference to the hunched-over appearance of infected individuals due to the characteristically painful and incapacitating arthralgia caused by the virus. ChikV is endemic throughout Africa, India, and more recently the Caribbean islands. In 2014, the first case of autochthonous or local transmission in the United States occurred in Florida. 


Humans are the primary reservoir for ChikV and Aedes species mosquitos are the primary vectors for transmission. Unlike other mosquito-borne viruses such as West Nile virus (WNV) and Dengue, the majority of individuals who are exposed to ChikV become symptomatic, with the most severe manifestations observed at the extremes of age and in those with suppressed immunity. Once exposed to ChikV virus, individuals develop lasting immunity and protection from reinfection.


The incubation period, prior to development of symptoms, ranges on average from 3 to 7 days. Infected patients typically present with sudden onset high fever, incapacitating joint pain, and often a maculopapular rash lasting anywhere from 3 to 10 days. Notably, symptom relapse can occur in some individuals 2 to 3 months following resolution of initial symptoms. Currently, there are no licensed vaccines and treatment is strictly supportive care.

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This test looks for signs of chemical poisoning in your blood.


Cholinesterase is an enzyme that helps your nervous system work the way it should. Certain toxic chemicals in the environment can interfere with this enzyme and affect your nervous system.


These chemicals include organophosphates and carbamates. They are most often found in insecticides used in fields. They have also been used as chemical warfare agents. These chemicals can be found in common household insect sprays, too. They have been used in insecticides for more than 50 years.


If these chemicals get into your body, they can affect how you breathe and can cause general muscle weakness. They are called cholinesterase inhibitors. An overdose of these chemicals can be fatal.

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Ultrasound  is safe and paUltrasoundinless, and produces pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or sonography, involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is no radiation exposure to the patient. Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels.


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Chromium (Cr) exists in valence states ranging from 2(-) to 6(+). Hexavalent chromium (Cr[+6]) and trivalent chromium (Cr[+3]) are the 2 most prevalent forms. Cr(+6) is used in industry to make chromium alloys including stainless steel, pigments, and electroplated coatings. Cr(+6), a known carcinogen, is immediately converted to Cr(+3) upon exposure to biological tissues. Cr(+3) is the only chromium species found in biological specimens.


Serum Cr concentrations are likely to be increased above the reference range in patients with metallic joint prosthesis. Prosthetic devices produced by Depuy Company, Dow Corning, Howmedica, LCS, PCA, Osteonics, Richards Company, Tricon, and Whiteside typically are made of chromium, cobalt, and molybdenum. This list of products is incomplete, and these products change occasionally; see prosthesis product information for each device for composition details.

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Gonadotropin-releasing hormone (GnRH) stimulation test is the gold standard to identify central precocious puberty (CPP). This test requires multiple blood samples at different time points to measure gonadotropin levels, and is therefore expensive, time-consuming, and uncomfortable for patients. We aimed to simplify the GnRH stimulation test to require fewer blood samples.

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Chromogranin A is a secretory protein, composed of 439 amino acids, found in the large dense-core vesicles of the neuroendocrine cells. It belongs to the family of granins that includes chromogranin B, chromogranin C, and secretogranin II.

Chromogranin A can be either measured in the serum or detected by immunohistochemistry in a tissue specimen.

Although it varies widely with the techniques used, the reference ranges for serum chromogranin A are as follows:

Less than 36.4 ng/mL (conventional unit) [1]

Less than 36.4 µg/L (system international)

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Growth hormone (GH) is a hormone that is essential for normal growth and development in children. It promotes proper linear bone growth from birth through puberty. In both children and adults, growth hormone helps regulate the rate at which the body both produces energy from food (metabolism) and makes lipids, proteins, and glucose (sugar). It also helps regulate the production of red blood cells and muscle mass.


Growth hormone is produced by the pituitary gland, a grape-sized gland located at the base of the brain behind the bridge of the nose. It is normally released into the bloodstream in pulses throughout the day and night with peaks that occur mostly during the night. Because of this, a single measurement of the level of GH in blood is difficult to interpret and not usually clinically useful. The value will be higher if the sample is taken during a pulse and lower if it is taken during a period between pulses. GH stimulation and suppression tests are therefore often used to diagnose GH abnormalities. (See the "How is it used?" section.)


GH deficiency


Children with insufficient GH production grow more slowly and are smaller in size for their age. Some children have GH deficiency at birth (congenital), but some may develop a deficiency later due, for example, to a brain injury or tumor. These conditions can affect the pituitary gland, causing a decrease in pituitary function, resulting in a lowered production of pituitary hormones (hypopituitarism). Sometimes, the cause of the deficiency is not known.


In adults, growth hormone plays a role in regulating bone density, muscle mass, and glucose and lipid metabolism. It can also affect heart and kidney function. Deficiencies may have begun in childhood or develop in adulthood. A deficiency can develop, for example, because of damage to the pituitary gland caused by a head injury, brain tumor, or surgery or radiation treatment. This can result in a decrease in pituitary hormones (hypopituitarism). The deficiency in GH can lead to decreased bone density, less muscle mass, and altered lipid levels. However, testing for GH deficiency is not routine in adults who have decreased bone density and/or muscle strength or increased lipids. GH deficiency is a very rare cause of these disorders.

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When pregnancy screening tests are abnormal; whenever signs of a chromosomal abnormality-associated disorder are present; as indicated to detect chromosomal abnormalities in a person and/or detect a specific abnormality in family members; sometimes when a person has leukemia, lymphoma, myeloma, myelodysplasia or another cancer and an acquired chromosome abnormality is suspected

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Cytogenetics of hematologic disorders attempts to define and interpret chromosomal aberrations that occur in neoplastic cells associated with leukemia, lymphoma and other hematologic malignancies. Chromosome abnormalities in cancer cells of patients with malignant hematologic disorders including acute and chronic myeloid and lymphoid leukemias, myelodysplastic and myeloproliferative disorders, lymphomas and unexplained anemias may correlate with the diagnosis, prognosis, treatment and etiology of disease.

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A growth hormone (GH) test measures the amount of human growth hormone (GH) in the blood. GH is made by the pituitary gland and is needed for growth. It plays an important role in how the body uses food for energy (metabolism). The amount of GH in the blood changes during the day and is affected by exercise, sleep, emotional stress, and diet.


Too much GH during childhood can cause a child to grow taller than normal (gigantism). Too little GH during childhood can cause a child to grow less than normal (dwarfism). Both conditions can be treated if found early.


In adults, too much GH is caused by a noncancerous tumor of the pituitary gland (adenoma). Too much GH can cause bones of the face, jaw, hands, and feet to grow larger than normal (acromegaly).


Growth hormone can cause the release of other substances (factors) that affect growth and metabolism. One of these is insulin-like growth factor 1 (IGF-1). When the GH level is very high, the IGF-1 level is also very high. A test for IGF-1 may also be done to confirm high GH levels.

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The Orton Materials Testing and Research Center is a full service, independent testing laboratory that specializes in measuring the behavior of ceramic materials.  The Testing Center performs physical properties tests, thermal analysis measurements, and provides consulting services on ceramics and other related materials.


Initially, MTRC was known as The Refractories Fellowship Laboratory, which was established in 1917 at the Mellon Institute in Pittsburgh, Pennsylvania. It was relocated to The Ohio State University in Columbus, Ohio in 1965 and renamed the Refractory Research Center. Since 1990, the Center has been operated by the Edward Orton Jr. Ceramic Foundation.

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Simmons citrate agar tests the ability of organisms to utilize citrate as a carbon source. Simmons citrate agar contains sodium citrate as the sole source of carbon, ammonium dihydrogen phosphate as the sole source of nitrogen, other nutrients, and the pH indicator bromthymol blue. This test is part of the IMViC tests and is helpful in differentiating the Enterobacteriaceae .


Organisms which can utilize citrate as their sole carbon source use the enzyme citrase or citrate-permease to transport the citrate into the cell.   These organisms also convert the ammonium dihydrogen phosphate to ammonia and ammonium hydroxide, which creates an alkaline environment in the medium.  At pH 7.5 or above, bromthymol blue turns royal blue. At a neutral pH, bromthymol blue is green, as evidenced by the uninoculated media.

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Growth hormone promotes development from birth to puberty. It is also essential for the maintenance of metabolism, skeletal muscle, and bone tissue throughout one’s life

The pituitary gland, located at the base of the brain, releases growth hormone in periodic bursts. Most growth hormone is released during deep sleep

They hypothalamus of the brain in turn releases hormones that control growth hormone release by the pituitary gland. Growth hormone-releasing hormone (GH-RH) and growth hormone-inhibiting hormone (GH-IH) stimulate and depress growth hormone secretion, respectively

Growth hormone affects nearly every cell in the body. It causes cells to increase their protein production and their fatty acid metabolism

The growth-inducing effects of growth hormone are important for adaptation to strenuous demands, such as exercise. Growth hormone also stimulates the replenishment of tissues during everyday wear and tear. The hormone is especially important during childhood development

Problems with the pituitary gland or GH-RH may cause growth hormone underproduction. This results in stunted growth, abnormal fat distribution, and difficulty regulating blood sugar

Excessive production of growth hormone, caused by tumors or problems with the regulatory mechanisms, may cause excessive growth. The resulting conditions, though similar, differ depending on the stage in life that a growth hormone overproduction occurred:

Growth hormone overproduction before puberty results in gigantism. This is marked by extreme lengthening of the skeleton, sometimes causing heights in excess of 8 feet

Growth hormone overproduction during adulthood results in acromegaly. Because the bones have already reached their maximum length, acromegaly is marked by bone thickening but not lengthening

The Growth Hormone-Releasing Hormone Blood Test helps measure the levels of growth hormone-releasing hormone in blood. It is used to differentiate between a pituitary tumor and an ectopic secretion of GH-RH

If GH-RH levels are normal, the result of excessive growth hormone is likely a tumor of the pituitary gland that releases growth hormone without the need for stimulation by GH-RH

If GH-RH levels are increased, there may be an ectopic tumor of the hypothalamus that secretes GH-RH

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The diagnosis of pheochromocytoma/paraganglioma (PPGL) involves detection of elevated levels of plasma and/or 24-h urine catecholamines and/or their metabolites, including metanephrines. Although these tests are reasonably sensitive, false-positive results are often encountered. Follow-up tests can provide additional information to correctly diagnose PPGL. In this regard, the utility of the urinary clonidine suppression test (UCST) remains unknown.

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Normal clot retraction time is 0-2 hours. If the weight of the clot or the percent of extruded serum is used as the end measure, the result depends on the volume of the specimen used, which varies from laboratory to laboratory. [1]


The coagulation cascade is complex. Platelets play a major role to initiate the process and regulate it through biochemical and mechanical interactions. The 3 steps of this process for platelets are adhesion, aggregation, and finally, retraction. [2] The clot retraction study measures the time taken for a platelet plug to undergo this last step, which indicates overall platelet function.

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When you get a cut, your body jumps into action to keep things from getting out of hand. Cells called platelets get there first to slow the bleeding. Then, a bunch of proteins, called clotting factors, show up. They all fit together to form a solid mass -- a blood clot -- to stop the bleeding so you can start healing.


That’s what typically happens. But if you tend to bleed easily or you get clots when you shouldn’t, then you may have a problem with your clotting factors.


That’s when you might need a prothrombin time test, which measures how quickly your blood clots. It’s also called a PT, pro time, or INR test.

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This test measures Cobalt levels in the blood.  Cobalt is a naturally occurring element which contributes to good health in the right amount.  Overexposure to Cobalt due to ingestion, inhalation, or skin contact can be dangerous to a person's health.  Exposure typically occurs in industrial settings which use products containing cobalt.  Depending on the type of exposure, Cobalt poisoning can cause symptoms such as coughing, breathing problems, skin irritation, nerve damage and heart problems.


Coblat blood testing is typically ordered when a person believes they have been exposed, especially if they work in environments where cobalt is present.  Periodic testing to monitor blood Cobalt levels is recommended for anyone who is at risk of exposure even if they are not experiencing symptoms.

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Growth hormone (GH) is secreted in a pulsatile manner and is cleared rapidly, resulting in dramatic fluctuations in GH levels.1-3 For this reason, random GH levels are generally not useful in establishing GH deficiency. A number of physiologic and pharmacologic stimuli can be used to provoke GH release. Several growth hormone stimulation protocols are described below. These tests are best performed in the morning after an overnight fast.3 Patients should be confirmed as euthyroid before these protocols are initiated.

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This Immunoglobulin test measures levels of 3 classes of immunoglobulins in the blood.  Results will include measurements for Immunoglobulin A (IgA), Immunoglobulin G (IgG) and Immunoglobulin M (IgM).  Immunoglobulins, or antibodies, are an important part of the immune system which fight off bacteria, viruses and other foreign organisms. Measuring Immunoglobulin levels can help evaluate a person's immune system.


This test may be ordered when a person is suffering from chronic infections, especially of the lungs or gastrointestinal tract.  It can also help to diagnose various conditions resulting in excess or deficiencies in one or more types of antibodies.  Abnormal results will typically need to be followed up with further testing.

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Magnetic resonance (MR) imaging has opened new horizons in the diagnosis and treatment of many musculoskeletal diseases of the ankle and foot. It demonstrates abnormalities in the bones and soft tissues before they become evident at other imaging modalities. The exquisite soft-tissue contrast resolution, noninvasive nature, and multiplanar capabilities of MR imaging make it especially valuable for the detection and assessment of a variety of soft-tissue disorders of the ligaments (eg, sprain), tendons (tendinosis, peritendinosis, tenosynovitis, entrapment, rupture, dislocation), and other soft-tissue structures (eg, anterolateral impingement syndrome, sinus tarsi syndrome, compressive neuropathies [eg, tarsal tunnel syndrome, Morton neuroma], synovial disorders). MR imaging has also been shown to be highly sensitive in the detection and staging of a number of musculoskeletal infections including cellulitis, soft-tissue abscesses, and osteomyelitis. In addition, MR imaging is excellent for the early detection and assessment of a number of osseous abnormalities such as bone contusions, stress and insufficiency fractures, osteochondral fractures, osteonecrosis, and transient bone marrow edema. MR imaging is increasingly being recognized as the modality of choice for assessment of pathologic conditions of the ankle and foot.


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A carotid Doppler test is generally an outpatient procedure, states Johns Hopkins Medicine. During the test, the patient must lie on his back with his neck bent back slightly. A technician applies a gel to the skin, presses a device called a transducer against the neck, and moves it around the area of the carotid artery. The technician then repeats the process on the other side of the neck. Carotid Doppler tests do not expose patients to radiation, and they usually do not cause any discomfort.


Patients who have carotid artery blockage or narrowing sometimes experience symptoms such as dizziness, confusion, drowsiness or headache that prompt a doctor to perform a carotid Doppler test, states Johns Hopkins Medicine. Other symptoms that may indicate problems with blood flow in the carotid arteries include momentary blindness in one eye or temporary problems speaking or moving. Carotid Doppler is sometimes performed as part of an evaluation prior to major cardiac surgery.

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Magnetic resonance imaging (MRI) of the brain is a safe and painless test that uses a magnetic field and radio waves to produce detailed images of the brain and the brain stem. An MRI differs from a CAT scan (also called a CT scan or a computed axial tomography scan) because it does not use radiation. An MRI scanner consists of a large doughnut-shaped magnet that often has a tunnel in the center. Patients are placed on a table that slides into the tunnel. Some centers have open MRI machines that have larger openings and are helpful for patients with claustrophobia. MRI machines are located in hospitals and radiology centers. During the exam, radio waves manipulate the magnetic position of the atoms of the body, which are picked up by a powerful antenna and sent to a computer. The computer performs millions of calculations, resulting in clear, cross-sectional black and white images of the body. These images can be converted into three-dimensional (3-D) pictures of the scanned area. This helps pinpoint problems in the brain and the brain stem when the scan focuses on those areas.


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A Doppler ultrasound is a noninvasive test that can be used to estimate the blood flow through your blood vessels by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells. A regular ultrasound uses sound waves to produce images, but can't show blood flow.


A Doppler ultrasound may help diagnose many conditions, including:


Blood clots

Poorly functioning valves in your leg veins, which can cause blood or other fluids to pool in your legs (venous insufficiency)

Heart valve defects and congenital heart disease

A blocked artery (arterial occlusion)

Decreased blood circulation into your legs (peripheral artery disease)

Bulging arteries (aneurysms)

Narrowing of an artery, such as in your neck (carotid artery stenosis)

A Doppler ultrasound can estimate how fast blood flows by measuring the rate of change in its pitch (frequency). During a Doppler ultrasound, a technician trained in ultrasound imaging (sonographer) presses a small hand-held device (transducer), about the size of a bar of soap, against your skin over the area of your body being examined, moving from one area to another as necessary.


This test may be done as an alternative to more-invasive procedures, such as angiography, which involves injecting dye into the blood vessels so that they show up clearly on X-ray images.


A Doppler ultrasound test may also help your doctor check for injuries to your arteries or to monitor certain treatments to your veins and arteries.

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Thyroid ultrasound uses sound waves to produce pictures of the thyroid gland within the neck. It does not use ionizing radiation and is commonly used to evaluate lumps or nodules found during a routine physical or other imaging exam.This procedure requires little to no special preparation. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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Magnetic Resonance Imaging is a highly advanced imaging modality. Epilepsy Protocol MRI involves obtaining images of brain slices through MRI scanning in epileptic patients. This scanning enables the doctor in obtaining evidences of abnormalities or injuries in brain. Underlying pathologies inside of brain like infections or tumors cannot be seen externally. Such occurrences can be investigated through an MRI Epilepsy Protocol. As a result, MRI becomes the most accurate mode for planning line of treatment.


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At least 3 blood samples are taken.


The test is done in the following way:


The first blood sample is collected between 6 a.m. and 8 a.m before you eat or drink anything.

You then drink a solution containing glucose (sugar). You may be told to drink slowly to avoid becoming nauseated. But you must drink the solution within 5 minutes to ensure the test result is accurate.

The next blood samples are usually collected for 1 to 2 hours after you finish drinking the glucose solution. Sometimes they are taken every 30 or 60 minutes.

Each sample is sent to the laboratory right away. The lab measures the glucose and growth hormone (GH) levels in each sample.

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Alterations of the abdominal aorta are relatively common, particularly in older people. Technological advances in the fields of ultrasonography, computed tomography, angiography, and magnetic resonance imaging have greatly increased the imaging options for the assessment of these lesions. Because it can be done rapidly and is also non-invasive, ultrasonography plays a major role in the exploration of the abdominal aorta, from its emergence from the diaphragm to its bifurcation. It is indicated for the diagnosis and follow-up of various aortic diseases, especially aneurysms. It can be used to define the shape, size, and location of these lesions, the absence or presence of thrombi and their characteristics. It is also useful for monitoring the evolution of the lesion and for postoperative follow-up. However, its value is limited in surgical planning and in emergency situations.

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HE  MRI technician should be informed if you have any inner ear implants, artificial joints, a defibrillator or pacemaker, particular types of heart valves, vascular stents, brain aneurysm clips.

The staff will ask you to remove anything that contains metal, including jewelry, sunglasses or any electronic gadgets. All these interferes with the MRI machine’s ability to produce a clear image. Braces and dental fillings will typically not pose a problem, but pens, pins, and certain dental appliances can interfere. 

In the case of implants and pacemakers, those items can stop working properly due to an MRI’s magnetic field.

You will be asked to wear a hospital gown or clothing that doesn’t contain metal fasteners. 

Lastly if you’re pregnant , kindly inform the staff, the doctor may postponed the test if required.

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Magnetic resonance imaging (MRI) of the chest uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the structures within the chest. It is primarily used to assess abnormal masses such as cancer and determine the size, extent and degree of its spread to adjacent structures. It’s also used to assess the anatomy and function of the heart and its blood flow. Tell your doctor about any health problems, recent surgeries or allergies and whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should always tell the technologist if you have any devices or metal in your body. Guidelines about eating and drinking before your exam vary between facilities. Unless you are told otherwise, take your regular medications as usual. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. If you have claustrophobia or anxiety, you may want to ask your doctor for a mild sedative prior to the exam.


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This study aimed to evaluate the vascular pattern of solid breast lesions using power Doppler ultrasonography (PDUS) and assess whether the presence of intratumoural penetrating vessels can predict breast cancer malignancy.

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A glucose tolerance test measures how well your body’s cells are able to absorb glucose, or sugar, after you ingest a given amount of sugar. Doctors use fasting blood sugar levels and hemoglobin A1c values to diagnose type 1 and type 2 diabetes, and prediabetes. A glucose tolerance test can also be used. Doctors primarily use a glucose tolerance test to diagnose gestational diabetes.


Doctors often diagnose type 1 diabetes quickly because it usually develops quickly and involves high blood sugar levels. Type 2 diabetes, on the other hand, often develops over years. Type 2 diabetes is the most common form of diabetes, and it usually develops during adulthood.


Gestational diabetes occurs when a pregnant woman who doesn’t have diabetes before pregnancy has high blood sugar levels as a result of the pregnancy. The American Diabetes Association estimates that gestational diabetes occurs in 9.2 percent of pregnancies.

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Helicobacter pylori is a type of bacteria that is known to be a major cause of peptic ulcer disease. H. pylori testing detects an infection of the gastrointestinal (GI) tract caused by the bacteria.


H. pylori is very common, especially in developing countries. The bacteria are present in (colonize) the stomachs and intestines of as many as 50% of the world's population. Most of those affected will never have any symptoms, but the presence of H. pylori increases the risk of developing ulcers (peptic ulcer disease), chronic gastritis, and gastric (stomach) cancer. The bacteria decrease the stomach's ability to produce mucus, making the stomach prone to acid damage and peptic ulcers.


There are several different types of H. pylori testing that can be performed. Some are less invasive than others.


Noninvasive


Stool antigen test – detection of H. pylori in a stool sample

Urea breath test – detection of labeled carbon dioxide in the breath after drinking a solution 


An antibody test using a blood sample is not recommended for routine diagnosis or for evaluation of treatment effectiveness. This test detects antibodies to the bacteria and will not distinguish between a present and previous infection. If the antibody test is negative, then it is unlikely that a person has had an H. pylori infection. If ordered and positive, results should be confirmed using a stool antigen or breath test.


Invasive


Invasive tests using an endoscopy procedure are less frequently performed than noninvasive tests because they require a tissue biopsy collection. Tests include:


Histology – examination of tissue under a microscope

Rapid urease testing – detects urease, an enzyme produced by H. pylori

Culture – growing H. pylori in/on a nutrient solution

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The absolute hemoglobin A2 concentration in mg. per 100 ml. of blood was calculated from the hemoglobin level in Gm. per 100 ml. and hemoglobin A2 percentage for 38 patients with documented iron deficiency, 37 patients with proven beta-thalassemia minor, 26 patients with simple chronic anemia and 40 normal control laboratory workers. The mean hemoglobin A2 concentration (mg. per 100 ml.) in the control group was 459 plus or minus 60 (2 S.D.) and that in the beta-thalassemia group, 766 plus or minus 99. However, in the iron deficiency group it was 229 plus or minus 58, while in the simple chronic anemia group it was 315 plus or minus 39. The mean corpuscular volume (M.C.V.) in cu. mu was 90 plus or minus 8 (2 S.D.) in the normal controls, 68 plus or minus 10 in beta-thalassemia, 69 plus or minus 9 in iron deficiency, and 90 plus or minus 15 in secondary anemia. It is proposed that the absolute hemoglobin A2 level in mg. per 100 ml. of blood taken in conjunction with the M.C.V. is of value in establishing the diagnosis of iron deficiency.

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A hemoglobin electrophoresis test is a blood test used to measure and identify the different types of hemoglobin in your bloodstream. Hemoglobin is the protein inside red blood cells responsible for transporting oxygen to your tissues and organs.


Genetic mutations can cause your body to produce hemoglobin that is formed incorrectly. This abnormal hemoglobin can cause too little oxygen to reach your tissues and organs.


There are hundreds of different types of hemoglobin. They include:


Hemoglobin F: This is also known as fetal hemoglobin. It’s the type found in growing fetuses and newborns. It’s replaced with hemoglobin A soon after birth.

Hemoglobin A: This is also known as adult hemoglobin. It’s the most common type of hemoglobin. It’s found in healthy children and adults.

Hemoglobin C, D, E, M, and S: These are rare types of abnormal hemoglobin caused by genetic mutations.

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Hemoglobin is the iron-containing protein found in all red blood cells (RBCs) that gives the cells their characteristic red color. Hemoglobin enables RBCs to bind to oxygen in the lungs and carry it to tissues and organs throughout the body. It also helps transport a small portion of carbon dioxide, a product of cell metabolism, from tissues and organs to the lungs, where it is exhaled.


The hemoglobin test measures the amount of hemoglobin in a person's sample of blood. A hemoglobin level can be performed alone or with a hematocrit, a test that measures the proportion of blood that is made up of RBCs, to quickly evaluate an individual's red blood cells. Red blood cells, which make up about 40% (ranging 37-49%) of the blood's volume, are produced in the bone marrow and are released into the bloodstream when they are, or nearly are, mature. The typical lifespan of an RBC is 120 days, and the bone marrow must continually produce new RBCs to replace those that age and degrade or are lost through bleeding.


Several diseases and conditions can affect RBCs and consequently the level of hemoglobin in the blood. In general, the hemoglobin level and hematocrit rise when the number of red blood cells increases. The hemoglobin level and hematocrit fall to less than normal when there is a drop in production of RBCs by the bone marrow, an increase in the destruction of RBCs, or if blood is lost due to bleeding. A drop in the RBC count, hemoglobin and hematocrit can result in anemia, a condition in which tissues and organs in the body do not get enough oxygen, causing fatigue and weakness. If too many RBCs are produced, polycythemia results and the blood can become thickened, causing sluggish blood flow and related problems.

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A Complete Blood Count (cbc) or a Heamogram is the one of the most commonly ordered test. A complete blood count gives info in to components of blood i.e. White Blood Cells, Red Blood Cells and Platelet Count. The CBC also gives you information on Haemoglobin, the oxygen carrying component of your blood.


Why is Cbc Test is Performed?

A complete blood count (CBC) is a commonly performed pathology  lab test. It can be used to detect or monitor many different health conditions. It is a part of a routine check-up, if you are having symptoms, such as fatigue, weight loss, fever or other signs of an infection, weakness, bruising, bleeding, or any signs of cancer

When you are receiving treatments (medicines or radiation) that may change your blood count results

This test helps to monitor a chronic health problem that may change your blood count results, such as chronic kidney disease.


Advantage of  Complete Blood Count test: It can record any abnormality in the above components and give information of any underlying medial cause, especially in the case of Anaemia, Leukaemia and infection.


CBC is also ordered when you are suffering from fever or an infection. The test results can give multiple insights in to your infection.

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CSF flow studies are performed using a variety of MRI techniques and are able to qualitatively assess and quantify pulsatile CSF flow. The most common technique used is time resolved 2D phase contrast MRI with velocity encoding. Note, when referring to CSF flow in the setting on imaging we are referring to pulsatile to-and-fro flow due to vascular pulsations rather than bulk transport of CSF (the mechanism by which produced CSF is absorbed, via absorption at arachnoid granulations and via the glymphatic pathway). The latter is too slow to be easily assessed clinically. 


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The anatomy of the craniovertebral junction, although complex, may be well visualized by routine MR imaging. This essay discusses the anatomy of the complex articulations of the craniovertebral junction. Representative MR images and gross anatomic photographs are presented to illustrate the intricate ligamentous and articular anatomy. Knowledge of the normal anatomy of the occipitoatlantoaxial region is necessary in order to understand the common disorders that affect this area. The most common disorders are trauma and arthropathies, but also include congenital abnormalities and neoplasm. The resultant abnormal mechanics may lead to neurologic sequelae or pain

 

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 Magnetic Resonance Imaging (MRI) of the dorsal spine is a non invasive process used to scan the dorsal section of your spinal cord. It uses radio waves and high intensity magnetic fields to learn about the internal tissue structures of the dorsal spine. This scanning technique is used for various diagnostic as well as treatment purposes


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Magnetic Resonance Imaging (MRI) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. MR imaging uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. The images can then be examined on a computer monitor, transmitted electronically, printed or copied to a CD. MRI does not use ionizing radiation (X-rays). Detailed MR images allow physicians to better evaluate various parts of the body and determine the presence of certain diseases that may not be assessed adequately with other imaging methods such as x-ray, ultrasound or computed tomography (also called CT or CAT scanning)


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Haptoglobin is a protein produced by the liver that the body uses to clear free hemoglobin (found outside of red blood cells) from circulation. This test measures the amount of haptoglobin in the blood.


Hemoglobin is the iron-containing protein complex that transports oxygen throughout the body. It is normally found within red blood cells (RBCs) and very little is found free circulating in the blood. Haptoglobin binds to free hemoglobin in the blood. This forms a haptoglobin-hemoglobin complex that is rapidly cleared out of circulation for degradation and iron recycling.


However, when an increased number of RBCs are damaged and/or break apart (hemolysis), they release their hemoglobin into the blood, increasing the amount of free hemoglobin in circulation. When large numbers of RBCs are destroyed, haptoglobin concentrations in the blood will temporarily decrease as the haptoglobin is used up faster than the liver can produce it. A decrease in the amount of haptoglobin may be a sign that a person has a condition that is causing red blood cells to be destroyed or break apart. When the binding capacity of haptoglobin is exceeded, free hemoglobin level in circulation goes up and may cause tissue damage and organ dysfunction.


Increased RBC destruction may be due to inherited or acquired conditions. Some examples include transfusion reactions, certain drugs, and mechanical breakage, such as may be seen with some prosthetic heart valves. The destruction may be mild or severe, occurring suddenly (acute) or developing and lasting over a long period of time (chronic), and it can lead to hemolytic anemia. People with hemolytic anemia may experience symptoms such as fatigue, weakness, and shortness of breath and their skin may be pale or jaundiced. (For additional details, read the article on Hemolytic Anemia.)


Liver disease may also result in decreased haptoglobin concentrations as liver damage may inhibit both the production of haptoglobin and the clearing of the haptoglobin-free hemoglobin complexes.



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The right hip pain diagnosis is essential to obtaining the right care. Specialization and unmatched experience are the hallmarks of the Center for Hip Preservation’s medical staff. The advanced hip pain tests available at our center assist our specialists in making the right diagnosis and pursuing the right treatment. Both a physical examination and radiological examinations are conducted to diagnose hip joint pain. Without an official reading by an experienced radiologist, subtle X-ray findings (e.g., tears, infections, systematic diseases, tumors, etc.) may remain undetected until such time as an abnormality has progressed to the point where a non-imaging specialist may identify it. Delays in diagnosis add to medical cost and may considerably effect treatment and ultimate patient outcome. The skilled staff members at the Center for Hip Preservation help patients and families understand their hip pain and all of the treatment options available.


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Hip pain is a common and disabling condition that affects patients of all ages. The differential diagnosis of hip pain is broad, presenting a diagnostic challenge. Patients often express that their hip pain is localized to one of three anatomic regions: the anterior hip and groin, the posterior hip and buttock, or the lateral hip. Anterior hip and groin pain is commonly associated with intra-articular pathology, such as osteoarthritis and hip labral tears. Posterior hip pain is associated with piriformis syndrome, sacroiliac joint dysfunction, lumbar radiculopathy, and less commonly ischiofemoral impingement and vascular claudication. Lateral hip pain occurs with greater trochanteric pain syndrome. Clinical examination tests, although helpful, are not highly sensitive or specific for most diagnoses; however, a rational approach to the hip examination can be used. Radiography should be performed if acute fracture, dislocations, or stress fractures are suspected. Initial plain radiography of the hip should include an anteroposterior view of the pelvis and frog-leg lateral view of the symptomatic hip. Magnetic resonance imaging should be performed if the history and plain radiograph results are not diagnostic. Magnetic resonance imaging is valuable for the detection of occult traumatic fractures, stress fractures, and osteonecrosis of the femoral head. Magnetic resonance arthrography is the diagnostic test of choice for labral tears.


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Hepatitis B tests detect substances that reflect a current or previous infection with hepatitis B virus (HBV). Some tests detect viral proteins (antigens) or the antibodies that are produced in response to an infection, while other types of tests detect or evaluate the genetic material (DNA) of the virus. The pattern of test results can identify a person who has a current active infection or one who has immunity as a result of previous exposure.


For details on the various tests, see the table under "How is it used?"


Hepatitis is a condition characterized by inflammation and enlargement of the liver. It has several various causes, one of which is infection by a virus. HBV is one of five "hepatitis viruses" identified so far that are known to mainly infect the liver. The other four are hepatitis A, hepatitis C, hepatitis D, and hepatitis E.


HBV is spread through contact with blood or other body fluids from an infected person. Exposure can occur, for example, through sharing of needles for IV drug use or through unprotected sex. People who live in or travel to areas of the world where hepatitis B is prevalent are at a greater risk. Rarely, mothers can pass the infection to their babies, usually during or after birth. The virus is not spread through casual contact such as holding hands, coughing or sneezing. However, the virus can survive outside the body for up to seven days, including in dried blood, and can be passed by sharing items such as razors or toothbrushes with an infected person.

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Magnetic resonance imaging (MRI) of the knee uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the structures within the knee joint. It is typically used to help diagnose or evaluate pain, weakness, swelling or bleeding in and around the joint. Knee MRI does not use ionizing radiation, and it can help determine whether you require surgery. Tell your doctor about any health problems, recent surgeries or allergies and whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should always tell the technologist if you have any devices or metal in your body. Guidelines about eating and drinking before your exam vary between facilities. Unless you are told otherwise, take your regular medications as usual. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. If you have claustrophobia or anxiety, you may want to ask your doctor for a mild sedative prior to the exam.


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 Magnetic resonance imaging (MRI) is a test done with a large machine that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the belly. In many cases MRI gives information about structures in the body that cannot be seen as well with an X-ray, ultrasound, or CT scan. For an MRI test, you are placed inside the magnet so that your belly is inside the strong magnetic field. MRI can find changes in the structure of organs or other tissues. It also can find tissue damage or disease, such as infection or a tumor. Pictures from an MRI scan are digital images that can be saved and stored on a computer for further study. The images also can be reviewed remotely, such as in a clinic or an operating room. Photographs or films of selected pictures can also be made.In some cases, contrast material may be used during the MRI scan to show certain structures more clearly in the pictures. The contrast material may be used to check blood flow, find some types of tumors, and show areas of inflammation or infection.


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 An MRI scan uses magnets and radio waves to capture images inside your body without making a surgical incision. The scan allows your doctor to see the soft tissue of your body, like muscles and organs, in addition to your bones. An MRI can be performed on any part of your body. A lumbar MRI specifically examines the lumbar section of your spine — the region where back problems commonly originate.The lumbosacral spine is made up of the five lumbar vertebral bones (L1 thru L5), the sacrum (the bony “shield” at the bottom of your spine), and the coccyx (tailbone). The lumbosacral spine also consists of large blood vessels, nerves, tendons, ligaments, and cartilage.


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Myelography uses a real-time form of x-ray called fluoroscopy and an injection of contrast material to evaluate the spinal cord, nerve roots and spinal lining (meninges). It is particularly useful for assessing the spine following surgery and for assessing disc abnormalities in patients who cannot undergo MRI. You will be instructed on how to prepare. Tell your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking and allergies, especially to iodinated contrast materials. You may be advised to stop taking blood thinners or other medications several days prior to your exam. You also may be told to avoid solid food and increase your fluid intake beforehand. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.


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Neoplastic disease of the nose, paranasal sinuses, the nasopharynx and the parapharyngeal space requires thorough assessment of location and extent in order to plan appropriate treatment. CT allows the deep soft tissue planes to be evaluated and provides a complement to the physical examination. It is especially helpful in regions involving thin bony structures (paranasal sinuses, orbita); here CT performs better than MRI. MRI possesses many advantages over other imaging modalities caused by its excellent tissue contrast. In evaluating regions involving predominantly soft tissue structures (ec nasopharynx and parapharyngeal space) MRI is superior to CT. The possibility to obtain strictly consecutive volume data sets with spiral CT or 3D MRI offer excellent perspectives to visualize the data via 2D or 3D postprocessing. Because head and neck tumors reside in a complex area, having a 3D model of the anatomical features may assist in the delineation of pathology. Data sets may be transferred directly into computer systems and thus be used in computer assisted surgery.


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Head and neck MRI uses a strong magnetic field combined with radiofrequency waves to create highly detailed, cross-sectional images of internal structures in the head and neck area; these scans are examined for abnormalities. For certain studies, an MRI contrast dye such as gadolinium may be injected to provide better definition of soft tissues and blood vessels and thus enhance the images. Head and neck MRI is used to detect abnormalities outside of the skull.


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Orbit/Face MRI is a painless radiology exam which may be performed to help visualize the face area in a non-invasive manner. It aids doctors in visualizing tumors, infection, inflammation, and any neck disorders that a patient might have.


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A pelvis MRI (magnetic resonance imaging) scan is an imaging test that uses a machine with powerful magnets and radio waves to create pictures of the area between the hip bones. This part of the body is called the pelvic area. Structures inside and near the pelvis include the bladder, prostate and other male reproductive organs, female reproductive organs, lymph nodes, large bowel, small bowel, and pelvic bones. An MRI does not use radiation. Single MRI images are called slices. The images are stored on a computer or printed on film. One exam produces dozens or sometimes hundreds of images.


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Pituitary gland plays a central role in body growth, metabolism, and reproductive function. A number of diseases that affect the pituitary-hypothalamic axis can have profound clinical, endocrinological as well as neurological consequences. These conditions can be classified as neoplastic, infectious, inflammatory, posttraumatic, congenital/developmental, and physiological. Various neoplastic conditions include pituitary adenoma/apoplexy, hypothalamic glioma, craniopharyngioma, rathke cleft cyst, germinoma, teratoma, metastasis, leukemic infiltration, lymphoma, and Langerhans cell histiocytosis. Infectious and inflammatory causes include tubercular/lymphocytic hypophysitis, sarcoidosis, and Wegener's granulomatosis. Traumatic causes include postoperative sella or transection of the pituitary stalk. Accurate diagnostic differentiation of these lesions is essential for both safe and effective disease management. Recent advances in neuroimaging helps the radiologists and endocrinologists to study the pituitary region in greater detail. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluating hypothalamic-pituitary-related endocrine diseases.

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Magnetic resonance imaging (MRI) of the shoulder uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the bones, tendons, muscles and blood vessels within the shoulder joint. It is primarily used to assess injuries. Tell your doctor about any health problems, recent surgeries or allergies and whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should always tell the technologist if you have any devices or metal in your body. Guidelines about eating and drinking before your exam vary between facilities. Unless you are told otherwise, take your regular medications as usual. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. If you have claustrophobia or anxiety, you may want to ask your doctor for a mild sedative prior to the exam.


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Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The first step in MR imaging of the TMJ is to evaluate the articular disk, or meniscus, in terms of its morphologic features and its location relative to the condyle in both closed- and open-mouth positions. Disk location is of prime importance because the presence of a displaced disk is a critical sign of TMJ dysfunction. However, disk displacement is also frequently seen in asymptomatic volunteers, so that other findings may be required to help make the diagnosis. These findings include thickening of an attachment of the lateral pterygoid muscle, rupture of retrodiskal layers, and joint effusion and can serve as indirect early signs of TMJ dysfunction. It is important for the radiologist to detect early MR imaging signs of dysfunction, thereby avoiding the evolution of this condition to its final stage, an advanced and irreversible phase that is characterized by osteoarthritic changes such as condylar flattening or osteophytes. Further studies conducted with the latest MR imaging techniques will allow a better understanding of the sources of TMJ pain and of any discrepancy between imaging findings and patient symptoms.


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The purpose of this study was to correlate disc position and the type of disc displacement, intra-capsular effusion and degenerative changes of the condyle as demonstrated in MRI studies. In this study, 126 temporomandibular joints (TMJs) of 63 patients with TMJ disorders were investigated using clinical examination and MRI. One hundred and twelve TMJs were found to have internal derangement as disc displacement. The angle between the posterior margin of the disc and the vertical line drawn through the centre of the condyle was measured on MRI for each TMJ. The positions of the discs were normal, 0 degrees-10 degrees, in 11.11%; slightly displaced, 11 degrees-30 degrees, in 37.30%; mildly displaced 31 degrees-50 degrees, in 15.08%; moderately displaced, 51 degrees-80 degrees, in 7.14% of the TMJs with anterior displacement with reduction (ADDR). The disc position was severely displaced anteriorly, as over 80 degrees, in all TMJs with anterior disc displacement without reduction (ADD), constituting 27.78% of all cases. We found that the smaller the degree of disc displacement the milder the internal derangement and that the intra-capsular effusion was more frequently associated with TMJ with ADDR. The degenerative condylar changes were more severe with an increased degree of anterior disc displacement.


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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels.

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Carotid ultrasound uses sound waves to produce pictures of the carotid arteries in the neck which carry blood from the heart to the brain. A Doppler ultrasound study – a technique that evaluates blood flow through a blood vessel – is usually part of this exam. It’s most frequently used to screen patients for blockage or narrowing of the carotid arteries, a condition called stenosis which may increase the risk of stroke.


Little or no special preparation is required for this procedure. Leave jewelry at home and wear loose, comfortable clothing. A loose-fitting, open necked shirt or blouse is ideal.

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 X-ray beams are passed through the abdomen, producing images of the kidneys, ureters, and bladder on a special type of film. KUB radiography is often used as a first step in diagnosing problems of the urinary system, and is usually done in conjunction with intravenous pyelography.

 

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The use of Doppler ultrasound to assess both the changing haemodynamics of the neonatal circulation and the perfusion of the brain is reviewed. The brain is particularly susceptible to both ischaemic and haemorrhagic injury in preterm and asphyxiated infants. However, the unique characteristics of the transitional neonatal circulation, and of the cerebral vasculature, pose considerable problems in the interpretation of Doppler signals from intracranial arteries. A volumetric Doppler method which eliminates some of those problems is discussed. The same method allows full assessment of the cardiovascular status of the newborn infant, including estimation of ductal shunting and left ventricular output. Doppler ultrasound, if used with a full understanding of the inherant assumptions and limitations of the particular methodology, is likely to prove invaluable in investigating pathological cerebral and cardiac vascular events in the newborn.

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With the most advanced Echo-cardiography ultrasound and color Doppler system from Philips which uses a X- Matrix Probe (>9000 piezoelectric crystals) and break-through pure wave single crystal technology deliver high wualty images.


This is the only diagnostic centre in city doing ultrasound contrast study. 

Some of the features are unique in the machine and not available elsewhere. The machine gives extreme resolution for excellent 2D and LIVE 3D (4D) images. It has extreme color sensitivity. 3D images in cross sectional view (all three planes). VOCAL ( Volumetric organ calculation), Multislice CT like images. PANORAMIC images to include a wide area in single image. Dynamic MR to give maximum resolution, Broad band frequency compounding, harmonic imaging etc.

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A recent estimate of the number of men in the United States suffering with complete erectile dysfunction is 10 to 20 million. When partial erectile dysfunction is included, the estimate jumps to 30 million.1 Age-specific prevalence is estimated to be 5% at age 40, increasing to 15% to 25% by age 65. In clinical series, the ratio of organic to psychologic male sexual dysfunction also varies with age: 70% of patients under 35 years of age have a psychogenic cause, and 85% of patients over 50 years of age have organic impotence.2 Patient accounts of coital frequency similarly vary with age: 75% of men in their seventh decade report having coitus once monthly, and 37% of patients 60 to 69 years old describe having weekly coitus.

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Doppler ultrasonography of the lower extremity arteries is a valuable technique, although it is less frequently indicated for peripheral arterial disease than for deep vein thrombosis or varicose veins. Ultrasonography can diagnose stenosis through the direct visualization of plaques and through the analysis of the Doppler waveforms in stenotic and poststenotic arteries. To perform Doppler ultrasonography of the lower extremity arteries, the operator should be familiar with the arterial anatomy of the lower extremities, basic scanning techniques, and the parameters used in color and pulsed-wave Doppler ultrasonography.

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A Doppler ultrasound is a test that uses high-frequency sound waves to measure the amount of blood flow through your arteries and veins, usually those that supply blood to your arms and legs.


Vascular flow studies, also known as blood flow studies, can detect abnormal flow within an artery or blood vessel. This can help to diagnose and treat a variety of conditions, including blood clots and poor circulation. A Doppler ultrasound can be used as part of a blood flow study.


A Doppler ultrasound is a risk-free and pain-free procedure that requires little preparation. The test provides your doctor with important information about the flow of blood through your major arteries and veins. It can also reveal blocked or reduced blood flow through narrowed areas in the arteries, which could eventually lead to a stroke.

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A prospective study comparing colour Doppler ultrasound (US) with the 'gold standard' of intra-arterial digital subtraction angiography in the evaluation of renal transplant artery stenosis was performed. Both the intrarenal vessels and the transplant renal artery were examined by Doppler US. Diagnostic arteriography was performed only if, on Doppler, the peak systolic velocity in the transplant renal artery exceeded 1.5 ms-1. Of 109 patients, the transplant artery could not be visualized using colour Doppler US in three, and these were omitted from statistical analysis. Of the remaining 106 patients, 31 had a peak systolic velocity greater than 1.5 ms-1 in the transplant renal artery and were referred for DSA. Of the multiple renal Doppler indices recorded, the peak systolic velocity in the transplant artery was the best discriminating measurement for the detection of renal artery stenosis. A peak systolic velocity of > or = 2.5 ms-1 in the transplant renal artery had a sensitivity of 100% and a specificity of 95% for the detection of renal artery stenosis ( > 50% diameter reduction). Although a significant difference in Pulsatility Index, Resistive Index, Acceleration Index and Acceleration Time was recorded from the intrarenal vessels in the angiographically normal and stenosed groups with Doppler, these measurements were less useful as discriminating diagnostic tests. In conclusion, the peak systolic velocity in the transplant renal artery is the most sensitive Doppler criterion for renal artery stenosis and is sensitive and specific enough to be used as a screening test. The intrarenal acceleration time and index should not be used in isolation.

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Magnetic resonance cholangiopancreatography (MRCP) is a special type of magnetic resonance imaging (MRI) exam that produces detailed images of the hepatobiliary and pancreatic systems, including the liver, gallbladder, bile ducts, pancreas and pancreatic duct. Magnetic resonance imaging (MRI) is a non-invasive medical test that physicians use to diagnose and treat medical conditions.MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. MRI does not use ionizing radiation (x-rays). Detailed MR images allow physicians to evaluate various parts of the body and determine the presence of certain diseases.

Doctors use MRCP to examine diseases of the liver, gallbladder, bile ducts, pancreas and pancreatic duct. These may include tumours, stones, inflammation or infection evaluate patients with pancreatitis to detect the underlying cause. In patients with pancreatitis, an MRCP may be performed using a medication called Secretin to assess for long term scarring and to determine the amount of healthy pancreatic function and secretions help to diagnose unexplained abdominal pain and provide a less invasive alternative to endoscopic retrograde cholangiopancreatography (ERCP). ERCP is a diagnostic procedure that combines endoscopy, which uses an illuminated optical instrument to examine inside the body, with iodinated contrast injection and x-ray images. You may be asked to wear a gown during the exam or you may be allowed to wear your own clothing if it is loose-fitting and has no metal fasteners. Guidelines about eating and drinking before an MRI exam vary. Usually, you will be instructed not to eat or drink anything for several hours before your procedure.Jewellery and other accessories should be left at home if possible, or removed prior to the MRI scan. Because they can interfere with the magnetic field of the MRI unit, metal and electronic items are not allowed in the exam room. In general, metal objects used in orthopaedic surgery pose no risk during MRI. However, a recently placed artificial joint may require the use of another imaging procedure. If there is any question of their presence, an x-ray may be taken to detect and identify any metal objects.


You will usually be alone in the exam room during the MRI procedure. However, the technologist will be able to see, hear and speak with you at all times using a two-way intercom. Many MRI centres allow a friend or parent to stay in the room as long as they are also screened for safety in the magnetic environment.  A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician, who will share the results with you.


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A device called a transducer is passed over the scrotum, directing high-frequency sound waves (ultrasound) at the structures within, including the testicle, epididymis (the tube that transports sperm from the testicle), and blood vessels. The sound waves are reflected back to the transducer and electronically converted into real-time images displayed on a viewing monitor. These images are then saved on film or video and reviewed for abnormalities.

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Color Doppler ultrasound is a medical imaging technique which is used to provide visualization of the bloodflow, using color processing to add color to the image so that a doctor or care provider can clearly see what is happening inside the body. This technique requires the use of an ultrasound machine which is capable of color Doppler ultrasound, and can be performed in a hospital or clinic as an outpatient procedure. Having this imaging study performed is not usually painful, and the patient does not require sedatives. 

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Venous ultrasound uses sound waves to produce images of the veins in the body. It is commonly used to search for blood clots, especially in the veins of the leg – a condition often referred to as deep vein thrombosis. Ultrasound does not use ionizing radiation and has no known harmful effects.


On occasion, you may be asked not to eat or drink anything but water for six to eight hours beforehand. Otherwise, little or no special preparation is required for this procedure. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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Magnetic resonance imaging (MRI) is an advanced medical imaging technique that does not use x-rays or radiation. Instead it uses a strong magnetic field, radio waves, and a computer. This creates very clear pictures of internal body structures. An MRI is used to examine soft tissues like organs, muscles, tendons, & blood vessels in many parts of the body. This includes areas of the brain, spine, abdomen, chest, pelvis, and joints (like knees and shoulders). The MRI image offers unique information to help your doctor better plan your treatment and care.


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A Doppler ultrasound, also called a Color Doppler test is a non-invasive test that can be used to estimate your blood flow through blood vessels. It helps doctors evaluate blood flow through major arteries and veins, such as those of the arms, legs, and neck. It can show blocked or reduced flow of blood through narrow areas in the major arteries of the neck that could cause a stroke. It also can reveal blood clots in leg veins (deep vein thrombosis, or DVT) that could break loose and block blood flow to the lungs (pulmonary embolism). During pregnancy, Doppler ultrasound may be used to look at blood flow in an unborn baby (foetus) to check the health of the foetus.

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Complement C3 is a blood test that measures the activity of a certain protein. This protein is part of the complement system. The complement system is a group of proteins that move freely through your bloodstream. The proteins work with your immune system and play a role in the development of inflammation.


The complement system protects the body from infections, dead cells and from foreign material. Rarely, people may inherit deficiency of some complement proteins. These people are prone to certain infections or autoimmune disorders.


There are nine major complement proteins. They are labeled C1 through C9. This test measures C3.

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This test measures the amount of C4 proteins in your blood. These proteins are part of your complement system, an important part of your immune system that helps kill disease-causing bacteria and viruses.


By measuring complement C4 levels, especially in how they compare with other parts of the complement system, your healthcare provider can diagnose and monitor treatment of certain diseases. One of the diseases that commonly involves abnormal C4 is systemic lupus erythematosus, or lupus, an autoimmune disorder.

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 B-scan ultrasonography is an important adjuvant for the clinical assessment of various ocular and orbital diseases. With understanding of the indications for ultrasonography and proper examination technique, one can gather a vast amount of information not possible with clinical examination alone. This article is designed to describe the principles, techniques, and indications for echographic examination, as well as to provide a general understanding of echographic characteristics of various ocular pathologies. 

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A Whole Spine MRI Scan is an imaging test done to access the spinal anatomy and investigate the causes of a patient's back pain. The MRI can find changes in the spine and other tissues. MRI scans are needed when other imaging tests like X-ray, and CT scan fails to obtain any critical information and conservative treatment has stopped working or responding well. A Whole Spine MRI Scan is recommended to better diagnose the problems with your spine and provide an alternative treatment. The MRI Scan can also find problems such as infection or a tumour.


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A complement test is a blood test that measures the activity of a group of proteins in the part of the blood called the serum. These proteins make up the complement system, which is part of the immune system.


The complement system helps antibodies fight off infections and destroy substances that are foreign to the body, such as viruses, bacteria, and other germs. It’s also activated when the body makes antibodies against its own tissues that it views as foreign. This happens in autoimmune diseases.


A complement test can monitor the progress of people undergoing treatment for autoimmune diseases, such as lupus and rheumatoid arthritis (RA). The test can measure how advanced these diseases are based on the activity of the complement protein in the blood. It can also gauge the effectiveness of ongoing treatments for autoimmune disorders and diagnose some cancers and infectious diseases.


There are nine major complement proteins. They’re labeled C1 through C9. A total complement measurement checks the function of your complement system by gauging the total amount of complement protein in your blood.


The complement test involves a simple blood draw. It requires no preparation and carries few risks. Your doctor will send the blood sample to a laboratory for analysis. Your doctor will receive the results.

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Pulmonary embolism is a blockage in one of the pulmonary arteries in your lungs. In most cases, pulmonary embolism is caused by blood clots that travel to the lungs from the legs or, rarely, other parts of the body (deep vein thrombosis).


Because the clots block blood flow to the lungs, pulmonary embolism can be life-threatening. However, prompt treatment greatly reduces the risk of death. Taking measures to prevent blood clots in your legs will help protect you against pulmonary embolism.


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The mumps virus is a member of the Paramyxoviridae family of viruses, which include parainfluenza virus serotypes 1-4, measles, respiratory syncytial virus, and metapneumovirus. Mumps is highly infectious among unvaccinated individuals and is typically transmitted through inhalation of infected respiratory droplets or secretions. Following an approximately 2-week incubation period, symptom onset is typically acute with a prodrome of low-grade fever, headache, and malaise.(1,2) Painful enlargement of the salivary glands, the hallmark of mumps, occurs in approximately 60% to 70% of infections and in 95% of patients with symptoms. Testicular pain (orchitis) occurs in approximately 15% to 30% of postpubertal men and abdominal pain (oophoritis) is found in 5% of postpubertal women.(1) Other complications include mumps-associated pancreatitis (<5% of cases) and central nervous system disease (meningitis <10% and encephalitis <1%).

Widespread routine immunization of infants with attenuated mumps virus has dramatically decreased the number of reported mumps cases in the United States. However, outbreaks continue to occur, indicating persistence of the virus in the general population. Laboratory diagnosis of mumps is typically accomplished by detection of IgM- and IgG-class antibodies to the mumps virus. However, due to the widespread mumps vaccination program, in clinically suspected cases of acute mumps infection, serologic testing should be supplemented with virus isolation in culture or detection of viral nucleic acid by PCR in throat, saliva, or urine specimens.


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Proximal conduction studies by F-wave technique, with conventional distal motor and sensory conduction were performed along the ulnar nerves of 20 patients each with cervical spondylotic radiculopathy and/or myelopathy and with classical motor neurone disease (MND). Such F-wave parameters as shortest F-latency, F-conduction velocity, conduction time and F-ratio were calculated. Twenty-five age- and sex-matched healthy volunteers acted as controls. Proximal slowing associated with sensory conduction abnormalities and normal distal motor conduction favored cervical spondylosis (CS). Distal slowing with a normal proximal motor and sensory conduction was associated with motor neurone disease.


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 Ultrasound imaging of the head uses sound waves to produce pictures of the brain and cerebrospinal fluid. It is most commonly performed on infants, whose skulls have not completely formed. A transcranial Doppler ultrasound evaluates blood flow in the brain’s major arteries. Ultrasound is safe, noninvasive, and does not use ionizing radiation.This procedure requires little to no special preparation. Your doctor will instruct you on how to prepare, including whether adults undergoing the exam should refrain from using nicotine-based products that may cause blood vessels to constrict. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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A nerve conduction velocity (NCV) test is used to assess nerve damage and dysfunction. Also known as a nerve conduction study, the procedure measures how quickly electrical signals move through your peripheral nerves.Your peripheral nerves are located outside of your brain and along your spinal cord. These nerves help you control your muscles and experience the senses. Healthy nerves send electrical signals more quickly and with greater strength than damaged nerves.The NVC test helps your doctor differentiate between an injury to the nerve fiber and an injury to the myelin sheath, the protective covering surrounding the nerve. It can also help your doctor tell the difference between a nerve disorder and a condition where a nerve injury has affected the muscles.Making these distinctions is important for proper diagnosis and determining your course of treatment.

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Hepatitis B tests detect substances that reflect a current or previous infection with hepatitis B virus (HBV). Some tests detect viral proteins (antigens) or the antibodies that are produced in response to an infection, while other types of tests detect or evaluate the genetic material (DNA) of the virus. The pattern of test results can identify a person who has a current active infection or one who has immunity as a result of previous exposure.


For details on the various tests, see the table under "How is it used?"


Hepatitis is a condition characterized by inflammation and enlargement of the liver. It has several various causes, one of which is infection by a virus. HBV is one of five "hepatitis viruses" identified so far that are known to mainly infect the liver. The other four are hepatitis A, hepatitis C, hepatitis D, and hepatitis E.


HBV is spread through contact with blood or other body fluids from an infected person. Exposure can occur, for example, through sharing of needles for IV drug use or through unprotected sex. People who live in or travel to areas of the world where hepatitis B is prevalent are at a greater risk. Rarely, mothers can pass the infection to their babies, usually during or after birth. The virus is not spread through casual contact such as holding hands, coughing or sneezing. However, the virus can survive outside the body for up to seven days, including in dried blood, and can be passed by sharing items such as razors or toothbrushes with an infected person.

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A nerve conduction velocity test (NCV) is an electrical test that is used to determine the adequacy of the conduction of the nerve impulse as it courses down a nerve. This test is used to detect signs of nerve injury. In this test, the nerve is electrically stimulated, and the electrical impulse 'down stream' from the stimulus is measured. This is usually done with surface patch electrodes (they are similar to those used for an electrocardiogram) that are placed on the skin over the nerve at various locations. One electrode stimulates the nerve with a very mild electrical impulse. The resulting electrical activity is recorded by the other electrodes. The distance between electrodes and the time it takes for electrical impulses to travel between electrodes are used to calculate the speed of impulse transmission (nerve conduction velocity). A decreased speed of transmission indicates nerve disease or abnormal pressure on the nerve. A nerve conduction velocity test is often done at the same time as an electromyogram (EMG). An EMG is carried out in order to exclude or detect muscle conditions which may be present due to muscular or neurologic disease.


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Hepatitis B surface antigen (HBsAg): A protein on the surface of hepatitis B virus; it can be detected in high levels in serum during acute or chronic hepatitis B virus infection. The presence of HBsAg indicates that the person is infectious HBsAg is the antigen used to make hepatitis B vaccine.

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The facial nerve conduction velocity was measured in 30 healthy subjects (60 sides) and in 51 patients with a unilateral Bell's palsy. The normal value was 47.8 +/- 5.1 m/s. Incomplete recovery was common in Bell's palsy when the velocity was below 30 m/s. Mild synkinesis was observed in only one patient when the nerve conduction velocity was above 30 m/s. When the degree of degeneration revealed by electroneuroneography did not exceed 60%, the conduction velocity was in the normal range. For degrees of degeneration in excess of this, the conduction velocity decreased in parallel with the increase in the degree of degeneration.


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High-density lipoprotein (HDL cholesterol, HDL-C) is one of the classes of lipoproteins that carry cholesterol in the blood. HDL-C consists primarily of protein with a small amount of cholesterol. It is considered to be beneficial because it removes excess cholesterol from tissues and carries it to the liver for disposal. Hence, HDL cholesterol is often termed "good" cholesterol. The test for HDL cholesterol measures the amount of HDL-C in blood.


High levels of cholesterol have been shown to be associated with the development of hardening of the arteries (atherosclerosis) and heart disease. When cholesterol levels in the blood increase (not enough is removed by HDL), it may be deposited on the walls of blood vessels. These deposits, termed plaques, can build up, causing vessel walls to become more rigid, and may eventually narrow the openings of blood vessels, constricting the flow of blood.

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As an O Positive donor you are incredibly important to maintaining the blood supply in our community. O Positive is the most common blood type and therefore needed by so many patients. 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 O+ blood (approximately 37.4% of the population)


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When the plasma hemoglobin level is >50 to 200 mg/dL after hemolysis, the capacity of haptoglobin to bind hemoglobin is exceeded, and hemoglobin readily passes through the glomeruli of the kidney. Part of the hemoglobin is absorbed by the proximal tubular cells where the hemoglobin iron is converted to hemosiderin. When these tubular cells are later shed into the urine, hemosiderinuria results. If all of the hemoglobin cannot be absorbed into the tubular cells, hemoglobinuria results.

Hemosiderin is found as yellow-brown granules that are free or in epithelial cells and occasionally in casts in an acidic or neutral urine.

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Hepatitis A is a highly contagious liver infection caused by the hepatitis A (HAV). It is one of several various causes of hepatitis, a condition characterized by inflammation and enlargement of the liver. This test detects antibodies in the blood that are produced by the immune system in response to a hepatitis A infection.


Hepatitis A is one of five "hepatitis viruses" identified so far, including B, C, D, and E, that are known to cause the disease. While hepatitis A can cause a severe, acute disease that typically lasts 1 to 2 months, it does not cause a chronic infection as do some of the other hepatitis viruses.


Hepatitis A is spread, most commonly, from person-to person through stool (fecal) contamination or by ingesting food or water contaminated by the stool of an infected person (a foodborne illness). Recognized risk factors for hepatitis A include close contact with an infected person, international travel, household or personal contact with a child who attends a child care center, household or personal contact with a newly arriving international adoptee, a recognized foodborne outbreak, men who have sex with men, and use of illegal drugs.


Although there are many causes of hepatitis, the symptoms remain the same. In hepatitis, the liver is damaged and unable to function normally. It cannot process toxins or waste products such as bilirubin for their removal from the body. During the course of the disease, bilirubin and liver enzyme levels in the blood can increase. While tests such as bilirubin or a liver panel can tell a health practitioner that someone has hepatitis, they do not identify the cause. Antibody tests for hepatitis viruses may help determine the cause.

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n addition to a complete blood cell count, the principal studies used to establish the diagnosis of paroxysmal nocturnal hemoglobinuria (PNH) are flow cytometry of peripheral blood and bone marrow analysis. Flow cytometry measures the percentage of cells that are deficient in the glycosyl phosphatidylinositol–anchored proteins (GPI-APs) and identifies discrete populations with different degrees of deficiency. Because of the missing GPI-APs, red blood cells (RBCs) and other cells in patients with PNH lack DAF (CD55) and MIRL (CD59), which regulate complement. Hemosiderin is nearly always present in the urine sediment and can accumulate in the kidneys; this is visible on magnetic resonance images (MRI) or computed tomography (CT) scans. An elevated reticulocyte count and serum lactate dehydrogenase (LDH) level with a low serum haptoglobin level in the absence of hepatosplenomegaly are the hallmarks of intravascular hemolysis.Bone marrow examination will differentiate classic PNH from PNH that develops in the setting of other bone marrow disorders. In addition, bone marrow examination will identify an erythroid and hyperplastic bone marrow during the hemolytic phase or a hypoplastic bone marrow in the aplastic phase.


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Pulmonary function tests are a broad range of tests that measure how well the lungs take in and exhale air and how efficiently they transfer oxygen into the blood. Spirometry measures how well the lungs exhale. The information gathered during this test is useful in diagnosing certain types of lung disorders, but is most useful when assessing for obstructive lung diseases (especially asthma and chronic obstructive pulmonary disease, COPD). Lung volume measurement detects restrictive lung diseases. In this set of diseases, a person cannot inhale a normal volume of air. Restrictive lung diseases may be caused by inflammation or scarring of the lung tissue (interstitial lung disease) or by abnormalities of the muscles or skeleton of the chest wall. Testing the diffusion capacity (also called the DLCO) permits an estimate of how efficiently the lungs transfer oxygen from the air into the bloodstream.


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Hepatitis B core antibodies (anti-HBc Ab) appear shortly after the onset of symptoms of hepatitis B infection and soon after the appearance of hepatitis B surface antigen (HBsAg). Initially, anti-HBc Ab consist almost entirely of the IgM class, followed by appearance of anti-HBc IgG, for which there is no commercial diagnostic assay.


The anti-HBc total antibodies test, which detects both IgM and IgG antibodies, and the test for anti-HBc IgM antibodies may be the only markers of a recent hepatitis B infection detectable in the "window period." The window period begins with the clearance of HBsAg and ends with the appearance of antibodies to hepatitis B surface antigen (anti-HBs Ab). Anti-HBc total Ab may be the only serologic marker remaining years after exposure to hepatitis B.

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Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). It is one of several various causes of hepatitis, a condition characteriszed by inflammation and enlargement of the liver. Other causes of hepatitis include, for example, certain drugs, inherited disorders, and autoimmune diseases. HBV is one of five "hepatitis viruses" identified so far. The other four are A, C, D, and E. 


The course of HBV infections can vary from a mild form (acute) that lasts only a few weeks to a more serious, chronic, form lasting years. Sometimes chronic HBV leads to serious complications such as cirrhosis or liver cancer. 


HBV is spread through contact with blood or other body fluids from an infected person. Exposure can occur, for example, through sharing of needles for IV drug use or through unprotected sex. People who live in or travel to areas of the world where hepatitis B is prevalent are at a greater risk. Mothers can pass the infection to their babies, usually during or after birth. The virus, however, is not spread through food or water, casual contact such as holding hands, or coughing or sneezing.

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This test measures the actual amount of hepatitis B in a blood sample, which helps determine whether HBV is reproducing in the liver. In a person with detectable HBeAg, an HBV viral load greater than 20,000 international units per milliliter (IU/mL) of blood indicates that the virus is active and has the greatest potential to cause damage to the liver. Similarly, in a person with an HBeAg-negative chronic hepatitis B, an HBV viral load of greater than 2,000 IU/mL indicates that the virus is active and has the potential to cause damage to the liver. Generally speaking, if the HBV viral load is above these numbers, treatment is considered necessary. However, HBV treatment decisions are based on multiple factors, and your medical provider may make recommendations based on other input.

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HBeAg is the hepatitis B envelope antigen, and anti-HBe are the antibodies produced against this antigen. If HBeAg is detectable in a blood sample, this means that the virus is still active in the liver (and can be transmitted to others). If HBeAg is negative and anti-HBe is positive, this generally means that the virus is inactive. However, this is not always the case. Some people with chronic hepatitis—especially those who have been infected with HBV for many years—may have what is known as a precore or core variant mutated form of HBV. This can cause HBeAg to be negative and anti-HBe to be positive, even though the virus is still active in the liver.

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Often used as a marker of ability to spread the virus to other people (infectivity); it may also be used to monitor the effectiveness of treatment. However, there are some types (strains) of HBV that do not make e-antigen; these are especially common in the Middle East and Asia. In areas where these strains of HBV are common, testing for HBeAg is not very useful to determine whether the virus can be spread to others.

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An HCV antibody test is typically reported as "positive" or "negative."


Results of HCV viral load testing are reported as a number if virus is present. If no virus is present or if the amount of virus is too low to detect, the result is often reported as "negative" or "not detected."


Interpretation of the HCV screening and follow-up tests is shown in the table below. In general, if the HCV antibody test is positive, then the individual tested is infected or has likely been infected at some time with hepatitis C. If the HCV RNA test is positive, then the person has a current infection. If no HCV viral RNA is detected, then the person either does not have an active infection or the virus is present in very low numbers.


For monitoring purposes, an HCV viral load (HCV RNA quantitative) can indicate whether or not treatment is effective. A high or increasing viral load may be a sign that treatment is not successful whereas a low, decreasing, or undetectable viral load may imply that the treatment is working.


Successful treatment causes a decrease of 99% or more in viral load soon after starting treatment (as early as 2-4 weeks) and usually leads to undetectable viral load after treatment is completed. According to guidelines from the American Association for the Study of Liver Diseases and the Infectious Disease Society of America, an undetectable viral load in a treated person's blood 12 weeks after the end of the treatment means that the HCV infection has responded to therapy.

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The qualitative HCV RNA tests use either a process called polymerase chain reaction (PCR) or a process called transcription-mediated amplification (TMA). Either type of qualitative test will report whether the hepatitis C virus is present in the bloodstream or not. The result is reported as either "detected" or "not detected."

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Hepatitis E virus (HEV) causes an acute, usually self-limited infection. This small, non-enveloped RNA virus is from animal reservoir (eg, hogs) to humans via the fecal-oral route. HEV is endemic in Southeast and Central Asia, with several outbreaks observed in the Middle East, northern and western parts of Africa, and Mexico. In developed countries, HEV infection occurs mainly in persons who have traveled to disease-endemic areas. Transmission of HEV may also occur parenterally, and direct person-to-person transmission is rare. Clinically severe cases occur in young to middle-aged adults. Unusually high mortality (approximately 20%) occurs in patients infected during the third trimester of pregnancy. Although there is no carrier state associated with HEV, immunocompromised patients may have prolonged periods (eg, months) of viremia and virus shedding in the stool.


In immunocompetent patients, viremia and virus shedding in the stool occur in the preicteric phase, lasting up to 10 days into the clinical phase. After an incubation period ranging from 15 to 60 days, HEV-infected patients develop symptoms of hepatitis with appearance of anti-HEV IgM antibody in serum, followed by detectable anti-HEV IgG within a few days. Anti-HEV IgM may remain detectable up to 6 months after onset of symptoms, while anti-HEV IgG usually persists for many years after infection. Anti-HEV IgM is the serologic marker of choice for diagnosis of acute HEV infection.

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When the occasional headache strikes, most of us take an over-the-counter (OTC) analgesic, such as acetaminophen, ibuprofen, aspirin, or a pain-relief medication containing caffeine. While OTC analgesics can help relieve headache pain they must be taken correctly — or they could actually make your headaches worse. The overuse or misuse of analgesic drugs — exceeding labeling instructions (such as taking the medications three or more days per week) or not following your healthcare provider’s advice — can cause you to "rebound" into another headache. When the pain reliever wears off, you may experience a withdrawal reaction, prompting you to take more medication. This only leads to another headache and the desire to take yet more medication. So the cycle continues until you start to suffer from chronic daily headaches, with more frequent headaches and more severe pain.

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Cancer starts when cells begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas of the body. To learn more about how cancers start and spread, see What Is Cancer? For information about the differences between childhood cancers and adult cancers, see Cancer in Children. Retinoblastoma is a cancer that starts in the retina, the very back part of the eye. It is the most common type of eye cancer in children. Rarely, children can have other kinds of eye cancer, such as medulloepithelioma, which is described briefly below, or melanoma.To understand retinoblastoma, it helps to know about the parts of the eye and how they work.


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A retrograde urethrogram is a routine radiologic procedure (most typically in males) used to image the integrity of the urethra. Hence a retrograde urethrogram is essential for diagnosis of urethral injury, or urethral stricture. The procedure involves the insertion of a Foley catheter into the distal urethra and minimally inflating it. This is followed by instillation of 30mL of water-soluble contrast and a plain radiograph is obtained; leakage of the contrast suggests urethral injury (usually secondary to pelvic trauma) and is an indication for surgical intervention.It is used when there is suspicion of urethral trauma, such as a history of trauma to the area followed by pain, inability to void urine, or the presence of blood at the urethral meatus, a scrotal hematoma, or free-floating prostate on rectal examination. If a urethral injury is suspected, a retrograde urethrogram should be performed before attempting to place a Foley catheter into the bladder. If there is a urethral disruption, a suprapubic catheter should be placed.

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Sarcomas are cancers that develop from connective tissues in the body, such as muscles, fat, bones, the linings of joints, or blood vessels. There are many types of sarcomas. Rhabdomyosarcoma (RMS) is a cancer made up of cells that normally develop into skeletal muscles. The body has 3 main types of muscles.


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Ringworm of the body is a fungal infection that develops on the top layer of your skin. It's characterized by a red circular rash with clearer skin in the middle. It may itch. Ringworm gets its name because of its appearance. No actual worm is involved. Also called tinea corporis, ringworm of the body is closely related to athlete's foot (tinea pedis), jock itch (tinea cruris) and ringworm of the scalp (tinea capitis). Ringworm often spreads by direct skin-to-skin contact with an infected person or animal. Mild ringworm often responds to antifungal medications that you apply to your skin. For more-severe infections, you may need to take antifungal pills for several weeks


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Rubella is an acute, contagious viral infection. While rubella virus infection usually causes a mild fever and rash illness in children and adults, infection during pregnancy, especially during the first trimester, can result in miscarriage, fetal death, stillbirth, or infants with congenital malformations, known as congenital rubella syndrome (CRS). The rubella virus is transmitted by airborne droplets when infected people sneeze or cough. Humans are the only known host.


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Have your dinners planned for the week within seconds!  As a Scramble member, each week you receive a suggested meal plan with:


Five family-friendly dinners complete with main course and one to two easy, healthy side dishes

Meals feature seasonal fruits and vegetables for great flavors and savings

All meals have full nutritional information by meal and by individual dish

An organized shopping list with items listed by grocery store section


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Sebaceous glands are part of epidermal appendages. Neoplasms of the sebaceous glands may be benign, such as sebaceous hyperplasia or sebaceous gland adenomas. The malignant sebaceous gland carcinoma most commonly arises in the periocular area. Fewer than 120 cases of sebaceous cell carcinoma have been reported at extraocular sites. The most common site of origin is the meibomian glands of the eyelids, leading to the term meibomian gland carcinoma. However, this neoplasm can occur in other sebaceous glands, such as in the caruncle, the glands of Zeis, and in the eyebrow. Sebaceous cell carcinoma is a lethal eyelid malignancy and can masquerade as benign conditions. Error or delay in diagnosis is common, and this tumor carries a significant mortality rate with metastasis.


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Seborrheic (seb-o-REE-ik) dermatitis is a common skin condition that mainly affects your scalp. It causes scaly patches, red skin and stubborn dandruff. Seborrheic dermatitis can also affect oily areas of the body, such as the face, sides of the nose, eyebrows, ears, eyelids and chest. Seborrheic dermatitis may go away without treatment. Or you may need many repeated treatments before the symptoms go away. And they may return later. Daily cleansing with a gentle soap and shampoo can help reduce oiliness and dead skin buildup.Seborrheic dermatitis is also called dandruff, seborrheic eczema and seborrheic psoriasis. For infants, the condition is known as cradle cap and causes crusty, scaly patches on the scalp.


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Seborrheic keratosis (seb-o-REE-ik ker-uh-TOE-sis) is one of the most common noncancerous skin growths in older adults.A seborrheic keratosis usually appears as a brown, black or light tan growth on the face, chest, shoulders or back. The growth has a waxy, scaly, slightly elevated appearance. Seborrheic keratoses don't become cancerous and aren't thought to be related to sun exposure, but they can look like skin cancer. Seborrheic keratoses are normally painless and require no treatment. You may decide to have them removed if they become irritated by clothing or for cosmetic reasons.

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Your bowels are made up of two parts -- the large intestine, also called the colon, and the small intestine. Short bowel syndrome usually affects people who’ve had a lot of their small intestine removed. Without this part, your body can’t get enough nutrients and water from the food you eat. This causes bowel troubles, like diarrhea, which can be dangerous if you go without treatment.If you learn you have short bowel syndrome, know that doctors can do a lot of things to ease your symptoms and make sure you get the right nutrition. People who have the disease can lead active lives.Over time, your body may adjust to having a shorter small intestine, and you may be able to take fewer medicines. The key is to stick to your treatment plan and get the support you need.


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A fistulogram uses a form of real-time x-ray called fluoroscopy and a barium-based contrast material to produce images of an abnormal passage within the body called a fistula. Similarly, a sinogram assesses an abnormal passage called a sinus that originates or ends in one opening, often on the skin. Both examinations are used to assess and diagnose the size and shape of fistulas and sinuses and any related abscess and/or infection. You will be instructed on how to prepare. You may be asked to refrain from eating or drinking anything for several hours before the examination, but you should be allowed to take medications with small amounts of clear fluid up to two hours prior. Tell your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking and allergies, especially to contrast materials. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown


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Obstructive sleep apnea is a potentially serious sleep disorder. It causes breathing to repeatedly stop and start during sleep.There are several types of sleep apnea, but the most common is obstructive sleep apnea. This type of apnea occurs when your throat muscles intermittently relax and block your airway during sleep. A noticeable sign of obstructive sleep apnea is snoring. Treatments for obstructive sleep apnea are available. One treatment involves using a device that keep your airway open while you sleep. Another option is a mouthpiece to thrust your jaw forward during sleep. In more severe cases, surgery may be an option too


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The small bowel makes up most of the digestive tract. Cancers of the small bowel are rare. Cancers that have spread to the small bowel from another part of the body, are called secondary cancers. Look at the information about where the cancer started (the primary cancer) because the treatment is the same. 


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A somatosensory evoked potential (SSEP) is an evoked potential caused by a physical stimulus (usually a small electric pulse). Electrodes positioned over particular areas of the body record responses of the SSEP, these are then observed as a reading on an electroencephalogram (EEG).  A SSEP can most commonly involve stimulation of the median nerve at the wrist, or the posterior tibial nerve at the ankle. This investigation therefore tests the pathway of the sensory nerves to the sensory areas of the brain, even though the stimuli are non-physiological.


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Somatosensory Evoked Potentials (SSEPs) are electric signals recorded from the scalp or spine following stimulation to the peripheral nerves. They are time-locked responses, representing the function of the ascending sensory pathways. Early in the 1960s Larson et al introduced the use of somatosensory evoked potentials to monitor neural structure during neurosurgical procedures. It was utilized as a supplement to the wake-up test during correctional spinal surgeries for spinal deformities such as scoliosis to provide warning of compromised spinal cord function to the spine surgeons, as reported by McCallum et al and Nash et al in the 1970s. Since then SSEP has become one of the earliest and primary tools for intraoperative neurophysiological monitoring.


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Somatosensory Evoked Potentials (SSEPs) are electrical responses recorded from the nervous system following electrical stimulation of a peripheral nerve.  For example, stimulation of the median nerve at the wrist produces electrical activity that travels along the sensory pathway on its way to the brain. This activity can be recorded with electrodes positioned along that pathway.


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This test is the same as a treadmill exercise test. This test checks the function of the heart during and after physical activity. In addition, an IV will be started and, at the peak of exercise, the patient will be injected with a mild isotope. The patient will then be escorted to the scanning room adjacent to the stress lab for approximately 30 minutes. From there, the patient will be free to leave and will return 3 hours later for a repeat scan.


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TMT Laboratories (a.k.a. Tension Member Technology or simply TMT) is primarily a large-scale mechanical test facility. Our 24,000-square-foot laboratory houses several large test machines with load frames, cylinders, and load cells that range in capacity from a few pounds to several million. These machines and their auxiliary equipment can be configured in various combinations to simulate a wide variety of mechanical service situations. To compliment the mechanical testing, TMT also keeps a large suite of electrical and optical test equipment that can be used to monitor various test parameters during mechanical or stand-alone tests. Since we opened our doors in 1976, we have worked with the oil & gas, telecommunication, military & defense, space & aviation, oceanographic, shipping, automotive, construction, and recreation industries. During this time, we have developed world-renowned expertise in the testing and optimizing of rope and cable systems. Despite our attraction to ropes and cables, we are always looking for new areas to apply our resources. Our test machines, diverse instrumentation, data acquisition equipment, and experienced engineers are ready to tackle a wide range of testing needs.


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Ultrasound imaging also called as sonography uses a transducer or probe to generate sound waves and produce pictures of the body's internal structures. It is often used to help diagnose unexplained pain, swelling or infection. It is used to see internal body structures such as tendons, muscles, joints, vessels and internal organs. It may also be used to provide imaging guidance to needle biopsies or to see and evaluate conditions related to blood flow. It is also the preferred imaging method for monitoring a pregnant woman and her unborn child. It does not use ionizing radiation, has no known harmful effects, and provides a clear picture of soft tissues that don't show up well on x-ray images.Most of these level II ultrasounds should be done in the second trimester of pregnancy usually between 18 and 22 weeks. It uses sound waves to produce pictures of a baby (embryo or fetus) within a pregnant woman, as well as the mother's uterus and ovaries. It does not use ionizing radiation, has no known harmful effects, and is the preferred method for monitoring pregnant women and their unborn babies. A Doppler ultrasound study – a technique that evaluates blood flow in the umbilical cord, fetus or placenta – may be part of this exam. It is a totally painless and safe procedure. It is useful test to establish the presence of fetus, estimate the age of pregnancy, diagnose congenital abnormalities of the fetus, assess fetal growth and well being etc. Preparation - No special preparation is needed.


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Your doctor has requested an ultrasound-guided biopsy. The goal of a biopsy is to remove a sample of tissue for testing in a laboratory. A biopsy can help diagnose abnormalities such as infection, inflammation or malignancy. During your biopsy, an imaging physician will use an ultrasound scanner to accurately guide a needle to the site of the biopsy. The needle will then be used to remove a tissue sample. At the S. Mark Taper Foundation Imaging Center, a highly trained medical team will oversee your procedure. This team will include an imaging physician, a diagnostic medical sonographer and a registered nurse.


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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels.

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A biophysical profile (BPP) test measures the health of your baby (fetus) during pregnancy. A BPP test may include a non stress test with electronic fetal heart monitoring and a fetal ultrasound. The BPP measures your baby's heart rate, muscle tone, movement, breathing, and the amount of amniotic fluid around your baby. A BPP is commonly done in the last trimester of pregnancy. If there is a chance that your baby may have problems during your pregnancy (high-risk pregnancy), a BPP may be done by 32 to 34 weeks or earlier. Some women with high-risk pregnancies may have a BPP test every week or twice a week in the third trimester. It is usually done to keep track of your baby’s health. 

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A breast ultrasound uses sound waves to make a picture of the tissues inside the breast. A breast ultrasound can show all areas of the breast, including the area closest to the chest wall, which is hard to study with a mammogram. Breast ultrasound does not use X-rays or other potentially harmful types of radiation. A breast ultrasound is used to see whether a breast lump is filled with fluid (a cyst) or if it is a solid lump. An ultrasound does not replace the need for a mammogram, but it is often used to check abnormal results from a mammogram


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Ultrasound imaging of the breast uses sound waves to produce pictures of the internal structures of the breast. It’s primarily used to help diagnose breast lumps or other abnormalities your doctor may have found during a physical exam, mammogram or breast MRI. Ultrasound is safe, noninvasive and does not use ionizing radiation.This procedure requires little to no special preparation. Leave jewelry at home and wear loose, comfortable clothing. You will be asked to undress from the waist up and to wear a gown during the procedure.

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This test is used to test the nerves and muscles in your entire lower extremity. Your doctor will usually order this test when he suspects that there may be some type of problem with the nerve supply to your foot and leg. Commonly the EMG/NCV test is used to diagnosis one of the following: Tarsal Tunnel Syndrome, Peripheral Neuropathy, Neuromuscular disorders, Nerve palsy or Paralysis, and Radioculopathy. Your doctor typically will refer you to either a hospital or a neurologist to have the test preformed.

The EMG portion of the test is used to record the electrical activity in your muscles. It can diagnose diseases of the nerves and muscles. It can detect conditions such as tarsal tunnel syndrome, inflamed muscles and pinched nerves. A tiny needle, called an electrode, is inserted directly into a specific muscle belly. The electrode then records the activity during the insertion, while the muscle is at rest, and while the muscle contracts. Nerve and muscle diseases alter the pattern of electrical activity in these muscles, which is record both audibly and on a computer screen. After the first muscle is tested, the electrode may be inserted into another muscle. Muscles chosen for the testing vary with the patient's symptoms and may be modified, depending on the results from the first muscles tested. Total testing time may range from just a few minutes to more than an hour, depending upon how many muscles are tested. After the exam, you may feel tenderness in the tested muscles. There is a slight risk of minor, localized inflammation in muscles during the test. This usually lasts only a few hours. Other common patient complaints are pain with insertion of the electrode.

Most of the time the Nerve Conduction Velocity Test will accompany the EMG Test. The NCV evaluates the health of the peripheral nerve by recording how fast electrical impulse travels through it. A peripheral nerve transmits information between the spinal cord and the muscles. You will be resting on a cart or bed and electrodes will be taped to your skin. A stimulator will be held against your skin, which sends out a small electrical charge along the nerve. You may feel a tingle or your muscles may twitch but this shock is not harmful. Each test will take only a few minutes. After the exam the electrodes will be removed and your skin cleaned. The time between the stimulation and response will be recorded to determine how quickly and thoroughly that the impulse is sent. A number of nervous system diseases may reduce the speed of this impulse. Each nerve test takes just a few minutes to an hour, depending upon how many nerves are being tested.

While the hospital or neurologist's office will give you instructions for the day of the examination, a few general preparations will help. Eat normally and take medication as you usually would. If you are taking a blood thinner, make sure you inform the testing facility and ask the ordering physician about the use of the medication and the timing of the test. Bath or shower the morning of the examination. Avoid bath oils or any skin lotions or emollients the day of the examination.


A typical EMG/NCV of the lower extremity takes approximately 45 minutes. This test is an important tool for diagnosing diseases of the nervous system, you can help ensure the best results if you relax and cooperate with the technicians. Make sure that you ask any questions that you have about the test before it is performed. Your physician will discuss the results with you. If you have any further questions regarding why this test was ordered for you, please ask your physician.



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A nerve conduction study (NCS) involves activating nerves electrically with small safe pulses over several points on the skin, usually on the limbs, and measuring the responses obtained. Usually, the response or signal is measured from the nerve itself or from a muscle supplied by the nerve being activated. This gives information about the state of health of the nerve, muscle and neuromuscular junction (the portion responsible for communication between the nerve and muscle). A commercial device is normally employed to measure the signals.

Electromyography (also known as needle EMG) involves the measuring of electrical activity within muscles by way of a needle electrode. It is rather similar to having an electrical microphone at the tip of the needle. Muscles are electrically active organs, and the signals and patterns of signals can lend additional information regarding the state of the muscle as well as the nerve supplying it.

In Australia, the person responsible for these tests is a neurologist, who frequently has had further training in the subspecialty of clinical neurophysiology.
A doctor may recommend that you undergo this test. There are a wide variety of conditions that are assessed with this technique. Quite frequently, the examination is requested because the patient is experiencing symptoms that suggest some problem with the nerves (numbness, tingling, weakness or pain) or muscles (weakness or pain), even though the physical examination is normal. Indeed, in many cases, there is no abnormality seen and the test can then be reassuring, but it cannot detect all conditions. In general terms, the test is useful for detecting if there is a significant abnormality, but this is also often easier when there is a definite clinical abnormality. In such cases, the test can help clarify what the problem is, although usually, unless the nerve problem is a common entrapment (site of compression), other tests may be required to ascertain the exact nature of the problem.
There are several types of nerves but generally speaking, the two major types are motor and sensory nerves. Motor nerves carry signals from the brain to the muscle to enable contraction and movement, and sensory nerves relay information to the brain. When the nerve is stimulated with metal electrodes (metallic patch/es that can conduct signals), a response can be measured by surface (on the skin) electrodes some distance away in sensory nerves overlying the nerve itself. For the motor nerves, the response is usually detected over the muscle that is activated by that nerve. In this fashion, results can reveal information about the size and speed of the electrically conducted impulse. The size usually reveals the number of nerve fibres present and the speed, the integrity of the myelin (insulating membrane around the nerve ‘axon’ or cable). This is why the word ‘conduction’ is used.
You will be given instructions on how to prepare for the test. You should not use creams or emollients on your hands and feet (the most common sites of your nerve tests) on the day of the test, and preferably since your last shower or bath. Generally speaking, there are no other preparations of note.

Please advise the neurologist performing the test if you have a pacemaker or other similar devices. If you are taking warfarin, heparin or some other medication to thin your blood, and if you are having a needle EMG test, you should advise both your GP and the neurologist. A measurement of how thin your blood is may be important before that test can be performed.
The NCS procedure is usually very safe and is non-invasive. Firstly, you will be told how to position yourself and the skin area will be prepared. Then some electrodes will be attached to your skin and you will be forewarned when to expect the stimulation. Many people are understandably anxious about the intensities of the small safe electrical pulses that are passed via the skin, but usually relax quickly when they know what to expect. It is faily important that you remain relaxed for the recordings to minimise the ‘noise’ (interference) in the recordings from excessive muscular activity.
Here, a small needle is inserted through the skin into a muscle belly. Sterilisation of the skin and a local anaesthetic is not generally required. Usually the consultation and procedure takes about 30-45 minutes in all. More complicated assessments may demand more time.
Following the test, you will be allowed to put on your garments and shoes. It should be noted that the final interpretation of the clinical meaning of the test rests with the clinician who ordered the test. This is because they can put together the whole picture. For this reason, the neurologist performing the test can only give you limited information about the meaning of the results, and may not even be able to provide any information on the next step or any possible treatments because they are unaware of all the other clinical information.


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Barium tests are used to help see the outline of the upper parts of the gut (gastrointestinal tract) such as the gullet (oesophagus), stomach and upper gut (small intestines). The gut (gastrointestinal tract) does not show up very well on ordinary X-ray pictures. However, if you drink a white liquid that contains a chemical called barium sulfate, the outline of the upper parts of the gut (oesophagus, stomach and small intestines) shows up clearly on X-ray pictures. This is because X-rays do not pass through barium.

Depending on what part of your gut is being looked at, you may have one or more of the tests listed below. In each test, the barium coats the lining of the gut being tested. Therefore, abnormalities in the lining or structure of the gut can be seen on the X-ray pictures. In each of the following tests, several X-ray pictures are taken using low-dose X-rays. The total amount of radiation for each test is quite small and thought to be safe. The X-ray machine is usually linked to a TV monitor. Still pictures, or a video recording of X-ray pictures taken in quick succession, can be taken if necessary.

In this test you drink some barium liquid. The barium liquid is often fruit-flavoured so it is pleasant to drink. You stand in front of an X-ray machine whilst X-ray pictures are taken as you swallow. This test aims to look for problems in the gullet (oesophagus). These include a narrowing (stricture), hiatus hernias, tumours, reflux from the stomach, disorders of swallowing, etc. You will usually be asked not to eat or drink for a few hours before this test. A barium swallow test takes about 10 minutes.

This is similar to a barium swallow (above). However, it aims to look for problems in the stomach and the first part of the gut (small intestine), known as the duodenum. These problems may include ulcers, small fleshy lumps (polyps), tumours, etc. You drink some barium liquid but you then lie on a couch whilst X-ray pictures are taken over your tummy (abdomen). It may take a little longer to do than a barium swallow.

So that the barium coats all around the lining of the stomach, the doctor doing the test (radiologist) may do one or more of the following:

Ask you to swallow some bicarbonate powder and citric acid before swallowing the barium. These 'fizz up' when they mix in the stomach and make some gas. (You may have to resist the urge to burp.) The gas expands the stomach and duodenum and also pushes the barium to coat the lining of the stomach and duodenum. This makes the X-ray pictures much clearer. It is the shape and contours of the lining of the stomach and duodenum which need to be seen most clearly on the pictures.

Ask you to turn over on to your stomach on the couch. Various X-ray pictures may be taken whilst you are in different positions. You may be given an injection of a drug that makes the muscles in the stomach and gut relax.You will usually be asked not to eat anything for several hours before this test. (Food particles in the gut can make it difficult to interpret the X-rays.) However, you may be allowed sips of water up to two hours before the test.


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A Doppler ultrasound, also called a Color Doppler test is a non-invasive test that can be used to estimate your blood flow through blood vessels. It helps doctors evaluate blood flow through major arteries and veins, such as those of the arms, legs, and neck. It can show blocked or reduced flow of blood through narrow areas in the major arteries of the neck that could cause a stroke. It also can reveal blood clots in leg veins (deep vein thrombosis, or DVT) that could break loose and block blood flow to the lungs (pulmonary embolism). During pregnancy, Doppler ultrasound may be used to look at blood flow in an unborn baby (foetus) to check the health of the foetus. 

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Color Doppler is an ultrasound-based diagnostic imaging technique used to visualize subcutaneous body structures including tendons, muscles, joints, vessels and internal organs for possible Pathology or Lesions. Colour Doppler is also used for the following applications:-

Carotid Colour Doppler to detect risk of stroke and paralysis by   evaluating the vessels   in the neck that supply blood to the brain.  Peripherial Arterial Colour Doppler.

Peripherial Venous Colour Doppler for detection of Deep Vein Thrombosis (DVT).

Renal Doppler (especially for hypertensive patients and diabetics).

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Computed Tomography or CT Scan is one of the advanced X-ray procedures. Different from the usual X-ray, CT scan employs multiple X-ray beams and creates a detailed, 3D-like image of the body parts. CT scan of chest—also CT scan thorax—focuses on lungs and is designed for identification of various lung-related disorders. Because CT scan chest gives elaborated images of lungs, it detects and predicts the presence of lung cancer at early stages. A CT scan of abdomen provides the details of the blood vessels, bones and organs in the abdominal cavity.

Let your physician know if you have particular allergies, are pregnant, have diabetes or weigh

more than 135 kg because CT scanners have a weight limit.

Your physician may ask you to do the following prior to the scan:

1. fast for 2–4 hours,

2. stop taking particular medicines,

3. drink a large glass of oral contrast (chemicals to get better images) wait for 60–90

minutes,

4. wear a loose clothing that is comfortable and

5. remove items like dentures, jewellery, hair clips, hearing aids, eyeglasses, etc.

Depending on the type of CT scan – chest/upper abdomen, the contrast may be:

1. delivered through a vein in your forearm or hand,

2. given via the rectum using an enema or

3. taken orally in a liquid form.

CT scan is done for the following: Chest: analysing the abnormalities in the chest; detecting lung cancers or tumours and blood clots or internal injuries; monitoring the effect of lung cancer drugs on cancer; etc. Abdomen: detecting pain or a mass in the abdomen; locating kidney stones; diagnosing cancers, appendicitis, or Crohn’s disease; etc.



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Triphasic spiral liver Computed Tomography (CT) is a standardized procedure for the detection and characterization of a large variety of benign and malignant liver lesions. This helps in the decline of mortality and morbidity rates among patients with liver disease. Spiral computed tomography has gained acceptance as the preferred computed tomography technique for routine liver evaluation because it provides image acquisition at peak enhancement of liver parenchyma during a single breath hold. In addition fast data acquisition allows successive scanning of the entire liver at different intervals after injection of the iodinated contrast material, thus creating the possibility of multiphase liver computed tomography.

Triphasic CT scan is a good non-invasive tool and can be used as first line imaging modality for differentiating benign and malignant focal liver lesions. Benign lesions like haemangioma can be reliably differentiated from malignant liver lesion; therefore unnecessary biopsies can be avoided. It is also particularly useful for hypervascular lesions which can be easily missed on routine CT scanning.



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Computed tomography (CT) perfusion of the head uses special x-ray equipment to show which areas of the brain are adequately supplied with blood (perfused) and provides detailed information about blood flow to the brain. CT perfusion is fast, painless, noninvasive and accurate. It’s a useful technique for measuring blood flow to the brain, which may be important for treating stroke, brain blood vessel disease and brain tumors.

Computed tomography (CT) perfusion imaging shows which areas of the brain are adequately supplied or perfused with blood and provides detailed information on delivery of blood or blood flow to the brain.

CT perfusion scanning is a noninvasive medical test that helps physicians diagnose and treat medical conditions.

CT scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body. These cross-sectional images of the area being studied can then be examined on a computer monitor, printed or transferred to a CD.

CT scans of internal organs, bones, soft tissue and blood vessels provide greater clarity and reveal more details than regular x-ray exams.

In many ways CT scanning works very much like other x-ray examinations. Different body parts absorb the x-rays in varying degrees. It is this crucial difference in absorption that allows the body parts to be distinguished from one another on an x-ray film or CT electronic image.

In a conventional x-ray exam, a small amount of radiation is aimed at and passes through the part of the body being examined, recording an image on a special electronic image recording plate. Bones appear white on the x-ray; soft tissue, such as organs like the heart or liver, shows up in shades of gray, and air appears black.With CT scanning, numerous x-ray beams and a set of electronic x-ray detectors rotate around you, measuring the amount of radiation being absorbed throughout your body. Sometimes, the examination table will move during the scan, so that the x-ray beam follows a spiral path. A special computer program processes this large volume of data to create two-dimensional cross-sectional images of your body, which are then displayed on a monitor. CT imaging is sometimes compared to looking into a loaf of bread by cutting the loaf into thin slices. When the image slices are reassembled by computer software, the result is a very detailed multidimensional view of the body's interior.

Refinements in detector technology allow nearly all CT scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, allow thinner slices to be obtained in a shorter period of time, resulting in more detail and additional view capabilities.


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USG scan for Follicular Monitoring is done to study ovarian follicles that are used to identify ovulation of egg. For couples planning for pregnancy, ovulation period is the important period to try on, for conception to happen. Out of many ways available, the most reliable way to understand the ovulation is Follicular monitoring. It’s an endovaginal scan carried to study the ovaries, uterus and uterus lining. Looking at ovaries, the growth of follicles inside ovaries can be assessed giving a chance to predict the ovulation and also look if the womb is getting ready for pregnancy.

With follicular monitoring, you will get to know the growth of follicles, the approximate rupture period of follicles and hence can predict the ovulation period thereby have an intercourse happen at the right time for conception to take place. The womb if not yet ready for pregnancy can be treated by some supplements prescribed by the doctors.

This scan is carried out in a slightly dark examination room. You will have to undress down from your waist while you get covered by a sheet. Now you will be asked to position yourself lying down on your back on a special bed with your knees bent. Once you position yourself comfortably; the transducer, a sterile lubricated covered electronic device, is gently inserted into your vagina to look at the uterus and ovaries. Depending on how relaxed the patient is, the test takes up to 15 minutes.


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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels.


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17-ketosteroids are substances that form when the body breaks down male steroid sex hormones called androgens and other hormones released by the adrenal glands in males and females, and by the testes in males.

A 24-hour urine sample is needed. You will need to collect your urine over 24 hours. Your health care provider will tell you how to do this. Follow instructions exactly to ensure accurate results.

Your provider will ask you to temporarily stop any medicines that may affect the test results. Be sure to tell your provider about all the medicines you take. These include:

1.Antibiotics

2.Aspirin (if you are on long-term aspirin)

3.Birth control pills

4.Diuretics (water pills)

5.Estrogen..


Increased levels of 17-ketosteroids may be due to:

1.Adrenal gland problems such as tumor, Cushing syndrome

2.Imbalance of sex hormones in females (polycystic ovary syndrome)

3.Ovarian cancer

4.Testicular cancer


Decreased levels of 17-ketosteroids may be due to:

1.Adrenal glands not making enough of their hormones (Addison disease)

2.Kidney damage

3.Pituitary gland not making enough of its hormones (hypopituitarism)

4.Removal of the testicles (castration)

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There are different types of cortisol tests that may be performed, including blood, saliva, and urine tests. The urine test is done over a period of 24 hours.

The cortisol urine test tends to be more comprehensive than the other types of cortisol tests. It measures the total amount of cortisol excreted into the urine over a 24-hour period. Blood tests or saliva tests, however, only measure cortisol levels at a particular time of day. Some people also find blood tests to be stressful, and since the body releases more cortisol during times of stress, the results may not be as precise. In some cases, your doctor may order both a cortisol urine test and another type of cortisol test to obtain more accurate results.


Cushing’s syndrome is a collection of symptoms associated with high cortisol levels. The most common symptoms include:


1.Increased urination

2.Increased thirst

3.Fatty tissue deposits, especially in the midsection and upper back

4.Pink or purple stretch marks on the skin

5.Weight gain

6.Fatigue

7.Muscle weakness

8.Thinning skin that bruises easily

9.Women may have irregular periods and excess facial and chest hair. Children may show delayed physical or cognitive development.


The symptoms of low cortisol levels often emerge slowly. At first, they may only appear during times of extreme stress, but they’ll gradually increase in intensity over several months. Potential symptoms include:


1.Weight loss

2.Fatigue

3.Dizziness

4.Fainting

5.Muscle weakness

6.Abdominal pain

7.Diarrhea

8.Constipation


When cortisol levels abruptly drop to life-threatening levels, an acute adrenal crisis may occur. The symptoms of an acute adrenal crisis include:


1.Darkening of the skin

2.Extreme weakness

3.Vomiting

4.Diarrhea

5.Fainting

6.Chills

7.Loss of appetite

8.Sudden onset of severe pain in the lower back, abdomen, or legs.


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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.


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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.



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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.

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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.


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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.


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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.



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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.


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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.



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CA 19-9 (carbohydrate antigen 19-9, also called cancer antigen 19-9 or sialylated Lewis (a) antigen) is a tumor marker that is used primarily in the management of pancreatic cancer. CA 19-9 is an antigen defined by monoclonal antibody binding to CA 19-9, the tumor surface marker Sialyl-Lewis A.

CA 19-9 can be elevated in many types of gastrointestinal cancer, such as colorectal cancer, esophageal cancer and hepatocellular carcinoma.Apart from cancer, elevated levels may also occur in pancreatitis, cirrhosis,and diseases of the bile ducts.It can be elevated in people with obstruction of the bile ducts.

In patients who lack the Lewis antigen (a blood type antigen on red blood cells), which is about 10% of the Caucasian population, CA 19-9 is not expressed,even in those with large tumors.This is because of a deficiency of a fucosyltransferase enzyme that is needed to produce CA 19-9 as well as the Lewis antigen.


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CA15-3 is a tumour marker. It is used to check how breast cancer treatment is working and look for cancer that has come back, or recurred, after treatment.

If you are diagnosed with breast cancer that has spread to other parts of the body, or metastasized, you may have this test, along with other tests such as hormone receptor testing and HER2 status testing.

CA15-3 is not measured for early stage breast cancer because the levels of this protein are rarely higher than normal at this stage.

A CA15-3 test is a blood test done with a needle. It’s usually done in a private lab or hospital lab. You don’t need to do anything special to prepare.

CA15-3 levels can be higher than normal with cancerous and non-cancerous conditions. CA15-3 is most often increased in breast cancer that has spread to other parts of the body.

In general, the higher the level of CA15-3 in the blood, the more cancer there is in the body. The levels are highest when breast cancer has spread to the bones, the liver or both. If the level of CA15-3 goes down or returns to normal, it may mean that treatment is working. If levels increase over time, it may mean that the cancer is not responding well to treatment, is still growing or is coming back (recurring).

CA15-3 may be higher than normal in cancer of the lung, pancreas, ovary and prostate, but these levels are not as high as with breast cancer.

Non-cancerous conditions that increase CA 15-3 include endometriosis, pelvic inflammatory disease and liver disease. It can also be increased during pregnancy. With these conditions, CA15-3 levels usually only go so high. They don’t usually keep climbing over time.



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Cancer antigen 27.29 (CA 27.29) is a blood test that is done specifically for people with breast cancer. It is one of the breast cancer tumor markers that can be used to monitor the course of the disease. One version of this test is called the " truquant BR radioimmunoassay test."
CA 27.29 is an antigen—that is, a specific type of protein present on the surface of cells and is produced by a gene called MUC-1.
CA-27 is a "glycoproteins," (glyco means sugar) and may be present on the surface of epithelial cells like breast cancer cells.  Breast cancer cells can shed copies of the CA 27.29 protein into the bloodstream too.
A blood CA 27.29 measurement is ordinarily less than 40 U/ml. With cancer, Ca-27 levels may increase, the higher the value, the greater the likelihood this may indicate the presence of cancer.
It can help to break down the different ways in which the CA 27.29 biomarker test may be used:

1.Diagnosis—This test is not often done to diagnose breast cancer, at least not alone. It's mentioned here to make note that the CA 27.29 test is the only blood test used specifically to determine the presence of breast cancer cells. If you have or think you may have early stage breast cancer, this test may be performed to help make your diagnosis.

2.To monitor treatments—The CA 27.29 test is often done to monitor your response to breast cancer treatments. If your levels rise, it may indicate that your cancer is coming back or progressing, and it may be necessary to adjust your treatments accordingly.  If your levels fall, it may indicate that your treatment is effectively killing your cancer.

3.To look for early recurrence—If your treatment for breast cancer has been completed, this test may be done at regular intervals to detect an early recurrence of your cancer. An elevation of CA 27.29 occurs, on average, around five months before a recurrence is evident based on symptoms or imaging studies alone. Despite this, there is still debate over whether or not finding a recurrence of cancer before symptoms makes a difference in the treatment and, ultimately, the outcome of the disease.

4.To monitor metastatic cancer (status check)—The test may help those with metastatic breast cancer know if their cancer is progressing. That said, elevated levels can linger for some time and, in one study, 30 percent of people had elevated levels which persisted for two to three months after the onset of effective treatment.

This test is not recommended as a method of screening for breast cancer, or as a way to diagnose breast cancer alone, as it lacks what scientists refer to as predictive value.
Moreover, physicians vary tremendously in their practice of ordering this test. Some physicians put little emphasis on the test, whereas others routinely order it on a regular basis.
It's important to note the limitations of the CA 27.29 test. In monitoring the treatment of metastatic breast cancer—how this test is most commonly used—it’s important to again note that elevated levels of CA 27.29 may persist for up to three months after treatment has been completed.
In other words, if you have the test done a few months after finishing treatment, the levels could still be high even if you are responding well to the treatment.
Since the CA 27.29 test is the only test used specifically to detect the presence of breast cancer cells, it would seem that it would be ordered more often to screen for breast cancer.
Yet, as noted, the test lacks predictive value in determining the presence of a breast cancer. 
Positive predictive value refers to the likelihood that you have a disease if you test positive for the disease. There are many tests in medicine that would seem to make sense as a method of screening for a disease, yet in studies, lack the accuracy to make a difference in survival rates.
The final limitation is when the test is used to find a recurrence. There is much debate over whether finding a recurrence of breast cancer early could make a difference. While, at first glance, it would seem that there would be benefits to this practice, studies have not found that survival rates improve when a recurrence of breast cancer is found early.
Part of the confusion lies in the goals of treatment for early-stage breast cancer versus metastatic breast cancer. With early stage breast cancer, the goal is usually to treat the disease aggressively in order to cure the cancer (or at least keep it from ever returning.) Aggressive treatment, however, is not the goal of metastatic breast cancer (though this may change in the near future) as it hasn't seemed to make a difference in survival rates. Instead, the goal is to usually use the least amount of treatment possible to control the disease. 

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CA 72 - 4 test is performed on a sample of blood to measure level of CA 72 - 4 in blood.It is performed to detect Gastrointestinal Cancer

Also known as GI Cancer Antigen 72-4 Monoclonal Antibody Blood, GI Cancer CA 72-4 Monoclonal Antibody Blood, GI Cancer Marker 72-4 Monoclonal Antibody Blood, GI Cancer Antigen 72-4, GI Cancer CA 72-4, GI Cancer Marker 72-4.

No special preparation is needed for CA 72 - 4. Inform your doctor if you are on any medications or have any underlying medical conditions or allergies before undergoing CA 72 - 4. Your doctor depending on your condition will give specific instructions.

CA 72 - 4 is done using Monoclonal Antibody method on a Blood sample. A blood sample of minimum 5mL is required for this test.

The normal result for CA 72 - 4 for CA 72 - 4 is < 7U/ml for Unisex gender and for All age groups.

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Transcortin, also known as corticosteroid-binding globulin (CBG) or serpin A6 is a protein that in humans is encoded by the SERPINA6 gene. It is an alpha-globulin.

This gene encodes an alpha-globulin protein with corticosteroid-binding properties. This is the major transport protein for glucocorticoids and progestins in the blood of most vertebrates. The gene localizes to a chromosomal region containing several closely related serine protease inhibitors (serpins) which have evolved by duplication events.


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Coxsackie viruses are enteroviruses belonging to the Picornavirus family, which is comprised of strains A and B as well as various serotypes A1-22, 24, and B1-6. Following incubation, a variety of well known diseases can manifest themselves within the host. Coxsackie A is commonly associated with hand, foot, and mouth disease, which primarily affects children younger than 10 years of age. In rare cases, Coxsackie infections may produce mild or subclinical symptoms, yet most infections trigger the onset of flu-like ailments but may include symptoms of other diseases along the lines of pneumonia, hepatitis, and meningitis.
A positive test result does not necessarily indicate current or recent infection as antibodies to Coxsackie species can be detected in uninfected individuals due to moderate passive exposure to infected hosts. It is, therefore, crucial that results from all Coxsackie A serologies correlate with the clinical history of the patient and all other data available to the physician. Samples collected at the early stage of infection (primarily in children) may not yield detectable antibodies. If a recent infection is suspected, a second specimen should be collected 10 to 20 days following the initial collection and tested.
Coxsackie A viruses are mainly associated with human hand, foot and mouth disease.
Coxsackie Bviruses can cause mild signs and symptoms, similar to a "cold", but these viruses also can lead to more serious diseases, including myocarditis (inflammation of the heart); pericarditis (inflammation of the sac lining the heart); meningitis (inflammation of the membranes that line the brain and spinal cord); and pancreatitis (inflammation of the pancreas).
Infection is common but most frequent in summer and autumn in temperate climates but all year round in the tropics. They tend to affect those under 16 but adults are also affected. Spread is usually from the faeco-oral route with an incubation period of 2 to 6 days.

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Cryptococcosis is an invasive fungal infection caused by Cryptococcus neoformans or C gattii. C neoformans has been isolated from several sites in nature, particularly weathered pigeon droppings. C gatti was previously only associated with tropical and subtropical regions; however, more recently this organism has also been found to be endemic in British Columbia and among the Pacific Northwest United States, and is associated with several different trees species.

Infection is usually acquired via the pulmonary route. Patients are often unaware of any exposure history. Approximately half of the patients with symptomatic disease have a predisposing immunosuppressive condition such as AIDS, steroid therapy, lymphoma, or sarcoidosis. Symptoms may include fever, headache, dizziness, ataxia, somnolence, and cough. While the majority of C neoformans infections occur in immunocompromised patient populations, C gattii is has a higher predilection for infection of healthy hosts.(1,2)

In addition to the lungs, cryptococcal infections frequently involve the central nervous system (CNS), particularly in patients infected with HIV. Mortality among patients with CNS cryptococcosis may approach 25% despite antibiotic therapy. Untreated CNS cryptococcosis is invariably fatal. Disseminated disease may affect any organ system and usually occurs in immunosuppressed individuals.

The presence of cryptococcal antigen in any body fluid (serum or cerebrospinal fluid) is indicative of cryptococcosis. Specimens that are positive by the lateral flow assay screen are automatically repeated with the same method utilizing dilutions in order to generate a titer value.

Disseminated infection is usually accompanied by a positive serum test.

Higher Cryptococcus antigen titers appear to correlate with more severe infections. Declining titers may indicate regression of infection. However, monitoring titers to cryptococcal antigen should not be used as a test of cure or to guide treatment decisions, as low level titers may persist for extended periods of time following appropriate therapy and the resolution of infection.(3)

A negative result does not preclude diagnosis of cryptococcosis, particularly if only a single specimen has been tested and the patient shows symptoms consistent with cryptococcosis. 

A positive result is indicative of cryptococcosis, however all test results should be reviewed in light of other clinical findings.

Testing should not be performed as a screening procedure for the general populations and should only be performed when clinical evidence suggests the diagnosis of cryptococcal disease.

Testing hemolyzed serum specimens may lead to false-negative results due to the high background color on the lateral flow assay strip.

Although rare, extremely high concentrations of cryptococcal antigen can result in weak test lines and in extreme instances, yield negative test results.



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Cysticercosis is caused by infection with the larval form (cysticercus) of the pork tapeworm Taenia solium. Clinical manifestations of cysticercosis most commonly result from the lodging of cysticerci in brain and neural tissue. Common symptoms of neurocysticercosis include seizures and convulsions. Antibodies from other parasitic infections, particularly echinococcosis, may crossreact in the cysticercus IgG ELISA. Confirmation of positive ELISA results by the Cysticercosis IgG antibody western blot (test code 34279X) is recommended.



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Fungal Smear test is performed on a sample of skin to measure the level of Fungal Smear (Skin) in the skin.It is performed to confirm Fungal Infection of Skin and also during the treatment and after the treatment of Fungal Infection of Skin and Immunosuppressive Condition.

No special preparation is needed for Fungal Smear Koh Test Skin. Inform your doctor if you are on any medications or have any underlying medical conditions or allergies before undergoing Fungal Smear Koh Test Skin. Your doctor depending on your condition will give specific instructions.

The normal result for Fungal Smear Koh Test Skin for Fungal Smear (Skin) is A normal KOH test result shows no Fungi. A stained slide fluoresce is observed if positive for fungus. A positive test indicates Fungal infection but it cannot identify the organism. If KOH test is positive then, specimen is inoculated into culture media. for Unisex gender and for All age groups.


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Hepatitis A is a highly contagious liver infection caused by the hepatitis A (HAV). It is one of several various causes of hepatitis, a condition characterized by inflammation and enlargement of the liver. This test detects antibodies in the blood that are produced by the immune system in response to a hepatitis A infection.

Hepatitis A is one of five "hepatitis viruses" identified so far, including B, C, D, and E, that are known to cause the disease. While hepatitis A can cause a severe, acute disease that typically lasts 1 to 2 months, it does not cause a chronic infection as do some of the other hepatitis viruses.

Hepatitis A is spread, most commonly, from person-to person through stool (fecal) contamination or by ingesting food or water contaminated by the stool of an infected person (a foodborne illness). Recognized risk factors for hepatitis A include close contact with an infected person, international travel, household or personal contact with a child who attends a child care center, household or personal contact with a newly arriving international adoptee, a recognized foodborne outbreak, men who have sex with men, and use of illegal drugs.

Although there are many causes of hepatitis, the symptoms remain the same. In hepatitis, the liver is damaged and unable to function normally. It cannot process toxins or waste products such as bilirubin for their removal from the body. During the course of the disease, bilirubin and liver enzyme levels in the blood can increase. While tests such as bilirubin or a liver panel can tell a health practitioner that someone has hepatitis, they do not identify the cause. Antibody tests for hepatitis viruses may help determine the cause.

There are two different classes of hepatitis A antibody that may be tested, IgM and IgG. When a person is exposed to hepatitis A, the body first produces hepatitis A IgM antibodies. These antibodies typically develop 2 to 3 weeks after first being infected (and are detectable before the onset of symptoms) and persist for about 3 to 6 months. Hepatitis A IgG antibodies are produced within 1 to 2 weeks of the IgM antibodies and usually persist for life.

1.Because hepatitis A IgM antibodies develop early in the course of infection, a positive hepatitis A IgM test is usually considered diagnostic for a current or recent infection of hepatitis A. This test may be done as part of an acute viral hepatitis panel used to determine which virus is causing symptoms when viral hepatitis is suspected.

2.An HAV IgG test may be used to help determine if a person has been infected in the past and has some immunity to the disease.

3.A total hepatitis A antibody test detects the presence of both the IgM and IgG antibodies, thus can identify current and past infections.

A vaccine that prevents hepatitis A has been available since 1995. Historically, infection rates varied cyclically, with nationwide increases every 10-15 years. However, rates have declined in general since the vaccine was introduced. In 2010, the number of acute hepatitis A cases reported nationwide declined by approximately 53% from about 3,600 in 2006.



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Hepatitis B tests detect substances that reflect a current or previous infection with hepatitis B virus (HBV). Some tests detect viral proteins (antigens) or the antibodies that are produced in response to an infection, while other types of tests detect or evaluate the genetic material (DNA) of the virus. The pattern of test results can identify a person who has a current active infection or one who has immunity as a result of previous exposure.

For details on the various tests, see the table under "How is it used?"

Hepatitis is a condition characterized by inflammation and enlargement of the liver. It has several various causes, one of which is infection by a virus. HBV is one of five "hepatitis viruses" identified so far that are known to mainly infect the liver. The other four are hepatitis A, hepatitis C, hepatitis D, and hepatitis E.

HBV is spread through contact with blood or other body fluids from an infected person. Exposure can occur, for example, through sharing of needles for IV drug use or through unprotected sex. People who live in or travel to areas of the world where hepatitis B is prevalent are at a greater risk. Rarely, mothers can pass the infection to their babies, usually during or after birth. The virus is not spread through casual contact such as holding hands, coughing or sneezing. However, the virus can survive outside the body for up to seven days, including in dried blood, and can be passed by sharing items such as razors or toothbrushes with an infected person.

Effective hepatitis B vaccines have been available in the U.S. since 1981, and beginning in 1991, health care providers in the U.S. began vaccinating infants at birth. Still, the Centers for Disease Control and Prevention (CDC) estimates that between 804,000 and 1.4 million people in the U.S. are infected with the virus, most of whom are not aware that they are infected.

The course of HBV infections can vary from a mild form that lasts only a few weeks to a more serious chronic form lasting years. Sometimes chronic HBV leads to serious complications such as cirrhosis or liver cancer. Some of the various stages or forms of hepatitis B include:

  • Acute infection — presence of typical signs and symptoms with a positive screening test
  • Chronic infection — persistent infection with the virus detected by laboratory tests accompanied by inflammation of the liver
  • Carrier (inactive) state — persistent infection but no liver inflammation (a carrier is someone who may appear to be in good health but harbors the virus and can potentially infect others)
  • "Cleared" infection — no longer has any evidence of infection; viral antigen and DNA tests are negative and no signs or symptoms of liver inflammation (although, in many cases, the virus is present in an inactive state in the liver)
  • Reactivation — return of HBV infection with liver damage in a person who was a carrier or who had "cleared" infection; this most commonly occurs in persons treated with chemotherapy for cancer or with drugs that suppress the immune system used to treat autoimmune diseasesor following an organ transplant.

Though a potentially serious infection, acute HBV infection usually resolves on its own in most adults. Infants and children tend to develop a chronic infection more often than adults. Approximately 90% of infants infected with HBV will develop a chronic condition. For children between the ages of one and five, the risk of developing chronic hepatitis drops to between 25% and 50%. Over the age of five, only 6% to 10% of HBV infections become chronic.

The vast majority of those with chronic infections will have no symptoms. For acute infections, the symptoms are very similar to those of other types of acute hepatitis. Symptoms include fever, fatigue, nausea, vomiting, and jaundice. With acute hepatitis, the liver is damaged and is not able to function normally. It may not process toxins or waste products such as bilirubin for their removal from the body. During the course of disease, bilirubin and liver enzyme levels in the blood may increase. While tests such as bilirubin or a liver panel can tell a health practitioner that someone has hepatitis, they will not indicate what is causing it. Tests that detect infection with a hepatitis virus may help determine the cause.

Hepatitis B testing can be used to screen for infection in the absence of symptoms, to determine whether infection is acute or chronic, or to monitor a chronic infection and the effectiveness of treatment. Initial testing may include the following, often performed together as a panel of tests:

  • Hepatitis B surface antigen
  • Hepatitis B surface antibody
  • Total hepatitis B core antibody (IgM and IgG)

Additional or follow-up testing may include:

  • IgM antibody to hepatitis B core antigen
  • Hepatitis B e-antigen
  • Anti-hepatitis B e antibody
  • Hepatitis B viral DNA
  • Hepatitis B genotyping

Two tests, hepatitis B surface Ag and hepatitis B core antibody, IgM, may be performed as part of an acute viral hepatitis panel.



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There are two types of pregnancy tests; one uses a urine sample, the other a sample of blood. Both tests detect the presence of a hormone called human chorionic gonadotropin (hCG). This hormone is produced by the placenta shortly after the embryo attaches to the uterine lining and builds up rapidly in your body in the first few days of pregnancy. It is this rapid shift in hormones that triggers most of your pregnancy symptoms.

URINE TEST  :-Urine tests can be performed in two different ways and these can be performed at home or in a clinic. One way involves collecting your urine in a cup and dipping a stick into the urine or putting urine into a special container with an eyedropper. Another option involves placing a stick into your urine stream and catching your urine in midstream.

Tests vary in how long you have to wait to get a result. You will be looking for a change in color, a line, or a symbol (like a plus or minus). The newer digital pregnancy test offered by Clearblue Easy makes reading your results simple: the window will either show the words “not pregnant” or “pregnant”.


BLOOD TEST:- There are two types of blood tests. A quantitative blood test measures the exact amount of hCG in the blood, and a qualitative hCG blood test gives a simple yes or no answer to whether you are pregnant or not.


Advantages of having a blood test done:

1.Can detect a pregnancy earlier than a urine test at about 7-12 days from possible conception (but if a negative result is received, a test should be repeated if a period is missed.)

2.Can measure the concentration of hCG hormone in your blood (this is useful information for your healthcare provider in tracking certain problems in pregnancy)


Disadvantages to having a blood test done:

1.More expensive than a urine test (price depends on cost of doctor’s visit and lab fees)

2.Takes longer to get result

3.Must be done in a doctor’s office.


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Mycobacterioses (tuberculosis, leprosy, atypical mycobacterioses, paratuberculosis, and perhaps

Crohn’s Disease) are the infectious diseases of men and animals with the largest diffusion on earth.

The infectious agents of tuberculosis are acid-resistant rod-like formed bacteria of the family

Mycobacteriaceae, genus Mycobacterium. The germ was detected by Robert Koch in 1882. Owing

to the very high infectious power of pathogenic mycobacteria, early diagnosis is essential to

prevent spreading of the disease. Convergence of various approaches are necessary to control the

mycobacterioses, immune reactions and bacterial shedding being variable during the diseases.

However, usual diagnostic procedures were up to now unsatisfactory and did not allow to

distinguish among different mycobacterial species. The illness is normally transferred by droplets

of saliva from infected persons. The target of the infection are mostly the lungs, but also other

organs like the brain, intestinal tract, bones, lymph nodes and kidneys can be afflicted.

Tuberculosis is not only found in developing countries with 8 million of new infections yearly, but

also in industrialized civilizations, as an actual disease with some thousands of cases yearly.

Without treatment, the disease leads in 50% of the cases to death within less than two years.

Clinical symptoms are fatigue, loss of weight, lack of appetite, light fever, nocturnal sweat and

pain in the chest. Especially patients with HIV are threatened by tuberculosis due to their impaired

immune system. A vaccination with living attenuated bacteria is possible (BCG = Bacille Calmette

Guérin). This is mostly done with newborn or young children. With older patients, before the

vaccination there is normally performed the tuberculin test (Pirquet or Mantoux), where a small

amount of tuberculin is injected under the skin. In a positive case, there exist antibodies against

Mycobacteria, and a vaccination is not necessary. Up to recently, there have not existed any

serological methods to detect tuberculosis antibodies in serum. The only available procedure was

besides the skin tuberculin test the direct microscopical identification of the dyed bacteria in

sputum. Meanwhile specific antigens have been prepared either by purification of natural material

or by recombinant methods. This ELISA test kit for the determination of IgG antibodies uses a

cocktail of highly pure proteins in order to determine an immune response against the bacteria in

human serum. A fresh or chronically active infection can be diagnosed by IgA and IgM tests,

which are also available. 




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In order to establish a rapid and stable method for diagnosis of Mycobacterium tuberculosis infection and minimize the side effects of delayed diagnosis on patients and health system, a cross sectional study was carried out. Since, the infection rate with this bacteria increasing and one of the reasons for this increase is long process of laboratory identification, therefore establishing new diagnosis methods could decrease disease rate. To achieve this aim, collected sputum and blood specimens from 50 patients with clinical suspicion of pulmonary tuberculosis were studied with both traditional, acid-fast stain (AFB) and culture method compare to Enzyme-linked immunosorbent assay (Elisa) (IgG and IgM) and Polymerase Chain Reaction (PCR) methods. The sensitivity and specificity of all methods were determined by using the PCR results as the gold standard. The overall sensitivity, specificity, positive predictive value and negative predictive value of AFB were 17.64, 100, 100 and 70.12%. These values for culture method was 29.41, 100, 100 and 73.33% and for IgG antibody were 66.7, 81.81, 64.7 and 81.81% and IgM antibody were 70.58, 90.9, 80 and 85.71%, respectively. It was concluded that maximum sensitivity and specificity can be achieved by PCR method.

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This test provides a measure of myelin fragments released into the spinal fluid as a result of the breakdown of myelin during acute phases in the course of demyelinating disease of the CNS (most common example of which is multiple sclerosis). MBP is a 169 amino acid peptide that comprises 30% of the protein of the myelin sheath. While MBP is a useful test in the diagnosis of active MS, some patients with this disorder will have normal limits, especially during remissions, and elevations may be seen in other disorders as well. Therefore, tests such as CSF oligoclonal bands and IgG index, which are positive in 90% of MS patients during active disease or remission, are preferred for the initial diagnosis. However, MBP is useful for providing objective evidence of disease activity.

CSF MBP levels were found to decrease to the level of controls in a group of 11 cases of chronic progressive multiple sclerosis patients receiving immunosuppressive therapy (cyclophosphamide and prednisone). These findings suggest that MBP might be used to monitor the hoped for beneficial effect of such therapy in some cases of MS.

It has been suggested that MBP levels in the CSF might be used in the assessment of radiation-induced myelopathy. MS patients in relapse have been shown to have increased interleukin 1 and interleukin 2 production as the result of MBP stimulated peripheral blood mononuclear cells.



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Myoglobin is a small, oxygen-binding protein found in heart and skeletal muscles. It traps oxygen within muscle cells, allowing the cells to produce the energy required for muscular contraction. When heart or skeletal muscle is injured, myoglobin is released into the blood. Elevated levels can be measured within a few hours following an injury.
Myoglobin is filtered from the blood by the kidneys and is released into the urine. Large quantities of myoglobin are toxic to the kidneys. If significant amounts of myoglobin are released into the bloodstream, which can happen after severe trauma or muscle injuries, the excess myoglobin may cause damage to the kidneys and eventually result in kidney failure. Measurement of myoglobin in urine helps to detect this condition.


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Eosinophils from nasal smears can be easily distinguished from other granulocytes when submitted to a cytochemical stain. A careful evaluation of the cytological picture may be of diagnostic value in the differentiation of allergy from super imposed infections, or in the attribution of a cause of asthma in children and adults.While it is well documented that the scope of eosinophil stains goes well beyond screening for allergic rhinitis when evaluating body fluids other than those of nasal origin, for compliance purposes with CLIA regulations, the scope of this procedure is restricted to the examination of nasal secretions. This procedure does not apply to the examination of specimens such as urine, stool, or GI secretions.In non-allergic patients experiencing acute infections, few scattered eosinophils may be noted mixed with neutrophils in the resolution stage of the infection. If the number of eosinophils adds up to portray an allergic response, it is recommended follow- up smears are done to achieve distinction between the 2 cases. In the allergic patient, the eosinophils will increment to large numbers whereas neutrophils will disappear (provided a chronic infection does not complicate the picture). Goblet cells, a constant and reliable feature observed in smears from allergy patients even when eosinophils are not demonstrated. These cells are normally not exfoliated; therefore, they will only be apparent if the specimen was obtained by swabbing the mucosa. Goblet cells are “edematous” columnar epithelial cells that are goblet in form. Their cytoplasm is vacuolated and mostly without cilia. Cells eventually rupture leaving the nucleus behind.

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Enolase is a glycolytic enzyme that catalyzes the conversion of 2-phosphoglycerate to phosphoenolpyruvate. Enolase exists in the form of several tissue-specific isoenzymes, consisting of homo or heterodimers of 3 different monomer-isoforms (alpha, beta, and gamma). Neuron specific enolase (NSE) is a 78 kD gamma-homodimer and represents the dominant enolase-isoenzyme found in neuronal and neuroendocrine tissues. Its levels in other tissues, except erythrocytes, are negligible. The biological half-life of NSE in body fluids is approximately 24 hours.

Due to this organ-specificity, concentrations of NSE in serum or, more commonly, cerebrospinal fluid (CSF), are often elevated in diseases which result in relative rapid (hours/days to weeks, rather than months to years) neuronal destruction. Measurement of NSE in serum of CSF can therefore assist in the differential diagnosis of a variety of neuron-destructive and neurodegenerative disorders. The most common application is in the differential diagnosis of dementias, where elevated CSF concentrations support the diagnosis of rapidly progressive dementias, such as Creutzfeldt-Jacob Disease. NSE might also have utility as a prognostic marker in neuronal injury. There is, for example, increasing evidence that elevated serum NSE levels correlate with a poor outcome in coma, in particular when caused by hypoxic insult.

NSE is also frequently overexpressed by neural crest-derived tumors. Up to 70% of patients with small cell lung carcinoma (SCLC) have elevated serum NSE concentrations at diagnosis, and approximately 90% of patients with advanced SCLC will have serum levels above the healthy reference range. Other neuroendocrine tumors with frequent expression of NSE include carcinoids (up to 66% of cases), islet cell tumors (typically <40% of cases), and neuroblastoma (exact frequency of NSE expression unknown). NSE levels in NSE-secreting neoplasms correlate with tumor mass and tumor metabolic activity. High levels have therefore some negative prognostic value. Falling or rising levels are often correlated with tumor shrinkage or recurrence, respectively.

Serum neuron-specific enolase (NSE) measurement has its greatest utility in the follow-up of patients with tumors of any type that have been shown to secrete NSE. With successful treatment, serum concentrations should fall with a half-life of approximately 24 hours. Persistent NSE elevations in the absence of other possible causes (see Cautions) suggest persistent tumor. Rising levels indicate tumor spread, or in patients who had previously become NSE negative, recurrence.

In the context of a patient with a lung mass, disseminated malignancy of unknown origin or symptoms suggestive of paraneoplastic disease without identifiable tumor, elevated NSE suggests an underlying small cell lung carcinoma (SCLC).


In patients with suspected carcinoid, islet cell tumor, or neuroblastoma, who have no clear elevations in the primary tumor markers used to diagnose these conditions, an elevated serum NSE level supports the clinical suspicion.

1.Carcinoid: chromogranin A, urinary 5-hydroxyindoleacetic acid, serum/blood 5-hydroxytryptamine

2.Islet cell tumors: variety of peptide and amine-derived hormones, chromogranin A

3.Neuroblastoma: vanillylmandelic acid and homovanillic acid


When considered alongside established outcome predictors of coma, such as Glasgow coma scale and other clinical predictors (papillary light responses, corneal reflexes, motor responses to pain, myoclonus, status epilepticus), electroencephalogram, sensory evoked potentials, measurement of serum NSE concentrations provides additional information. Elevated levels are indicative of a poor outcome. Currently, no established algorithms exist to combine serum NSE concentrations and the various other predictors into a composite score that gives clear predictive outcome information. The NSE measurement therefore needs to be considered in a qualitative or semi-quantitative fashion and carefully weighed against other predictors by a physician experienced in examining and managing coma patients.

All neuron-specific enolase (NSE) test results must be considered in the clinical context, and interferences or artifactual elevations should be suspected if the clinical NSE test results are at odds with the clinical picture or other tests. The laboratory should be contacted for assistance in these situations.

Hemolysis can lead to significant artifactual NSE elevations, since erythrocytes contain NSE.

Hemoglobin concentrations as low as 20 mg/dL were found to have an adverse effect on NSE testing.

Proton pump inhibitor treatment, hemolytic anemia, hepatic failure, and end stage renal failure can also result in artifactual NSE elevations.

Other false positives depend on the treating context. When performing NSE testing for tumor diagnosis or follow-up, epileptic seizure, brain injury, encephalitis, stroke, and rapidly progressive dementia might result in false-positive results. On the other hand, when NSE testing is performed to assist in neurological diagnosis, NSE-secreting tumors can represent a source of false-positive results.

NSE values can vary significantly between methods/assays. Serial follow-up should be performed with the same assay. If assays are changed, patients should be re-baselined. This assay is an immunometric assay, and can therefore in rare situations be affected by false low results in the presence of extremely high NSE concentrations ("hooking") or autoantibodies to NSE, as well as by false results in the presence of heterophile antibodies.


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Diagnosis of Niemann-Pick disease begins with a thorough physical exam, which can show an early warning sign such as an enlarged liver or spleen. Your doctor will also take a detailed medical history and discuss symptoms and family health history. Niemann-Pick disease is rare, and its symptoms can be confused with other diseases. Diagnostic techniques depend on the type of Niemann-Pick disease.

1.Type A or B. Using a blood or skin sample (biopsy), experts measure how much sphingomyelinase is in white blood cells to confirm the diagnosis.

2.Type C. Experts take a small sample of skin to test for Niemann-Pick to assess how the cells move and store cholesterol.


Other tests also may be done, such as:

1.Magnetic resonance imaging (MRI). An MRI of the brain may show loss of brain cells. But in the early stages of Niemann-Pick, an MRI may be normal because symptoms typically occur before the loss of brain cells.

2.Eye exam. An eye exam can show signs that may be an indication of Niemann-Pick disease, such as eye movement difficulties.

3.Genetic testing. DNA testing of a blood sample may show the specific abnormal genes that cause Niemann-Pick types A, B and C. DNA tests can show who the carriers are for all types of Niemann-Pick disease if the mutations have been described in the first person identified in a family (the index case).

4.Prenatal testing. Ultrasound can detect the enlarged liver and spleen that's caused by type C. And amniocentesis or chorionic villus sampling may be used to confirm a diagnosis of Niemann-Pick.


No cure exists for Niemann-Pick disease. No effective treatment is available to people with type A or B. For people with mild to moderate type C, a drug called miglustat (Zavesca) may be an option. An international study of 92 people with type C Niemann-Pick showed improved neurological symptoms after taking miglustat regularly for an average of two years.

Physical therapy is an important part of treatment to help maintain mobility as long as possible. People with Niemann-Pick disease need to see their doctors regularly, because the disease progresses and symptoms worsen.


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Nipple discharge is the most common complaint of patients seeking medical attention for breast disease, accounting for about 5% of all breast symptoms. Nipple discharge can be either pathologic or physiologic. Pathologic nipple discharge typically is unilateral, involves a single duct, is spontaneous, and may be serous or bloody/ bloodstained. Physiologic nipple discharge is usually bilateral, involves multiple ducts, and is white or green. Although ominous to patients, most pathologic nipple discharge is due to benign breast disease. Most of the women presenting with pathologic nipple discharge have been reported to have an underlying malignancy.
Detection and differentiation of benign and malignant lesions Reduce mortality by early detection of diseases Breast cancer can be detected at early stage The test results are useful in surgical planning Diagnosis of recurrent or metastatic breast cancer Confirmation of locally advanced cancer Breast cytology has gradually established itself as an individual risk assessment tool for women at risk of developing breast cancer Unfolding and distinguishing benign and malignant breast lesions.



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Fatty acids are straight-chain carboxylic acids (either saturated or unsaturated). They are derived from the hydrolysis of fats or can be synthesized from two carbon units (acetyl- or malonyl-CoA) in the liver, mammary gland and, to some extent adipose tissue. Nearly all have an even number of carbon atoms. Individual fatty acids, free fatty acids (FFA), or the non-esterified fatty acids (NEFA), circulate primarily in association with albumin. They are an important metabolic fuel.

Fatty acids play a central role in providing energy to tissues, particularly during fasting. The liver, kidneys, myocardium, and skeletal muscles, but not the brain. The major storage form of fatty acids is in triglycerides (large amounts are also esterified to cholesterol or in phospholipids), and the enzymes lipoprotein lipase and hepatic lipase hydrolyze the triglycerides to fatty acids and glycerol, thereby releasing them as energy sources for the various tissues. FFA that have been released from triglyceride by the actions of lipoprotein lipase and hepatic lipase are elevated in blood of subjects with central obesity, insulin resistance and type II diabetes.
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In biology, the nuclear matrix is the network of fibres found throughout the inside of a cell nucleus and is somewhat analogous to the cell cytoskeleton. However, in contrast to the cytoskeleton, the nuclear matrix has been proposed to be a highly dynamic structure, perhaps more like a dynamic sponge with open compartments for free diffusion of molecules in the nucleus.The nuclear matrix, along with the nuclear lamina aid in organizing the genetic information within the cell.

The exact function of this matrix is still disputed, and its very existence has recently been called into question.Evidence for such a structure was recognised as long ago as 1948 (Zbarskii and Debov), and consequently many proteins associated with the matrix have been discovered. The presence of intra-cellular proteins is largely indisputable, and it is well recognized that proteins such as the Scaffold, or Matrix Associated Proteins (SAR or MAR) have some role in the organisation of chromatins. There is evidence that the nuclear matrix is involved in regulation of gene expression in Arabidopsis thaliana.

For a long time the question whether a polymer meshwork, a “nuclear matrix” or “nuclear-scaffold” or "NuMat"is an essential component of the in vivo nuclear architecture has remained a matter of debate. While there are arguments that the relative position of chromosome territories (CTs), the equivalent of condensed metaphase chromosomes at interphase, may be maintained due to steric hindrance or electrostatic repulsion forces between the apparently highly structured CT surfaces, this concept has to be reconciled with observations according to which cells treated with the classical matrix-extraction procedures maintain defined territories up to the point where a minor subset of acidic nuclear matrix proteins is released – very likely those proteins that governed their association with the nuclear skeleton.The nuclear matrix proteome consists of structural proteins, chaperones, DNA/RNA-binding proteins, chromatin remodeling and transcription factors. The complexity of NuMat is an indicator of its diverse structural and functional significance.
S/MARs (scaffold/matrix attachment elements), the DNA regions that are thought to attach genomic DNA to the nuclear skeleton, show an ever increasing spectrum of established biological activities. All these activities are in agreement with (or most easily explained by) the nuclear matrix hypothesis. This is one justification for maintaining this concept before equally plausible alternative models emerge.

S/MARs find increasing use for the rational design of vectors with widespread use in gene therapy and biotechnology. Nowadays S/MAR functions can be modulated, improved and custom-tailored to the specific needs of novel vector systems
The nuclear matrix composition on human cells has been proven to be cell type and tumor specific. It has been clearly demonstrated that the nuclear matrix composition in a tumor is different from its normal counterparts.This fact could be useful to characterize cancer markers and to predict the disease even earlier. These markers have been found in urine and blood and could potentially be used in early detection and prognosis of human cancers.

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Spherocytes are osmotically fragile cells that rupture more easily in a hypotonic solution than do normal RBCs. Because they have a low surface area:volume ratio, they lyse at a higher osmolarity than do normal discocyte (RBCs). Cells that have a larger surface area:volume ratio, such as target cells or hypochromic cells are more resistant to lysing. After incubation, an increase in hemolysis is seen in spherocytes. Hereditary spherocytosis typically has greater number of spherocytes than other causes of spherocytosis. Therefore, the degree of lysis is usually more pronounced, but this is not always the case. Some rare disorders can also cause marked fragility and hereditary spherocytosis cases can display moderate fragility.
Spherocytes are osmotically fragile cells that rupture more easily in a hypotonic solution than do normal RBCs. Because they have a low surface area:volume ratio, they lyse at a higher osmolarity than do normal discocyte (RBCs). Cells that have a larger surface area:volume ratio, such as target cells or hypochromic cells are more resistant to lysing. After incubation, an increase in hemolysis is seen in spherocytes. Hereditary spherocytosis typically has greater number of spherocytes than other causes of spherocytosis. Therefore, the degree of lysis is usually more pronounced, but this is not always the case. Some rare disorders can also cause marked fragility and hereditary spherocytosis cases can display moderate fragility.

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Osteocalcin, or bone Gla protein (BGP), is the major noncollagenous protein of bone matrix. It has a molecular weight of approximately 5.8 kilodaltons and consists of 49 amino acids, including three residues of γ-carboxyglutamic acid. Osteocalcin is synthesized in bone by osteoblasts. After production, it is partly incorporated into the bone matrix and partly delivered to the circulatory system. The precise physiological function of osteocalcin is still unclear. A large number of studies have shown that the circulating level of osteocalcin reflects the rate of bone formation.
Determination of serum osteocalcin has proven to be valuable as an aid in identifying women at risk of developing osteoporosis, for monitoring bone metabolism during perimenopause and postmenopause, and during antiresorptive therapy.



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Oxalate (Urine)is a urine test to see whether you have a high level of the chemical oxalate in your urine. Oxalate is a natural end product of metabolism in the body. It should leave your body through your urine. If your oxalate levels are too high, the extra oxalate can combine with calcium to form kidney stones. These stones are hard masses of chemicals that can get stuck in the urinary tract. They commonly cause severe pain. Calcium-oxalate kidney stones are the most common type. Higher levels of oxalate may be caused by eating foods high in oxalate, or by your body absorbing or making too much oxalate.
You may need this test if you have kidney stones often. Your healthcare provider might order this test to help him or her make a recommendation on treatment. It may also be used to find out how well limiting the amount of oxalate in your food is working. You might have this test to see whether you have a rare inherited condition called primary hyperoxaluria and are at risk of developing kidney stones. 

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The packed cell volume (PCV) is a measurement of the proportion of blood that is made up of cells. The value is expressed as a percentage or fraction of cells in blood. For example, a PCV of 40% means that there are 40 millilitres of cells in 100 millilitres of blood. 
Red blood cells account for nearly all the cells in the blood. The PCV rises when the number of red blood cells increases or when the total blood volume is reduced, as in dehydration. The PCV falls to less than normal, indicating anaemia, when your body decreases its production of red blood cells or increases its destruction of red blood cells.

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A Pap smear, also called a Pap test, is a procedure to test for cervical cancer in women.
A Pap smear involves collecting cells from your cervix — the lower, narrow end of your uterus that's at the top of your vagina.
Detecting cervical cancer early with a Pap smear gives you a greater chance at a cure. A Pap smear can also detect changes in your cervical cells that suggest cancer may develop in the future. Detecting these abnormal cells early with a Pap smear is your first step in halting the possible development of cervical cancer.
The Pap smear is usually done in conjunction with a pelvic exam. In women older than age 30, the Pap test may be combined with a test for human papillomavirus (HPV) — a common sexually transmitted infection that can cause cervical cancer in some women.
Doctors generally recommend repeating Pap testing every 3 years for women ages 21-65.
Women age 30 and older can consider Pap testing every 5 years if the procedure is combined with testing for HPV.
If you have certain risk factors, your doctor may recommend more-frequent Pap smears, regardless of your age. These risk factors include:

1.A diagnosis of cervical cancer or a Pap smear that showed precancerous cells
2.Exposure to diethylstilbestrol (DES) before birth
3.HIV infection
4.Weakened immune system due to organ transplant, chemotherapy or chronic corticosteroid use

You and your doctor can discuss the benefits and risks of Pap smears and decide what's best for you based on your risk factors.

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Parathyroid hormone (PTH) helps the body maintain stable levels of calcium in the blood. It is part of a feedback loop that includes calcium, PTH, vitamin D, and, to some extent, phosphorus (phosphate) and magnesium. Conditions and diseases that disrupt this feedback loop can cause inappropriate elevations or decreases in calcium and PTH levels and lead to symptoms of hypercalcemia or hypocalcemia. This test measures the amount of PTH in the blood.
PTH is produced by four button-sized parathyroid glands that are located in the neck behind the thyroid gland. Normally, these glands secrete PTH into the bloodstream in response to low blood calcium levels. The hormone works in three ways to help raise blood calcium levels back to normal:

1.PTH promotes the release of calcium from bones into the bloodstream.
2.It stimulates the kidneys to convert vitamin D from the inactive to the active form, which in turn increases the absorption of calcium from food in the intestines.
3.It acts on the kidneys to suppress the excretion of calcium in the urine while encouraging excretion of phosphorus.
4.As calcium levels begin to increase in the blood, PTH normally decreases.

Parathyroid hormone itself is composed of 84 amino acids (sometimes called PTH (1-84)). Intact and fragmented hormone is present in and secreted by the parathyroid gland. The intact hormone represents a smaller fraction, but its portion is increased when calcium levels are low and decreased when calcium levels are high.
Once released into the blood stream, PTH has a very short life span; levels fall by half in less than 5 minutes due to uptake and cleavage in the liver and kidneys. The fragments are referred to as C-terminal fragments and are variably sized, missing anywhere from 6 amino acids to more than half the N-terminal portion of the molecule. C-terminal fragments have a longer half-life, exist in much higher concentrations, and are eventually cleared by the kidneys. Although it was originally thought that the C-terminal fragments were inactive, it now appears that certain fragments may have biologic activities that are able to oppose those of intact PTH.

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Parietal cell antibodies are autoantibodies, proteins produced by the immune system that mistakenly target a type of specialized cells that line the stomach wall. This test detects these antibodies in the blood to help diagnose pernicious anemia.
Pernicious anemia is an autoimmune condition that can occur when the body's immune system targets its own tissues and develops antibodies directed against the parietal cells and/or intrinsic factor.

1.Parietal cells are specialized cells in the stomach that make acid to help in food digestion and also make intrinsic factor.
2.Intrinsic factor is required for the absorption of vitamin B12 from food.

During digestion, stomach acids produced by parietal cells release vitamin B12 from food, which binds to intrinsic factor to form a complex. The formation of this complex allows vitamin B12 to be absorbed in the small intestine. Among having functional roles in the brain and nervous system, vitamin B12 is important in the production of red blood cells (RBCs).
When the body’s immune system mistakenly targets its own tissues and develops antibodies directed against parietal cells and/or intrinsic factor, it can cause inflammation and progressively damage the parietal cells. This autoimmune condition, called autoimmune atrophic gastritis, can disrupt the production or function of intrinsic factor.
Without sufficient intrinsic factor, vitamin B12 goes largely unabsorbed, leading to vitamin B12 deficiency. Deficiency in vitamin B12 can result in megaloblastic anemia, characterized by the production of fewer but larger red blood cells (macrocytes). Vitamin B12 deficiency can also result in nerve-related signs and symptoms (neuropathy), such as numbness and tingling that start first in the hands and feet, muscle weakness, slow reflexes, loss of balance and unsteady walking. Other disorders can cause vitamin B12 deficiency and result in megaloblastic anemia. When it is due to a lack of intrinsic factor, it is called pernicious anemia. Besides anemia, a decrease in the numbers of neutrophils and platelets (neutropenia, thrombocytopenia) may also occur.
The tests for parietal cell and/or intrinsic factor antibodies may be used along with several other tests, such as complete blood count (CBC) and blood smear, to help diagnose pernicious anemia.

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The pericardium is a two-layered, sac-like membrane that surrounds the heart. Pericardial membranes produce pericardial fluid, a liquid that sits between the pericardium's membranes. The fluid acts as a lubricant for the movement of the heart, reducing friction as the heart pumps blood.

A variety of conditions and diseases can cause inflammation of the pericardium (pericarditis) and/or excessive accumulation of pericardial fluid (pericardial effusion). Pericardial fluid analysis is a group of tests that evaluate this liquid to help diagnose the cause of the increased fluid.

The two main reasons for fluid accumulation in the pericardial space are:

1.An imbalance between the pressure within blood vessels—which drives fluid out of blood vessels—and the amount of protein in blood—which keeps fluid in blood vessels. The fluid that accumulates in this case is called a transudate. Transudates are most often caused by congestive heart failure or cirrhosis.

2.An injury or inflammation of the pericardium, in which case the fluid that accumulates is called an exudate. Conditions such as infections, malignancies (metastatic cancer, lymphoma, mesothelioma), or autoimmune disease may cause the accumulation of exudate.

Determining if the increased fluid is transudate or exudate is important because it helps narrow down the possible causes of pericardial fluid buildup. Healthcare practitioners and laboratorians use an initial set of tests, including cell count, protein or albumin level, and appearance of the fluid, to distinguish between transudates and exudates. Once the fluid is determined to be one or the other, additional tests may be performed to further pinpoint the disease or condition causing pericarditis and/or pericardial effusion.

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A Peripheral smear is a drop of blood spread thinly onto a glass slide that is then treated with a special stain and examined under a microscope by a trained laboratorian. It is a snapshot of the cells that are present in the fluid portion of the blood (plasma) at the time the sample is obtained. The Peripheral smear allows for the evaluation of these cells:
White blood cells (WBCs, leukocytes) — help fight infections
Red blood cells (RBCs, erythrocytes) — carry oxygen to tissues
Platelets (thrombocytes) — small cell fragments that are vital to proper blood clot formation
These cell populations are produced and mainly mature in the bone marrow and are eventually released into the bloodstream as needed. The number and type of each cell present in the blood is dynamic but is generally maintained by the body within specific ranges.
The drop of blood on the slide used for a Peripheral smear contains millions of RBCs, thousands of WBCs, and hundreds of thousands of platelets. Under the microscope, the stained WBCs can be easily seen and the number and type of cells present can be estimated. The laboratorian can compare their size, shape, and general appearance to the established appearance of "normal" cells. It is also possible to distinguish between the five different types of WBCs and to determine their relative percentages (manual differential). During this examination, the laboratorian can also evaluate the size, shape, and color (indicators of hemoglobin content) of the RBCs (RBC morphology) and also estimate the number of platelets present.
A variety of diseases and conditions can affect the number and appearance of blood cells. Examination of the Peripheral smear can be used to support findings from other tests and examinations. For example, RBCs that appear larger and paler than normal may support other results that indicate a type of anemia. Similarly, the presence of WBCs that are not fully mature may add to information from other tests to help make a diagnosis of infection, malignancy, or other conditions.

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Phosphorus is a mineral that combines with other substances to form organic and inorganic phosphate compounds. The terms phosphorus and phosphate are often used interchangeably when talking about testing, but it is the amount of inorganic phosphate in the blood that is measured with a serum phosphorus/phosphate test.
Phosphates are vital for energy production, muscle and nerve function, and bone growth. They also play an important role as a buffer, helping to maintain the body's acid-base balance.
Phosphorus comes into the body through the diet. It is found in many foods and is readily absorbed by the intestines. About 70-80% of the body's phosphates combine with calcium to help form bones and teeth, another 10% are found in muscle, and about 1% is in nerve tissue. The rest is found within cells throughout the body, where they are mainly used to store energy.
Normally, only about 1% of total body phosphates are present in the blood. A wide variety of foods, such as beans, peas and nuts, cereals, dairy products, eggs, beef, chicken, and fish, contain significant amounts of phosphorus. The body maintains phosphorus/phosphate levels in the blood by regulating how much it absorbs from the intestines and how much it excretes via the kidneys. Phosphate levels are also affected by the interaction of parathyroid hormone (PTH), calcium, and vitamin D.
Phosphorus deficiencies (hypophosphatemia) may be seen with malnutrition, malabsorption, acid-base imbalances, hypercalcemia, and with disorders that affect kidney function. Phosphorus excesses (hyperphosphatemia) may be seen with increased intake of the mineral, hypocalcemia, and with kidney dysfunction.
Someone with a mild to moderate phosphorus deficiency often does not have any symptoms. With a severe phosphorus deficiency, symptoms may include muscle weakness and confusion. An extreme excess of phosphorus may cause symptoms that are similar to those seen with low calcium, including muscle cramps, confusion, and even seizures.

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Platelet antibodies may be allo- or autoantibodies and may be directed to a wide range of antigenic "targets" carried on platelet cytoplasmic membranes. Serum platelet antibody test is optimized to identify the presence of platelet allo-antibodies in the patient.
Platelet alloantibodies are involved in several clinical situations such as:

-Immune mediated refractoriness to platelet transfusions usually due to antibodies to HLA class I and sometimes to antibodies specific to platelet antigens.

-Neonatal alloimmune thrombocytopenia (NAIT)

-Posttransfusion purpura (PTP), which are usually associated with platelet-specific antibodies

This test is not recommended for the diagnosis of immune thrombocytopenia (ITP) or autoimmune thrombocytopenia. Tests that are optimized to detect antibodies bound to the platelets will be useful in these situations; cell-bound platelet antibody (Direct) test is strongly recommended instead (CBPAN / Cell Bound Platelet Auto-Antibody Screen, Blood).

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Platelets, also called thrombocytes, are tiny fragments of cells that are essential for normal blood clotting. They are formed from very large cells called megakaryocytes in the bone marrow and are released into the blood to circulate. The platelet count is a test that determines the number of platelets in a person's sample of blood.
When there is an injury to a blood vessel or tissue and bleeding begins, platelets help stop bleeding in three ways. They:

1.Adhere to the injury site
2.Clump together (aggregate) with other platelets
3.Release chemical compounds that stimulate further aggregation of other platelets

These steps result in the formation of a loose platelet plug at the site of the injury in a process called primary hemostasis. At the same time, activated platelets support the coagulation cascade, a series of steps that involves the sequential activation of proteins called clotting factors. This secondary hemostasis process results in the formation of strands of fibrin that weave through the loose platelet plug, form a fibrin net, and compress to form a stable clot that remains in place until the injury has healed. When the clot is no longer needed, other factors break the clot down and remove it.
Each component of primary and secondary hemostasis must be present, activated at the right time, and functioning properly for adequate clotting. If there are insufficient platelets, or if platelets are not functioning normally, a stable clot may not form and a person may be at an increased risk of excessive bleeding.
Platelets survive in the circulation about 8 to 10 days, and the bone marrow must continually produce new platelets to replace those that degrade, are used up, and/or are lost through bleeding. Determining the number of platelets in blood with a platelet count can help diagnose a range of disorders having to do with too few or too many platelets.

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When a doctor requires a platelet count, then a complete blood count may be ordered. The CBC blood test will include a measurement of platelet distribution width, which is how the PLATELET DISTRIBUTION WIDTH blood test results will be measured. The PLATELET DISTRIBUTION WIDTH is a reflection of how uniform in size a patient’s platelets happen to be. This can help to determine how effectively a person’s bone marrow is functioning and if follow-up tests may be required.
For platelet width, the general rule is that larger platelets are generally younger, while smaller platelets have been around for a few days. Having a high number of large platelets when someone has typically has a low platelet count indicates the bone marrow has stepped up production levels.
Because the PLATELET DISTRIBUTION WIDTH (PDW) is part of a complete blood count, it may be ordered for a wide variety of reasons. The most common issues that doctors will examine are unexplained bruising, bleeding that continues on from small cuts or wounds, numerous nosebleeds, or internal bleeding in the digestive tract. The presence of a continuous rash or purplish spots on the skin may also cause this test to be ordered.
For women, when there is continuous and heavy menstrual bleeding, the PLATELET DISTRIBUTION WIDTH (PDW) blood test may be ordered as well.
If the PDW blood test has abnormal results and if there isn’t a known cause for them, then a doctor may choose to perform additional follow-up tests in an attempt to confirm a diagnosis. This may include testing to find inflammatory conditions, the presence of infectious diseases, kidney failure, or bleeding disorders. Liver disease and iron studies may also be ordered, as will vitamin levels.
In severe instances of abnormality when there is not a definitive cause that can be determined, then a bone marrow biopsy may be ordered.
For patients who live in high altitude area, PDW test results may be affected by an individual’s living habits. Be sure to speak with a doctor about this issue if you have recently spent a at least 30 days in a high altitude climate.
The PDW blood test is generally used as a screening tool to see if a patient is experiencing good health. It is typically ordered as part of a routine health screening. If bone marrow disorders are suspected, however, it may also be ordered. Consider these results, compare them to your own results, and then be sure to speak with your doctor about what this may indicate for you and your unique health history.

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Pleural fluid is found in the pleural cavity and serves as a lubricant for the movement of the lungs during inhalation and exhalation. It is derived from a plasma filtrate from blood capillaries and is found in small quantities between the layers of the pleurae - membranes that cover the chest cavity and the outside of each lung.

A variety of conditions and diseases can cause inflammation of the pleurae (pleuritis) and/or excessive accumulation of pleural fluid (pleural effusion). Pleural fluid analysis comprises a group of tests used to determine the cause. There are two main reasons fluid may collect in the pleural space:


1.Fluid may accumulate in the pleural space because of an imbalance between the pressure within blood vessels—which drives fluid out of blood vessels—and the amount of protein in blood—which keeps fluid in blood vessels. The fluid that accumulates in this case is called a transudate. This type of fluid usually involves both lungs and is often a result of either cirrhosis or congestive heart failure.

2.Fluid accumulation may be caused by injury or inflammation of the pleurae, in which case the fluid is called an exudate. It usually involves one lung and may be seen in infections (pneumonia, tuberculosis, sarcoidosis), malignancies (lung cancer, metastatic cancer, lymphoma, mesothelioma), rheumatoid disease, or systemic lupus erythematosus.

Differentiation between the types of fluid is important because it helps diagnose the specific disease or condition. Doctors and laboratory scientists use an initial set of tests (cell count, albumin and appearance of the fluid) to distinguish between transudates and exudates. Once the fluid is determined to be one or the other, additional tests may be performed to further pinpoint the disease or condition causing pleuritis and/or pleural effusion.




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Pleural fluid is a liquid derived from the blood in the tiny blood vessels (capillaries) in the lungs. It is found in small quantities between the layers of the pleurae – membranes that cover the chest cavity and the outside of each lung. It serves as a lubricant for the movement of the lungs during breathing.
A variety of conditions and diseases can cause inflammation of the pleurae (pleuritis) and/or excessive accumulation of pleural fluid (pleural effusion). Pleural fluid analysis is a group of tests that evaluate this liquid to determine the cause of the increased fluid.

The two main reasons for fluid accumulation in the pleural space are:

1.An imbalance between the pressure of the liquid within blood vessels, which drives fluid out of blood vessels, and the amount of protein in blood, which keeps fluid in blood vessels. The fluid that accumulates in this case is called a transudate. This type of fluid more commonly involves both sides of the chest and is most frequently a result of either congestive heart failure or cirrhosis.
2.An injury to or inflammation of the pleurae, in which case the fluid that accumulates is called an exudate. It more commonly involves one side of the chest and may be seen in infections (pneumonia, tuberculosis), malignancies (lung cancer, metastatic cancer, lymphoma, mesothelioma), or other causes of inflammation (sarcoidosis, autoimmune diseases).
 
Determining the type of fluid present is important because it helps to shorten the list of possible causes of pleural effusion. Healthcare practitioners and laboratorians use an initial set of tests (cell count, protein, albumin, and lactate dehydrogenase (LD) level, and appearance of the fluid) to distinguish between transudates and exudates. If the fluid is an exudate, additional tests may be performed to further pinpoint the disease or condition causing pleuritis and/or pleural effusion. See the "The Test" tab for more on this.


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Porphyrins are a group of compounds defined by their chemical structure. These compounds are by-products of heme synthesis and are normally present at low concentrations in blood and other body fluids. Porphyrin tests measure porphyrins and their precursors in urine, blood, and/or stool.
Heme is an iron-containing pigment that is a component of hemoglobin and a number of other proteins. It consists of an organic portion (protoporphyrin) bound to an iron atom. The synthesis of heme is a step-by-step process that requires the sequential action of eight different enzymes. If there is a deficiency in one of these enzymes, the process is impeded and intermediate porphyrins such as uroporphyrin, coproporphyrin, and protoporphyrin build up in the body's fluids and tissues. The precursors that accumulate depend on which enzyme is deficient, and they can exert toxic effects.
Porphyrin tests are used to help diagnose and monitor a group of disorders called porphyrias. There are seven types of porphyria, and each one is associated with a different enzyme deficiency. Most porphyrias are inherited, the result of a gene mutation. They may be classified according to the signs and symptoms of the disease as neurological, cutaneous, or both.
The porphyrias that cause neurological symptoms present with acute attacks lasting days or weeks. Signs and symptoms during the attack include abdominal pain, constipation, confusion, hallucinations, and/or seizures. There are four neurologic porphyrias: acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and the very rare ALA dehydratase deficiency porphyria (ADP). Some cases of VP and HCP may also have skin-related symptoms.
The cutaneous porphyrias are associated with photosensitivity that causes redness, swelling, a burning sensation, blistering, skin thickening, hyperpigmentation, and/or scarring. There are three cutaneous porphyrias: porphyria cutanea tarda (PCT), erythropoietic protoporphyria (EPP), and congenital erythropoietic porphyria (CEP). For more information about each disease, see the article on Porphyria.

To diagnose porphyrias, clinical laboratories measure porphyrins and their precursors in urine, blood, and/or stool. Testing may include measurement of one or more of the following:

1.Porphobilinogen (PBG), a porphyrin precursor, in urine
2.Delta-aminolevulinic acid (ALA), another porphyrin precursor, in urine
3.Porphyrins (uroporphyrin, coproporphyrin, and protoporphyrin) in urine, blood, or stool

Specialized laboratories may offer testing for one or more of the affected enzymes. The most commonly measured enzyme is porphobilinogen deaminase (PBG-D) in red blood cells, which tests for acute intermittent porphyria. A few laboratories offer genetic testing for specific gene mutations that cause one of the porphyrias, but this type of testing is not widely available.
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The postcoital test (PCT) (also known as Sims test, Huhner test or Sims-Huhner test) is a test in the evaluation of infertility. The test examines interaction between sperm and mucus of the cervix.
The PCT is scheduled close to ovulation when mucus is abundant, and the infertile couple is asked to have sexual intercourse, preferably in early hours of morning. Several hours later (usually 2), the woman is examined by the physician. The mucus is aspirated from cervical canal and spread on a glass slide. Smear from posterior fornix is used as control. 10-50 motile sperms per high power field are considered normal. Rotatory or shaky motion of sperms indicates presence of antispermal antibody. Cervical mucus is examined for quality, viscosity and fern test.

A poor PCT may indicate sperm or mucus problems, including perhaps presence of immune factors that inactivate sperm. Also ovulatory problems and poor coital technique may affect the PCT. The test is useless in presence of cervical infection.

With the application of principles of evidence-based medicine the role of the PCT has been questioned and its use has become controversial.
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Potassium is an electrolyte that is vital to cell metabolism. It helps transport nutrients into cells and removes waste products out of cells. It is also important in muscle function, helping to transmit messages between nerves and muscles. This test measures the amount of potassium in the blood and/or urine.
Potassium, along with other electrolytes such as sodium, chloride, and bicarbonate (total CO2), helps regulate the amount of fluid in the body and maintains a stable acid-base balance. Potassium is present in all body fluids, but most potassium is found within the cells. Only a small amount is present in fluids outside the cells and in the liquid part of the blood (called serum or plasma).
We get most of the potassium we need from the foods that we eat and most people have an adequate intake of potassium. The body uses what it requires and the kidneys eliminate the rest in the urine. The body tries to keep the blood potassium level within a very narrow range. Levels are mainly controlled by aldosterone, a hormone produced by the adrenal glands in the kidneys.
Because the blood concentration of potassium is so small, minor changes can have significant consequences. If potassium levels are too low or too high, there can be serious health consequences; a person may be at risk for developing shock, respiratory failure, or heart rhythm disturbances. An abnormal potassium level can alter the function of the nerves and muscles; for example, the heart muscle may lose its ability to contract.


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