Report 76bebcf5
Report 76bebcf5
HAEMATOLOGY
FEVER PACKAGE EXTENSIVE
Test Name Result Unit Bio. Ref. Interval Method
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PO No :PO2030862719-337
HAEMATOLOGY
FEVER PACKAGE EXTENSIVE
Test Name Result Unit Bio. Ref. Interval Method
Absolute Eosinophil Count 0.03 10^3/µI 0.02 - 0.5 Calculated
Absolute Basophil Count 0.03 10^3/µI 0.02 - 0.1 Calculated
Platelet Count 150 10^3/µI 150-410 Electrical Impedence/
Microscopy
MPV 10 fL 7.5-12 Calculated
PDW 18 fL 11-22 Calculated
Comment:
As per the recommendation of International council for Standardization in Hematology, the differential leucocyte counts
are additionally being reported as absolute numbers of each cell in per unit volume of blood.
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PO No :PO2030862719-337
HAEMATOLOGY
FEVER PACKAGE EXTENSIVE
Test Name Result Unit Bio. Ref. Interval Method
Comment:
ESR provides an index of progress of the disease and is widely used as an indicator of inflammation, infection, trauma, or
malignant diseases. Changes are more significant than a single abnormal test
It is specifically indicated to monitor the course or response to the treatment of diseases like rheumatoid arthritis,
tuberculosis bacterial endocarditis ,acute rheumatic fever ,Hodgkins disease,temporal arthritis , and systemic lupus
erythematosis; and to diagnose and monitor giant cell arteritis and polymyalgia rheumatica.
An elevated ESR may also be associated with many other conditions, including autoimmune disease, anemia,
infection,malignancy,pregnancy, multiple myeloma, menstruation, and hypothyroidism.
Although a normal ESR cannot be taken to exclude the presence of organic disease, its rate is dependent on various
physiologic and pathologic factors.
The most important component influencing ESR is the composition of plasma. High level of C-Reactive Protein, fibrinogen,
haptoglobin, alpha-1antitrypsin, ceruloplasmin and immunoglobulins causes the elevation of Erythrocyte Sedimentation
Rate.
Drugs that may cause increase ESR levels include: dextran, methyldopa, oral contraceptives, penicillamine, procainamide,
theophylline, and Vitamin A. Drugs that may cause decrease levels include: aspirin, cortisone, and quinine
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PO No :PO2030862719-337
HAEMATOLOGY
FEVER PACKAGE EXTENSIVE
WBC - Leucopenia .
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PO No :PO2030862719-337
HAEMATOLOGY
FEVER PACKAGE EXTENSIVE
Test Name Result Unit Bio. Ref. Interval Method
Comment:
Four species of the Plasmodium parasites are responsible for human malaria infection - P.falciparum, P.vivax, P.ovale and
P.malariae. P.falciparum and P.vivax are the most prevalent . Falciparum infection is associated with Cerebral malaria and
drug resistance whereas vivax infection is associated with high rate of infectivity and relapse. Differentiation between
P.falciparum and P.vivax is of utmost importance for better patient management and speedy recovery.
This is only a screening test. The results must always be correlated with clinical history and relevant epidemiological and
therapeutic context.
A Positive result indicates malarial infection. False Positives may be seen due to cross reactivity and persistence
antigenemia.
False negatives may be seen in patient’s with very low parasitic index .
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PO No :PO2030862719-337
BIOCHEMISTRY
FEVER PACKAGE EXTENSIVE
Test Name Result Unit Bio. Ref. Interval Method
Comment:
•C-Reactive Protein [CRP] is an acute phase reactant ,hepatic secretion of which is stimulated in response to inflammatory
cytokines.
•CRP is a very sensitive but nonspecific marker of inflammation and infection.
•The CRP test is useful in patient with Inflammatory bowel disease, arthritis, Autoimmune diseases, Pelvic inflammatory disease
(PID), tissue injury or necrosis and infections.
•CRP levels can be elevated in the later stages of pregnancy as well as with use of birth control pills or hormone replacement
therapy i.e. estrogen. Higher levels of CRP have also been observed in the obese.
•As compared to ESR, CRP shows an earlier rise in inflammatory disorders which begins in 4-6 hrs, he intensity of the rise being
higher than ESR and the recovery being earlier than ESR. Unlike ESR, CRP levels are not influenced by hematologic conditions
like Anemia, Polycythemia.
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PO No :PO2030862719-337
SEROLOGY
FEVER PACKAGE EXTENSIVE
Test Name Result Unit Bio. Ref. Interval Method
Comment:
Typhoid fever is an infection caused by a bacterium, Salmonella Typhi. Timely diagnosis of typhoid fever at an early stage is
not only important for etiological diagnosis but also to identify and treat the potential carrier state in order to prevent acute
typhoid fever outbreaks. TYPHIDOT is an immunochromatographic assay designed for the qualitative detection and
differentiation of specific IgM and IgG antibodies against specific Salmonella Typhi antigen in human serum or plasma. This test is
an aid in the early diagnosis of typhoid infection.
Note:-
It is a rapid, qualitative, screening test for early detection of antibodies to Salmonella Typhi in human serum/plasma. All
positive results should be confirmed by supplement tests.
A negative result does not rule out recent infection, as positive result is influenced by the time elapsed after the onset of
fever and immuno- competence of the patient.
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PO No :PO2030862719-337
SEROLOGY
FEVER PACKAGE EXTENSIVE
Widal test is a serological test, used for invitro detection and quantitative estimation of specific antibodies to Salmonella
antigen (‘H’ and ‘O’) in the serum.
A positive widal test confirms Enteric fever or typhoid fever caused by Gram negative bacteria, Salmonella enterica (S.Typhi
or S.paratyphi). However, the positive slide widal test sometimes give a false positive result, which should be confirmed by
Tube widal test.
The widal test uses ‘O’ and ‘H’ antigens of S.Typhi and S. Paratyphi A and S. Paratyphi B
Titers ≥ 1:80 of O antigen and ≥ 1:160 of H antigen of S. Typhi and Titers ≥ 1:80 of H antigen for S. paratyphi A & B are
significant.
In the case of Low titres, it is suggested to perform repeat test after a week. A four fold rise in titre with gap of 1 week
confirms the Widal test.
Limitation:
1. False Positive: Anamnestic response is seen in person who had prior enteric infection or immunisation with TAB vaccination.
This response is seen during an unrelated fever like- Malaria, M.tuberculosis, Dengue, Influenza, Brucellosis, Rheumatic fever
etc. Where a transient rise in H antibody titer is seen whereas in the patient with enteric fever, a sustained rise is seen.
2. In endemic areas, people may show moderately elevated levels of ‘O’ and ‘H’ agglutinins.
3. False negative: seen in early course of disease (1st week) and immunosuppression.
4. False negative results can be seen in patient where antibiotic treatment is started before the sample is collected.
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PO No :PO2030862719-337
SEROLOGY
FEVER PACKAGE EXTENSIVE
Page 9 of 12
PO No :PO2030862719-337
SEROLOGY
FEVER PACKAGE EXTENSIVE
Test Name Result Unit Bio. Ref. Interval Method
Chikungunya IgM
Chikungunya IgM NEGATIVE Positive-Negative Immunocromatography
Comment:
Chikungunya virus (CHIKV) is an insect-borne virus of the Alphavirus, that is transmitted to humans by Aedes mosquitoes. CHIKV
causes an illness similar to dengue fever but unlike dengue there is no hemorrhagic fever or shock syndrome. CHIKV manifests
with an acute febrile phase of the illness lasting only two to five days,followed by a prolonged arthralgic disease that affects the
joints of the extremities.
NOTE
1. This is only a screening test . All samples detected reactive must be confirmed by using confirmatory test.
2. False positive results can be obtained due to cross reaction with Epstein-BARR virus, Influenza A & B, Brucella and Dengue
virus.
3. False negative results are seen if IgM antibody is below the detectable limit.
4. A negative result does not preclude the possibility of exposure or infection with CHIKV
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PO No :PO2030862719-337
SEROLOGY
FEVER PACKAGE EXTENSIVE
Test Name Result Unit Bio. Ref. Interval Method
Comment:
The referring centre/ Lab is responsible for informing concerned Local authorities on notifiable disease.
Recommended test is NS1 Antigen by ELISA in the first 5 days of fever. After 7-10 days of fever, the recommended test is
Dengue virus antibodies IgG & IgM by ELISA.
Comments:Dengue viruses belong to the family Flaviviridae and have 4 serotypes ( 1-4).It is transmitted by the mosquito Aedes
aegypti and Aedes albopictus and is widely distributed in Tropical and Subtropical areas of the world. The disease may be
subclinical, self limiting, febrile or may progress to a severe form of Dengue hemorrhagic fever or Dengue shock syndrome.
Positive: The presence of Dengue nonstructural protein 1 (NS1) antigen is typically detectable within 1 to 2 days following
infection and up to 9 days following symptom onset.NS1 antigen may also be detectable during secondary dengue virus
infection, but for a shorter duration of time (1-4 days following symptom onset).
Negative: The absence of dengue NS1 antigen is suggestive of absence of acute phase of the infection. The NS1 antigen may
be negative if specimen is collected too early such as immediately following dengue virus infection (<24-48 hours) or is collected
following 9 to 10 days of symptoms. Results should always be interpreted in conjunction with clinical presentation and
exposure history.
Limitations:
Cross reactivity is seen in the Flavivirus group between Dengue virus,Zika virus, Murray Valley encephalitis, Japanese
encephalitis, Yellow fever & West Nile viruses.
Negative NS1 antigen results may occur if the specimen was collected after 7 days following symptom onset. Serologic
testing for the presence of IgM and IgG antibodies to Dengue Virus is recommended in such cases.
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PO No :PO2030862719-337
CLINICAL PATHOLOGY
FEVER PACKAGE EXTENSIVE
Test Name Result Unit Bio. Ref. Interval Method
Comment:
•Note: Pre-test condition to be observed while submitting the sample-first void, mid stream urine, collected in a clean, dry, sterile
container is recommended for routine urine analysis, avoid contamination with any discharge from vaginal, urethra, perineum,
Avoid prolonged transit time & undue exposure to sunlight.
•During interpretation, points to be considered are Negative nitrite test does not exclude the urinary tract infections. Trace
proteinuria can be seen with many physiological conditions like prolonged recumbency, exercise, high protein diet. False positive
reactions for bile pigments, proteins, glucose and nitrites can be caused by peroxidase like activity by disinfectants, therapeutic
dyes, ascorbic acid and certain drugs.• Urine microscopy is done in centrifuged urine specimens
Page 12 of 12
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