Methodology: Sedimentation

Factors increasing ESR -Old age -Pregnancy -Anemia -Elevated fibrinogen -Macrocytosis 

Factors decreasing ESR -Microcytosis -Low fibrinogen -Polycythemia -Marked leukocytosis

METHOD: IMMUNOTURBIDIMETRIC

 The C -Reactive protein is normal alpha- globulin and it is elevated in patients who have an inflammatory conditions of infectious or noninfectious origin. The test is non specific and the resuts frequently overlap ESR values. The findings can be useful as a simple index of the disease ativity and treatment status.

Elevated levels of blood urea nitrogen are observed in pre renal , renal and post renal conditions .
Pre renal conditions .. diabetes mellitius, dehydration, cardiac failure , hematemesis, severe burns, high fever etc..
Renal conditions.. disease of kidneys.
Post renal conditions.. inlargement of prostate, stones in the urinary tract, tumor of the bladder . Decreased values have been reported in severe liver disease, protein malnutrition & pregnency.

Decreased serum calcium values are found in hypoparathyroidism, rickets, osteiomalacia and steatorrhea. A fall in serum calcium can occun in acute pancreatitis and in those forms of renal disease in which excessive proteinuria is observed. Increased serum calcium values are observed in hyperparathyroidism, hypervitamonosis D and multiple myeloma.

Uric acid is the end product of nucleoprotein metabolism. It is a low threshold excretory product. the serum uric acid level is ofter raised in gout. the determination has diagnostic value differentiating gout from non gout arthritis. uric acid levels are also increased in renal failure, uremia and leukemia.

NOTE  :- Lipid profile range as per ncep – atp 111 are :

Serum cholestrol  (Total) :

Desirable: < 200 mg/dl, Borderline: 200-239 mg/dl, Elevated : >250 mg/dl.

Serum high – density lipoprotein cholterol (HDL):

Desirable: > 60 mg/dl,  Borderline: 40-60 mg/dl, Elevated : >70 mg/dl.

TOTAL cholestrol : HDL cholestrol:

Low risk :  3.3 - 4.4, Average risk : 4.4 – 7.1, Moderate risk : 7.1 – 11.0, High risk : >11.0

Serum low – density lipoprotein (LDL) cholesterol:

Desirable : < 100 mg/dl, Borderline: 100-159 mg/dl, Elevated : >160 mg/dl.

* It is ptreferable to measure lipid after 12 hrs fasting, as triglyceride levels rised and both HDL & LDL levels fall after fat containing meals.

* since serum lipid levels a vary widely from day to day( being largely dependaent on diet) , at least 2 - 3 measurments should be made days or weeks apart , before labelling a person as hyper lipidaemic/ normolipidaemic or before initiating therapy.
*Both LDL & HDL levels remains decreased for several weeks after acute inflammatory states, following myocardial infection, stress, trauma, surgery and recent illness.
* lipid profile values should always be corroborated in the light of clinical findings, dietary habits / axcess/ restrictions, effects of illness, exercise, inter & intra individual variations and drugs( Anabolic steroids, oral contraceptives) progestogens, antithypertensives, oestrogen, insulin & hydrochlorthiazide.

METHOD :- HPLC for HbA1C  by LD 500 (AspenA1c)

(NGSP Certified)

Glycosylated Haeamoglobin Blood :-

Current methods of assessing control in patient with diabtes mellitus include measurement of blood and plasma. These glucose measurements reflect acute changes and not the long term aspects of diabetic control. A more useful technique for assessing the control of diabetes is the measurement of glycosylated haemoglobins that is haemoglobin with glucose or glucose phosphate moieties bound to the amino terminal valine of one or both beta chaings.

The level of haemoglobin Alc, which comose 3% to 6% of the total haemoglobin in healthy individuals is proportional to both the average glucose concentration and the life span of the red blood cells in the circulation.The measurement or HbA1C has therefore been accepted for the clinical management of diabetes through routine monitoring.

Increased level of HbA1C correlate  with lack of glucose control. In diabetics with good glucose control the amount of HbA1C may return to the reference interval. specimens for patients with hemolytic anemia  will exhibit decrease glycosylated haemoglobin values due to shorted life span of the red cells.

specimens from patients with polycythemia or post-splenectomy may exhibit increase glycosylated haemoglobin values due to a somewhat longer life span of the red cells.