HAEMATOLOGY. Test Name Status Result Unit Reference Interval HbA1c (Glycated Haemoglobin) 5.4 % Method : HPLC Sample Type : Whole Blood EDTA

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1 Institution Report Date 25-Dec :59 PM HAEMATOLOGY HbA1c (Glycated Haemoglobin) 5.4 % Method : HPLC Sample Type : Whole Blood EDTA REMARKS In vitro quantitative determination of HbA1c in whole blood is utilized in long term monitoring of glycemia.the HbA1c level correlates with the mean glucose concentration prevailing in the course of the patient's recent history (approx weeks) and therefore provides much more reliable information for glycemia monitoring than do determinations of blood glucose or urinary glucose. It is recommended that the determination of HbA1c be performed at intervals of 4-6 weeks during Diabetes Mellitus therapy. Results of HbA1c should be assessed in conjunction with the patient's medical history, clinical examinations and other findings. Note: If variant hemoglobin is observed in HbA1c HPLC screen, HbA1c levels may not truly represent in vivo condition. In such condition HbA1c analysis by HPLC may not be the method of choice. You are advised to consult your referring physician and discuss the alternative tests as suggested below. Advised 1.To follow patient for glycemic control test like fructosamine or glycated albumin may be performed instead. 2.Hemoglobin HPLC screen to analyze abnormal hemoglobin variant. Mean Plasma Glucose mg/dl Sample Type : Whole Blood EDTA Mean Plasma Glucose is based on estimated Average Glucose (eag) value calculated according to National Glycohemoglobin Standardization Program (NGSP) criteria. Page 1 of 5

2 Institution Report Date 25-Dec :22 PM LUPUS ANTICOAGULANT* Partial Thromboplastin Time (APTT) Patient Value Seconds Control Value Seconds drvvt Patient Value 32.0 Control Value 35.0 The lupus anticoagulant is an acquired autoantibody found in various autoimmune disorders and sometimes in otherwise healthy individuals. These immunoglobulins bind to certain proteins when bound to phospholipids. The effective sequestration of phospholipid can then cause prolongation of phospholipid dependant coagulation tests such as PT and APTT. The presence of these antibodies in the plasma leads to prolongation of PT and APTT in vitro (anticoagulants), however in vivo they are associated with thrombotic tendencies including recurrent venous thrombo-embolism, cerebro-vascular accidents and arterial events. It is also associated with recurrent abortions, fetal loss and other complications of pregnancy. Page 2 of 5

3 Institution Report Date 25-Dec :54 PM THYROID STIMULATING HORMONE (TSH) Thyroid Stimulating Hormone (TSH) Method : Chemiluminescence Immunoassay (CLIA) Sample Type : Serum TSH Clinical Condition Euthyroid Hyperthyroid <0.35 Hypothyroid >5.50 Range (uiu/ml) IMMUNOASSAY 1.25 uiu/ml INTERPRETATION Thyroid-stimulating hormone is a glycoprotein with two non-covalently bound subunits. TSH is synthesized and secreted by the anterior pituitary in response to a negative feedback mechanism involving concentrations of FT 3 (free T 3 ) and FT 4 (free T 4 ). Additionally, the hypothalamic tripeptide, thyrotropin-releasing hormone (TRH), directly stimulates TSH production. TSH interacts with specific cell receptors on the thyroid cell surface and exerts two main actions. The first action is to stimulate cell reproduction and hypertrophy. Secondly, TSH stimulates the thyroid gland to synthesize and secrete T 3 and T 4. The ability to quantitate circulating levels of TSH is important in evaluating thyroid function. It is especially useful in the differential diagnosis of primary (thyroid) from secondary (pituitary) and tertiary (hypothalamus) hypothyroidism. In primary hypothyroidism, TSH levels are significantly elevated, while in secondary and tertiary hypothyroidism, TSH levels are low. TRH stimulation differentiates secondary and tertiary hypothyroidism by observing the change in patient TSH levels. Typically, the TSH response to TRH stimulation is absent in cases of secondary hypothyroidism, and normal to exaggerated in tertiary hypothyroidism. Historically, TRH stimulation has been used to confirm primary hyperthyroidism, indicated by elevated T 3 and T 4 levels and low or undetectable TSH levels. TSH assays with increased sensitivity and specificity provide a primary diagnostic tool to differentiate hyperthyroid from euthyroid patients Page 3 of 5

4 Institution Report Date 25-Dec :54 PM FERRITIN Ferritin Method : Chemiluminescence Immunoassay (CLIA) Sample Type : Serum ng/ml Premenopausal Postmenopausal Comment:- Ferritin is the major iron storage compound and a readily available source & reserve of iron for metabolic requirements. Clinical utility:ferritin estimation is useful in the diagnosis of iron deficiency anemia and iron overload. Increased levels seen in hemachromatosis, frequent blood transfusions with packed RBCs and alcoholic liver disease. Decreased levels seen in heavy menstrual bleeding, poor absorption of iron, iron deficiency anaemia and long term GI bleed. Note: Ferritin is an acute phase reactant and thus may be increased with inflammation, chronic infection, liver disease, auto-immune disorders and some type of cancers. Ferritin is not used to detect or monitor these conditions. Page 4 of 5

5 Institution Report Date 26-Dec :57 PM ToRCH 10 IgG & IgM* Toxoplasma gondii IgG Toxoplasma gondii IgM Rubella (German Measles) IgG Rubella (German Measles) IgM Cytomegalovirus (CMV) IgG Cytomegalo Virus (CMV) IgM Herpes Simplex Virus 1 IgG Herpes Simplex Virus 1 IgM Herpes Simplex Virus 2 IgG Herpes Simplex Virus 2 IgM Immunology H 3.73 Ratio Negative < Ratio Negative < 0.9 H 3.59 Ratio Negative < 0.5 Equivocal >0.5 < Ratio Negative < 0.9 H 2.58 Ratio Negative < Ratio Negative < Ratio Negative < Ratio Negative < Ratio Negative < Ratio Negative < 0.9 Page 5 of 5