Full Blood Count

The Full Blood Count test evaluates the cells that circulate in your blood. Blood consists of three types of cells suspended in fluid called plasma: white blood cells, red blood cells and platelets. They are produced and mature primarily in the bone marrow and, under normal circumstances, are released into the bloodstream as needed.

Significant abnormalities in one or more of the blood cell populations can indicate the presence of one or more conditions. Typically other tests are performed to help determine the cause of abnormal results. Often, this requires visual confirmation by examining a blood smear / peripheral blood film under a microscope to evaluate the appearance and physical characteristics of the blood cells, such as size, shape and colour, noting any abnormalities that may be present. This information gives additional information to the cause of abnormal Full Blood Count results.

Erythrocyte sedimentation rate (ESR)

ESR is a test that indirectly measures the degree of inflammation present in the body. Inflammation is part of the body's immune response. It can be acute, developing rapidly after trauma, injury or infection 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.

Diabetic Screen

Glucose

Glucose is the primary energy source for the body's cells and the only energy source for the brain and nervous system. A steady supply must be available for use, and a relatively constant level of glucose must be maintained in the blood.

During digestion, fruits, vegetables, breads and other dietary sources of carbohydrates are broken down into glucose (and other nutrients); they are absorbed by the small intestine and circulated throughout the body.  A blood glucose test may be used to:

• Detect high blood glucose (hyperglycemia) and low blood glucose (hypoglycemia)
• Screen for diabetes in people who are at risk before signs and symptoms are apparent. Help diagnose diabetes, prediabetes and gestational diabetes
• Monitor glucose levels in people diagnosed with diabetes

Severe, acute changes in blood glucose, either high or low, can be life-threatening, causing organ failure, brain damage, coma, and, in extreme cases, death. Chronically high blood glucose levels can cause progressive damage to body organs such as the kidneys, eyes, heart and blood vessels, and nerves. Chronic hypoglycemia can lead to brain and nerve damage.

Some women may develop gestational diabetes, which is hyperglycemia that occurs during pregnancy. If untreated, this can cause these mothers to give birth to large babies who may have low glucose levels. Women who have had gestational diabetes may or may not go on to develop diabetes.

Glycated Haemoglobin (HbA1c)

The HbA1c test evaluates the average amount of glucose in the blood over the last 2 to 3 months by measuring the percentage of glycated hemoglobin in the blood.

An HbA1c test may be used to screen for and diagnose diabetes or risk of developing diabetes. HbA1c is also used to monitor treatment for individuals diagnosed with diabetes. It helps to evaluate how well an individual’s glucose levels have been controlled by treatment over time. For monitoring purposes, an HbA1c of less than 6.5% indicates good glucose control and a lower risk of diabetic complications for the majority of people with diabetes.

eAG (estimated Average Glucose)

The HbA1c test report may include an estimated Average Glucose (eAG) reading, which is a calculated result based on the HbA1c levels. The estimated Average Glucose reflects indirectly the glucose level over a period of 2-3 months before the HbA1c measurement.

The purpose of reporting eAG is to help an individual relate HbA1c results to everyday glucose monitoring levels and to laboratory glucose tests.

Lipid Profile

Lipids

Lipids are a group of fats and fat-like substances that are important constituents of cells and sources of energy. A lipid panel measures the level of specific lipids in the blood.

Two important lipids, cholesterol and triglycerides, are transported in the blood by lipoproteins (also called lipoprotein particles). Each type of lipoprotein contains a combination of cholesterol, triglyceride, protein, and phospholipid molecules. The particles measured with a lipid panel are classified by their density into high-density lipoproteins (HDL), low-density lipoproteins (LDL), and very low-density lipoproteins (VLDL).

A Lipid panel typically includes:

• Total cholesterol
  - measures all the cholesterol in all the lipoprotein particles

• High-density lipoprotein cholesterol (HDL)
  - measures the cholesterol in HDL particles; often called "good cholesterol" because HDL-C takes up excess cholesterol and carries it to the liver for removal.

• Low-density lipoprotein cholesterol (LDL)
  - calculates or measures the cholesterol in LDL particles; often called "bad cholesterol" because it deposits excess cholesterol in walls of blood vessels, which can contribute to atherosclerosis.

• Triglycerides
  - measures all the triglycerides in all the lipoprotein particles.

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, although the reason for this is not well understood.

Renal Function Test

A renal panel is a group of tests that may be performed together to evaluate kidney (renal) function. The tests measure levels of various substances, including several minerals, electrolytes, proteins, and glucose (sugar), in the blood to determine the current health of your kidneys. 

The kidneys are a pair of bean-shaped organs located at the bottom of the ribcage to the right and left of the spine. They are part of the urinary tract and perform a few essential roles and functions within the body.

If the kidneys are not functioning properly, waste products can accumulate in the blood and fluid levels can increase to dangerous volumes, causing damage to the body or a potentially life-threatening situation. Numerous conditions and diseases can result in damage to the kidneys. The most common causes of and main risk factors for kidney disease are diabetes and hypertension.

The individual tests included in a renal panel can vary by laboratory, but the tests typically performed include:

Electrolytes – electrically charged chemicals that are vital to normal body processes, such as nerve and muscle function; among other things, they help regulate the amount of fluid in the body and maintain the acid-base balance. Electrolytes include:

• Sodium
• Potassium
• Chloride
• Bicarbonate (Total CO₂)

Waste products

• Urea/Blood Urea Nitrogen (BUN) – urea is a nitrogen-containing waste product that forms from the metabolism of protein; it is released by the liver into the blood and is carried to the kidneys, where it is filtered out of the blood and eliminated in the urine.
• Creatinine – another waste product that is produced by the body's muscles; almost all creatinine is eliminated by the kidneys.

Bone & Joints

Bone is the rigid, hard connective tissue that comprises the majority of the skeleton in humans. It is a living, growing tissue that turns over at a rate of about 10% a year. Bone markers are blood and urine tests that detect products of bone remodelling to help determine if the rate of bone resorption and/or formation is abnormally increased, suggesting a potential bone disorder. The markers can be used to help determine a person's risk of bone fracture and to monitor drug therapy for people receiving. Several diseases and conditions can cause an imbalance between bone resorption and formation, and bone markers can be useful in detecting the imbalance and bone loss. Most often, the markers have been studied in the evaluation and monitoring of osteoporosis, including age-related osteoporosis or secondary osteoporosis, which is bone loss due to an underlying condition. Bone loss may result from conditions such as rheumatoid arthritis, hyperparathyroidism, Cushing disease, chronic kidney disease, multiple myeloma, or from prolonged use of drugs such as anti-epileptics, glucocorticoids, or lithium. 

Calcium

Calcium is the most abundant and one of the most important minerals in the body. It is essential for cell signaling and the proper functioning of muscles, nerves, and the heart. Calcium is needed for blood clotting and is crucial for the formation density, and maintenance of bones and teeth. This test measures the amount of calcium in the blood or urine, which reflects the amount of total and ionized calcium in the body.

About 99% of calcium is found complexed in the bones, while the remaining 1% circulates in the blood. Calcium levels are tightly controlled; if there is too little absorbed or ingested, or if there is excess loss through the kidney or gut, calcium is taken from bone to maintain blood concentrations. Some calcium is lost from the body every day, filtered from the blood by the kidneys and excreted into the urine and sweat. Measurement of the amount of calcium in the urine is used to determine how much calcium the kidneys are eliminating.

Phosphate

Phosphorus/Phosphate is a mineral that combines with other substances to form organic and inorganic phosphate compounds. 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.

We get the phosphorus we need through the foods we eat. It is found in many foods and is readily absorbed by the digestive tract. Most of the body's phosphates combine with calcium to help form bones and teeth. Smaller amounts are found in muscle and nerve tissue. The rest is found within cells throughout the body, where they are mainly used to store energy.

Phosphorus deficiencies (hypophosphatemia) may be seen with malnutrition, mal-absorption, acid-base imbalances, increased blood calcium, and with disorders that affect kidney function. Phosphorus excesses (hyperphosphatemia) may be seen with increased intake of the mineral, low blood calcium, 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.

Uric Acid

Uric acid is produced by the breakdown of purines. Purines are nitrogen-containing compounds found in the cells of the body, including our DNA. As cells get old and die, they break down, releasing purines into the blood. To a lesser extent, purines may come from the digestion of certain foods, such as liver, anchovies, mackerel, dried beans and peas and certain alcoholic drinks, primarily beer. Most uric acid is removed from the body by the kidneys and is eliminated from the body in the urine, with the remainder eliminated in the stool.

If too much uric acid is produced or not enough is removed, it can accumulate in the body, causing increased levels in the blood (hyperuricemia). The presence of excess uric acid can cause gout, a condition characterised by inflammation of the joints due to the formation of uric acid crystals in the joint (synovial) fluid. Excess uric acid can also be deposited in tissues such as the kidney, leading to kidney stones or kidney failure.

The build-up of too much uric acid in the body can be due to producing too much, not eliminating enough, or a combination of both. Elevated levels of uric acid can occur when there is an increase in cell death, as seen with some cancer therapies or, rarely, as an inherited tendency to produce too much uric acid. Decreased elimination of uric acid is often a result of impaired kidney function due to kidney disease.

Rheumatoid Factor (RA Factor)

Rheumatoid factor (RF) is an auto-antibody, an immunoglobulin M (IgM) protein that is produced by the body's immune system. Auto-antibodies attack a person's own tissues, mistakenly identifying the tissue as "foreign." While the biologic role of RF is not well understood, its presence is useful as an indicator of inflammatory and auto-immune activity.

Rheumatoid Arthritis (RA) is a chronic, systemic auto-immune disease that causes inflammation, pain, stiffness, and destructive changes in the hands, feet, and other joints throughout the body. Some patients may show signs of fatigue, low-grade fevers, and weight loss.

It can affect anyone at any age but usually develops in the late child-bearing years in women and between the ages of 60 to 80 in men. Over 70% of those affected with RA are women. The course of RA and its prognosis are variable. It may develop and progress slowly or rapidly. It may go into remission in some people and, in a few, it may go away. Left untreated, RA can shorten a person's lifespan and can, within a few years, leave many of those affected too disabled to work.

There are a variety of treatments available to minimise the complications of RA, but they depend on making an accurate diagnosis and on beginning treatment before the development of significant joint damage. 

Rheumatoid factor has been used to detect RA. Because the sensitivity and specificity of RF are not ideal, other laboratory tests are often performed in conjunction with RF testing. About 80% of those with RA will have a positive RF test, but it can be negative in people who have clinical signs of RA.

Total Vitamin D

Vitamin D is a family of compounds that is essential for the proper growth and formation of teeth and bones.  Two forms of vitamin D can be measured in the blood, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D. The 25-hydroxyvitamin D is the major form found in the blood and is the relatively inactive precursor to the active hormone, 1,25-dihydroxyvitamin D. Because of its long half-life and higher concentration, 25-hydroxyvitamin D is commonly measured to assess and monitor vitamin D status in individuals.

Vitamin D comes from two sources: endogenous, which is produced in the skin on exposure to sunlight, and exogenous, which is ingested in foods and supplements. The chemical structures of the types of vitamin D are slightly different, and they are named vitamin D₂ (ergocalciferol, which comes from plants) and vitamin D₃ (cholecalciferol, which comes from animals). The D₂ form is found in fortified foods and in most vitamin preparations and supplements. Vitamin D₃ is the form produced in the body and is also used in some supplements. Vitamin D₂ and D₃ are equally effective when they are converted by the liver and the kidney into the active form, 1,25-dihydroxyvitamin D.

Liver Function Test 

A liver panel is a group of tests that are performed together to detect, evaluate, and monitor liver disease or damage. The liver is one of the largest organs in the body and is located in the upper right-hand part of the abdomen and behind the lower ribs. The liver metabolises and detoxifies drugs and substances that are harmful to the body. It produces blood clotting factors, proteins, and enzymes, helps maintain hormone balances, and stores vitamins and minerals. Bile, a fluid produced by the liver, is transported through ducts directly to the small intestine to help digest fats or to the gallbladder to be stored and concentrated for later use.

A variety of diseases and infections can cause acute or chronic damage to the liver, causing inflammation (hepatitis), scarring (cirrhosis), bile duct obstructions, liver tumours, and liver dysfunction. Alcohol, drugs, some herbal supplements, and toxins can also pose a threat. A significant amount of liver damage may be present before symptoms such as jaundice, dark urine, light-coloured stools, itching (pruritus), nausea, fatigue, diarrhoea, and unexplained weight loss or gain emerge. Early detection is essential in order to minimise damage and preserve liver function.

The liver panel measures enzymes, proteins, and substances that are produced, processed or eliminated by the liver and are affected by liver injury. Some are released by damaged liver cells and some reflect a decrease in the liver's ability to perform one or more of its functions. When performed together, these tests give a healthcare practitioner a snapshot of the health of a person's liver, an indication of the potential severity of any liver injury, change in liver status over time, and a starting place for further diagnostic testing.

Hepatitis Screening

Hepatitis is an inflammation of the liver. Most often, hepatitis is caused by infection with certain viruses. However, liver inflammation can also result from exposure to chemicals, over-the-counter or prescription drugs, heavy alcohol use, inherited diseases, autoimmune disease, or fatty buildup in the liver.

Hepatitis can be acute, flaring up and then resolving within a few weeks to months, or chronic, enduring over many years. Chronic hepatitis may persist for 20 years or more before causing significant symptoms related to progressive liver damage, such as cirrhosis and liver cancer, and can cause death.

The liver is a vital organ located in the upper right-hand side of the abdomen. It performs many functions in the body, including processing the body's nutrients, producing bile to help digest fats, synthesizing many important proteins, regulating blood clotting, and breaking down potentially toxic substances into harmless ones that the body can use or eliminate. In severe cases, liver inflammation may interfere with these processes and allow potentially toxic substances to build up.

The following table summarises some common types of hepatitis:

Type of Hepatitis	Description	Examples of Causes
Viral	Infection with one of the hepatitis viruses causes inflammation; may be acute or chronic depending on virus.	Most common causes are hepatitis A, B and C viruses.
Toxic or drug-induced	The liver processes many substances for the body to use and/or eliminate. The byproducts of this process can be toxic to the liver and may cause hepatitis. In other cases, hepatitis occurs with a drug that is not directly toxic to the liver but the body recognises the drug as foreign and attacks it, causing hepatitis.	Alcohol, over-the-counter pain relievers, prescription drugs, herbal and vitamin supplements, industrial chemicals
Inherited	Certain gene mutations that are passed from one generation to the next can result in a disease that damages the liver, causing hepatitis.	Wilson disease, hemochromatosis, alpha-1 antitrypsin deficiency
Non-alcoholic fatty liver	Fat deposited in the liver cells in increasing amounts can lead to inflammation and liver injury, causing hepatitis.	Associated with metabolic syndrome
Autoimmune	The body's immune system inappropriately produces antibodies directed against liver tissue, causing hepatitis.	Sometimes associated with other autoimmune diseases, such as type 1 diabetes, Hashimoto thyroiditis, pernicious anemia, or Sjögren syndrome

There are different tests for hepatitis A and B. A positive test may mean:

• You currently have a hepatitis infection. This may be a new infection (acute hepatitis), or it may be an infection that you have had for a long time (chronic hepatitis).

• You had a hepatitis infection in the past, but you no longer have the infection and can't spread it to others.

Hepatitis A test results:

• IgM anti-hepatitis A virus (HAV) antibodies, you have had a recent infection with hepatitis A.
• Total (IgM and IgG) antibodies to hepatitis A, you have a previous or past infection, or immunity to hepatitis A 

Hepatitis B test results:

• Hepatitis B surface antigen (HBsAg): you have an active hepatitis B infection, either recent or chronic (long-term)
• Antibody to hepatitis B core antigen (Anti-HBc), you have a recent or past hepatitis B infection
• Antibody to HBsAg (Anti-HBs): you have a past hepatitis B infection or you have received the hepatitis B vaccine and are unlikely to become infected
• Hepatitis B type e antigen (HBeAg): you have a chronic hepatitis B infection and you are more likely to spread the infection to others through sexual contact or by sharing needles

Hepatitis C test results:

Antibodies to hepatitis C can most often be detected 4 to 10 weeks after you get the infection. Other types of tests may be done to decide on treatment and monitor the hepatitis C infection.

Tumour Markers

Tumour markers are substances, often proteins, that are produced by the cancer tissue itself or sometimes by the body in response to cancer growth. Because some of these substances can be detected in body samples such as blood, urine, and tissue, these markers may be used, along with other tests and procedures, to help detect and diagnose some types of cancer, predict and monitor a person's response to certain treatments, and detect recurrence.

While quite a few tumour markers are available and have been found to be clinically useful, others are available but not ordered frequently because they have been found to be less sensitive and/or specific.

Limitations

While tumour marker tests can provide very useful information, they do have limitations:

• Many tumour markers may also be elevated in persons with conditions or diseases other than cancer.
• Some tumour markers are specific for a particular type of cancer, while others are seen in several different types of cancer.
• Not every person with a particular type of cancer will have an elevated level of the corresponding tumour marker.
• Not every cancer has a tumour marker that has been identified as associated with it.

Consequently, tumour markers alone are not diagnostic for cancer; for some types of cancer, they provide additional information that can be considered in conjunction with a patient's medical history and physical exam as well as other laboratory and/or imaging tests.

Alpha Fetoprotein

Alpha Fetoprotein (AFP) is produced whenever liver cells are regenerating. With chronic liver diseases, such as hepatitis and cirrhosis, AFP may be chronically elevated. Very high concentrations of AFP may be produced by certain tumours. This characteristic makes the AFP test useful as a tumour marker. Increased amounts of AFP are found in many people with a type of liver cancer called hepatocellular carcinoma and in a liver cancer occurring in infants called hepatoblastoma. They are also found in some people with cancers of the testicles or ovaries. AFP exists in several different variants. The standard AFP test is for a total AFP, one that measures all of the AFP variants together.

Carcinoembryonic Antigen

Carcinoembryonic Antigen (CEA) is a protein that is present in certain tissues of a developing baby (fetus). By the time a baby is born, it drops to a very low level. In adults, CEA is normally present at very low levels in the blood but may be elevated with certain types of cancer. This test measures the amount of CEA in the blood to help evaluate individuals diagnosed with cancer.

CEA is a tumour marker. Originally, it was thought that CEA was a specific marker for colon cancer, but further study has shown that an increase in CEA may be seen in a wide variety of other cancers. CEA can also be increased in some non-cancer-related conditions, such as inflammation, cirrhosis, peptic ulcer, ulcerative colitis, rectal polyps, emphysema, and benign breast disease, and in smokers. For this reason, it is not useful as a general cancer screening tool, but it does have a role in evaluating response to cancer treatment. When an individual has been diagnosed with cancer, an initial baseline test for CEA may be performed. If this level is elevated, then subsequent serial testing of CEA may be performed to monitor the cancer as the individual undergoes treatment.

Cancer Antigen CA125

CA125  is a protein that is present on the surface of most, but not all, ovarian cancer cells. This makes the test useful as a tumour marker in specific circumstances. Significantly elevated concentrations of CA-125 may be present in the blood of a woman who has ovarian cancer. Thus the test may be used to monitor the effectiveness of treatment and/or for recurrence of the cancer. However, not all women with ovarian cancer will have elevated CA-125 so the test may not be useful in all cases.

Cancer Antigen 15-3 (CA15-3)

CA 15-3 is a protein that is produced by normal breast cells. In many people with cancerous breast tumours, there is an increased production of CA 15-3 and the related cancer antigen 27.29. CA 15-3 does not cause cancer; rather, it is shed by the tumour cells and enters the blood.

Since CA 15-3 can be measured in the blood, it is useful as a tumour marker to follow the course of the cancer. CA 15-3 is elevated in fewer than 50% of women with early localised, breast cancer or with a small tumour, but is elevated in about 80% of those with breast cancer that has spread (metastatic). Because not all women with invasive breast cancer will have elevated CA 15-3, the test is not useful in all cases.

CA 15-3 is not recommended as a screening test to detect breast cancer in women because it is non-specific. It may also be elevated in healthy people and in individuals with other cancers such as colon, lung, pancreas, ovarian, or prostate malignancies or certain conditions such as cirrhosis, hepatitis, and benign breast disease.

Cancer antigen 19-9 (CA 19-9)

CA19.9 is a protein that exists on the surface of certain cancer cells. CA 19-9 does not cause cancer; rather, it is shed by the tumour cells and can be detected by laboratory tests in blood and sometimes other body fluids.

Since CA 19-9 can be measured in blood, it is useful as a tumour marker to follow the course of the cancer. CA 19-9 is elevated in about 70% to 95% of people with advanced pancreatic cancer. However, CA 19-9 may also be elevated in other cancers, conditions, and diseases such as: gallbladder and bile duct cancers (cholangiocarcinoma), colorectal cancer, gastric cancers, ovarian cancer, lung cancer, liver cancer, bile duct obstruction (e.g., gallstones), pancreatitis, cystic fibrosis, thyroid disease, and liver disease. Small amounts of CA 19-9 are present in the blood of healthy people. Since CA 19-9 is not specific for pancreatic cancer, it cannot be used by itself for screening or diagnosis.

Prostate Specific Antigen (PSA)

PSA is a protein produced primarily by cells in the prostate, a small gland in males that encircles the urethra 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 blood. PSA exists in two main forms in the blood: complexed (cPSA, bound to other proteins) and free (fPSA, not bound). The most frequently used PSA test is the total PSA, which measures the sum of cPSA and fPSA in the blood.

The PSA test may be used as a tumour marker to screen for and to monitor prostate cancer. The goal of screening is to detect prostate cancer while it is still confined to the prostate. However, most experts agree that screening should be done on asymptomatic men only after thorough discussions with their healthcare practitioners on the benefits and risks and after informed decisions are made to undergo screening.  Elevated blood levels of PSA are associated with prostate cancer, but they may also be seen with inflammation of the prostate (prostatitis) and benign prostatic hyperplasia (BPH).

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. An elevated PSA may be followed by a biopsy, which has risk of complications such as pain, fever, blood in the urine, or urinary tract infection.

Free Prostate Specific Antigen (fPSA)

PSA exists in two main forms in the blood: complexed (cPSA, bound to other proteins) and free (fPSA, not bound). The free PSA test may be used to help to determine whether a biopsy should be done when the total PSA is only slightly elevated. Men with BPH tend to have higher levels of free PSA and men with prostate cancer tend to have lower amounts of free PSA. A relatively low percentage of free PSA (% fPSA) increases the chances that a cancer is present, even if the total PSA is not significantly elevated.

Thyroid Function Test

A thyroid panel is a group of tests that may be ordered together to help evaluate thyroid gland function and to help diagnose thyroid disorders. The tests included in a thyroid panel measure the amount of thyroid hormones in the blood. These hormones are chemical substances that travel through the blood and control or regulate the body's metabolism - how it functions and uses energy. The thyroid panel usually includes:

• Thyroid Stimulating Hormone (TSH) - to test for hypothyroidism, hyperthyroidism and to monitor treatment for a thyroid disorder
• Free T4 - to test for hypothyroidism and hyperthyroidism; may also be used to monitor treatment
• Free T3 – to test for hyperthyroidism; may also be used to monitor treatment

Sexually Transmitted Disease

 Sexually transmitted diseases (STDs), also called sexually transmitted infections (STIs) or venereal diseases, are infections caused by organisms that can be transmitted from one person to another through sexual activity and intimate contact.

Since many STDs have few or no symptoms, it is possible for a person to have an infection and to infect others without either of them knowing it. For this reason, screening for these infections is important to ensure early detection and prompt treatment. Tests for STDs are recommended as part of routine health screens for sexually active teens and young adults as well as older adults who may be at risk.

Untreated STDs have significant long-term consequences. They can lead to sterility in both sexes. In women, STDs can result in pelvic inflammatory disease, which increases the risk of infertility and ectopic pregnancies. One STD in particular, HPV, can increase risk of cervical cancer in women. In addition, women who are pregnant or planning a pregnancy should be aware that untreated STDs can cause complications for their newborn. Screening tests for several of these STDs are now part of routine prenatal care.

Urine Biochemistry & Stool Analysis

Urine Microalbumin

Albumin is a major protein normally present in blood, but virtually no albumin is present in the urine when the kidneys are functioning properly. However, albumin may be detected in the urine even in the early stages of kidney disease. The urine albumin test (formerly called microalbumin) detects and measures the amount of albumin in the urine to screen for kidney disease.

Most of the time, tests for albumin and creatinine are done on a urine sample collected randomly (not timed) and an albumin-to-creatinine ratio (ACR) is calculated. This is done to provide a more accurate indication of the how much albumin is being released into the urine. Creatinine, a byproduct of muscle metabolism, is normally released into the urine at a constant rate and its level in the urine is an indication of the urine concentration. This property of creatinine allows its measurement to be used to correct for urine concentration when measuring albumin in a random urine sample.

The presence of a small amount of albumin in the urine may be an early indicator of kidney disease. A small amount of albumin in the urine is sometimes referred to as urine microalbumin or microalbuminuria. "Microalbuminuria" is slowly being replaced with the term "albuminuria," which refers to any elevation of albumin in the urine.

If a person's kidneys become damaged or diseased, they begin to lose their ability to conserve albumin and other proteins. This is frequently seen in chronic diseases, such as diabetes and hypertension, with increasing amounts of protein in the urine reflecting increasing kidney dysfunction. Albumin is one of the first proteins to be detected in the urine with kidney damage. People who have consistently detectable small amounts of albumin in their urine (albuminuria) have an increased risk of developing progressive kidney failure and cardiovascular disease in the future.

URINALYSIS

A urinalysis is a group of physical, chemical, and microscopic tests. The tests detect and/or measure several substances in the urine, such as byproducts of normal and abnormal metabolism, cells, cellular fragments, and bacteria.

Urine is produced by the kidneys, two fist-sized organs located on either side of the spine at the bottom of the ribcage. The kidneys filter wastes out of the blood, help regulate the amount of water in the body, and conserve proteins, electrolytes, and other compounds that the body can reuse. Anything that is not needed is eliminated in the urine, traveling from the kidneys through ureters to the bladder and then through the urethra and out of the body. Urine is generally yellow and relatively clear, but each time a person urinates, the color, quantity, concentration, and content of the urine will be slightly different because of varying constituents.

Many disorders may be detected in their early stages by identifying substances that are not normally present in the urine and/or by measuring abnormal levels of certain substances. Some examples include glucose, protein, bilirubin, red blood cells, white blood cells, crystals, and bacteria. They may be present because:

1. There is an elevated level of the substance in the blood and the body responds by trying to eliminate the excess in the urine.
2. Kidney disease is present.
3. There is a urinary tract infection present, as in the case of bacteria and white blood cells.

A microscopic examination is typically performed when there is an abnormal finding on the visual or chemical examination, or if a healthcare practitioner specifically orders it. Abnormal findings on a urinalysis may prompt repeat testing to see if the results are still abnormal and/or may be followed by additional urine and blood tests to help establish a diagnosis. 

STOOL ANALYSIS 

Faecal Occult Blood Test (FOBT) Test is designed to evaluate stool samples for hidden ("occult") blood, meaning blood that cannot be seen with the naked eye. Although there are several possible causes of blood in the stool, one important cause is the presence of polyps or cancers in the digestive tract.

Colon polyps are common as people age, but most polyps do not cause any health problems and are benign. However, a benign polyp can turn into a cancerous polyp and the cancer may even spread to other parts of the body (metastasize). If detected early, colon cancer can be successfully treated. It is therefore important to determine whether pre-cancerous or cancerous polyps are present.

Polyps are finger-like growths that protrude into the cavity (lumen) of the colon or the rectum. They can be fragile and bleed intermittently, such as when food waste brushes against them. This blood is mixed in with the stool and when the amounts are small, the blood can only be detected by tests for occult blood. This small amount of blood may be the first and sometimes the only sign of polyps or early colon cancer, making the stool-based tests valuable screening tools.

Source: Testing.com - https://www.testing.com/

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