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Vitamin B12 (Cyanocobalamin)
Investigation Result Units Biological Reference Interval

Vitamin B12 (Cyanocobalamin) 891.9 pg/mL 191 - 663

• Sample type : Serum. • Method: ECLIA. • Comments : Vitamin B12 performs many important functions in the body, but the most significant function is to act as coenzyme for reducing ribonucleotides to deoxyribonucleotides, a step in the formation of genes. Inadequate dietary intake is not the commonest cause for cobalamine deficiency. The most common cause is malabsorption either due to atrophy of gastric mucosa or diseases of terminal ileum. Cobalamine deficiency leads to Megaloblastic anemia and demyelination of large nerve fibres of spinal cord. Normal body stores are sufficient to last for 3-6 years. Sources of Vitamin B12 are liver, shellfish, fish, meat, eggs, milk, cheese & yogurt. • Decreased Levels : 1. Lack of Intrinsic factor: Total or partial gastrectomy, Atrophic gastritis, Intrinsic factor antibodies. 2. Malabsorption: Regional ileitis, resected bowel, Tropical Sprue, Celiac disease, pancreatic insufficiency, bacterial overgrowth & achlorhydria. 3. Loss of ingested vitamin B12: fish tapeworm. 4. Dietary deficiency: Vegetarians. 5. Congenital disorders: Orotic aciduria & transcobalamine deficiency. 6. Increased demand: Pregnancy specially last trimester. • Increased Levels : Chronic renal failure, Congestive heart failure, Acute & Chronic Myeloid Leukemia, Polycythemia vera, Carcinomas with liver metastasis, Liver disease, Drug induced cholestasis & Protein malnutrition • Disclaimer : 1) The above result relate only to the specimens received and tested in laboratory and should be always correlate with clinical findings and other laboratory markers. 2) Improper specimen collection, handling, storage and transportation may result in false negative/Positive results.

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Vitamin D Total - 25 Hydroxy
Investigation Result Units Biological Reference Interval

25-OH Vitamin D 34.43 ng/mL Deficiency-<20
Insufficiency-20-<30
Sufficiency-30-100

• Sample type : Serum. • Method : ECLIA. Interpretation : Vitamin D is a fat soluble vitamin and exists in two main forms as cholecalciferol(vitamin D3) which is synthesized in skin from 7-dehydrocholesterol in response to sunlight exposure & Ergocalciferol(vitamin D2) present mainly in dietary sources.Both cholecalciferol & Ergocalciferol are converted to 25(OH)vitamin D in liver. Testing for 25(OH)vitamin D is recommended as it is the best indicator of vitamin D nutritional status as obtained from sunlight exposure & dietary intake. For diagnosis of vitamin D deficiency it is recommended to have clinical correlation with serum 25(OH)vitamin D, serum calcium, serum PTH & serum alkaline phosphatase. During monitoring of oral vitamin D therapy- suggested testing of serum 25(OH)vitamin D is after 12 weeks or 3 mths of treatment. However, the required dosage of vitamin D supplements & time to achieve sufficient vitamin D levels show significant seasonal(especially winter) & individual variability depending on age, body fat, sun exposure, physical activity ,genetic factors(especially variable vitamin D receptor responses), associated liver or renal disease, malabsorption syndromes and calcium or magnesium deficiency influencing the vitamin D metabolism Vitamin D toxicity is known but very rare. Disclaimer : 1) The above result relate only to the specimens received and tested in laboratory and should be always correlate with clinical findings and other laboratory markers. 2) Improper specimen collection, handling, storage and transportation may result in false negative/Positive results.

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Thyroid Function Test (TFT)
Investigation Result Units Biological Reference Interval

T3 (Triiodothyronine) 1.24 ng/mL 0.8 - 2.0
• Sample Type : Serum.
• Method : ECLIA.
T4 (Thyroxine) 8.8 ug/dl 5.1 - 14.1
• Sample Type : Serum.
• Method : ECLIA.
ULTRA Thyroid Stimulating Hormone (TSH) 6.12 uIU/mL 0.270 - 4.20
• Sample Type : Serum.
• Method : ECLIA.

1) TSH levels are subject to circadian variation, reaching peak levels between 2 - 4.a.m. and at a minimum between 6-10 pm. The variation is of the order of 50% . hence time of the day has influence on the measured serum TSH concentrations. 2) Recommended test for T3 and T4 is unbound fraction or free levels as it is metabolically active. 3) Physiological rise in Total T3 / T4 levels is seen in pregnancy and in patients on steroid therapy. Clinical Use : • Primary Hypothyroidism • Hyperthyroidism • Hypothalamic – Pituitary hypothyroidism • Inappropriate TSH secretion • Nonthyroidal illness • Autoimmune thyroid disease • Pregnancy associated thyroid disorders. • References : - Henry’s Clinical Diagnosis and Management, 23rd edition. -Tietz Fundamentals of Clinical Chemistry and Molecular Diagnosis, 7th edition. •Disclaimer: 1) The above result relate only to the specimens received and tested in laboratory and should be always correlate with clinical findings and other laboratory markers. 2) Improper specimen collection, handling,storage and transportation may result in false negative/Positive results.

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P011B000403027
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CBC (Haemogram)
Investigation Result Units Biological Reference Interval

Haemoglobin (Hb) 12.6 gm/dL 13 - 17
Sample Type : EDTA Whole Blood
Method : Free Cyanide
Hematocrit 38.4 % 40 - 50
Sample Type : EDTA Whole Blood
Method : Calculated
RBC Count 4.72 million/cmm 4.5 - 5.5
Sample Type : EDTA Whole Blood
Method : Electrical Impedance
WBC (Total Leukocyte) Count 9070 Cells/cumm 4000 - 10000
Sample Type : EDTA Whole Blood
Method : Flow Cytometry
Platelet Count 119000 /cmm 150000 - 450000
Sample Type : EDTA Whole Blood
Method : Electrical Impedance
CBC (Haemogram)
Investigation Result Units Biological Reference Interval

Manual Platelet Count 00 /cmm
Sample Type : EDTA Whole Blood
Method : Microscopy using Leishman stain
MCV 81.2 fL 83 - 101
Sample Type : EDTA Whole Blood
Method : Calculated
MCH 26.7 pg 27 - 32
Sample Type : EDTA Whole Blood
Method : Calculated
MCHC 32.9 g/dL 31.5 - 34.5
Sample Type : EDTA Whole Blood
Method : Calculated
RDW-CV 16.1 % 11.6 - 14
Sample Type : EDTA Whole Blood
Method : Calculated
RDW-SD 52.9 fL 35 - 56
Sample Type : EDTA Whole Blood
Method : Calculated
MPV (Mean Platelet Volume) 12.2 fL 6 - 9.5
Sample Type : EDTA Whole Blood
Method : Calculated
PDW (Platelet Distribution Width) 16.6 % 9 - 17
Sample Type : EDTA Whole Blood
Method : Calculated
PCT 0.15 % 0.2 - 0.5
Sample Type : EDTA Whole Blood
Method : Calculated
CBC (Haemogram)
Investigation Result Units Biological Reference Interval

Neutrophils (%) 68.4 % 40 - 80
Sample Type : EDTA Whole Blood
Method : Flow Cytometry
Lymphocytes (%) 21.6 % 20 - 40
Sample Type : EDTA Whole Blood
Method : Flow Cytometry
Monocytes (%) 5.7 % 2 - 10
Sample Type : EDTA Whole Blood
Method : Flow Cytometry
Eosinophils (%) 4.3 % 1 - 6
Sample Type : EDTA Whole Blood
Method : Flow Cytometry
Basophils (%) 0 % 0 - 2
Sample Type : EDTA Whole Blood
Method : Flow Cytometry
Absolute Neutrophils Count 6203.88 /c.mm 2000 - 7000
Sample Type : EDTA Whole Blood
Method : Calculated
CBC (Haemogram)
Investigation Result Units Biological Reference Interval

Absolute Lymphocyte Count 1959.12 /c.mm 1000 - 3000
Sample Type : EDTA Whole Blood
Method : Calculated
Absolute Monocyte Count 516.99 /c.mm 200 - 1000
Sample Type: EDTA Whole Blood
Method: Calculated
Absolute Eosinophil Count 390.01 /c.mm 20 - 500
Sample Type : EDTA Whole Blood
Method : Calculated
Absolute Basophil Count 0 /c.mm 20 - 100
Sample Type : EDTA Whole Blood
Method : Calculated
Absolute Neutrophil/Lymphocyte Ratio 00 -- --
Sample Type : EDTA Whole Blood
Method : Calculated
Blasts (%) 00 %
Sample Type: EDTA Whole Blood
Method: Microscopy using Leishman stain
Promyelocytes (%) 00 %
Sample Type: EDTA Whole Blood
Method: Microscopy using Leishman stain
Myelocytes (%) 00 %
Sample Type: EDTA Whole Blood
Method: Microscopy using Leishman stain
Metamyelocytes (%) 00 %
Sample Type: EDTA Whole Blood
Method: Microscopy using Leishman stain
CBC (Haemogram)
Investigation Result Units Biological Reference Interval

Band form Cells (%) 00 %
Sample Type: EDTA Whole Blood
Method: Microscopy using Leishman stain
RBC Morphology Normocytic Normochromic - -
Sample Type: EDTA Whole Blood
Method: Microscopy using Leishman stain
WBC Morphology Total leucocyte count within normal limits - -
Sample Type: EDTA Whole Blood
Method: Microscopy using Leishman stain
Platelets Just Adequate -- -
Sample Type: EDTA Whole Blood
Method: Microscopy using Leishman stain
CBC (Haemogram)
Clinical Significance:
Test Causes of Low Abnormal Causes of High Abnormal
White blood cell count (WBC) Autoimmune diseases, immunosuppression, bone marrow failure, chemotherapy, viral infections Infection, inflammation, leukemia, intense exercise, stress, corticosteroids
Lymphocytes, absolute (LY, abs) or percentage (LY, pct) Immunosuppression, HIV-AIDS, bone marrow failure, chemotherapy Viral infections, leukemia, lymphoma
Monocytes, absolute (MO, abs) or percentage (MO, pct) Immunosuppression, bone marrow failure, chemotherapy Chronic infections, autoimmune diseases, leukemia
Granulocytes, absolute (GR, abs) or percentage (GR, pct) Immunosuppression, bone marrow failure, chemotherapy Infection, inflammation, leukemia, intense exercise, stress, corticosteroids
Neutrophils, absolute (NE, abs) or percentage (NE, pct) Immunosuppression, bone marrow failure, chemotherapy Infection, inflammation, leukemia, intense exercise, stress, corticosteroids
Eosinophils, absolute (EOS, abs) or percentage (EOS, pct) Sepsis, Alcohol Intoxication, Stress, Increased Cortisol Parasitic infections, Active Allergic Response
Basophils, absolute (BAS, abs) or percentage (BAS, pct) Stress, Chemotherapy, Radiotherapy, Corticosteroid Chronic Inflammation, Autoimmune Disease, Leukemia
Red blood cell count (RBC) Iron, vitamin B12, or folate deficiency; bone marrow damage; leukemia or lymphoma; acute or chronic blood loss; red blood cell hemolysis Dehydration, renal problems, pulmonary disease, congenital heart disease, polycythemia vera
CBC (Haemogram)
Clinical Significance:
Test Causes of Low Abnormal Causes of High Abnormal
Hemoglobin (HgB) Iron, vitamin B12, or folate deficiency; bone marrow damage; leukemia or lymphoma; acute or chronic blood loss; red blood cell hemolysis Dehydration, renal problems, pulmonary disease, congenital heart disease, polycythemia vera
Hematocrit (PCV) Iron, vitamin B12, or folate deficiency; bone marrow damage; leukemia or lymphoma; acute or chronic blood loss; red blood cell hemolysis Dehydration, renal problems, pulmonary disease, congenital heart disease, polycythemia vera
Mean corpuscular volume (MCV) Iron deficiency, Thalassemia, lead poisoning Vitamin B12 or folate deficiency, Chronic liver disease
Mean corpuscular hemoglobin (MCH) Iron deficiency, Thalassemia Vitamin B12 or folate deficiency, Macrocytosis
Mean corpuscular hemoglobin concentration (MCHC) Iron deficiency, Thalassemia Sickle cell disease, hereditary spherocytosis
Red cell distribution width (RDW) Generally not a concern Iron deficiency, vitamin B12 or folate deficiency, recent blood loss
Platelet count (PLT) Bone marrow failure, chemotherapy, viral infections, lupus, pernicious anemia (due to vitamin B12 deficiency), leukemia or lymphoma, sequestration in the spleen, certain medications Leukemia, myeloproliferative disorders (which cause blood cells to grow abnormally in bone marrow), inflammatory conditions
Mean platelet volume (MPV) Aplastic anemia, thrombocytopenia, bone marrow suppression Certain inherited disorders

Disclaimer: The above result relate only to the specimens and should be always correlate with clinical findings and other laboratory markers.

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