Laboratory Test Preparation

Not Applicable

Not Applicable

Galectin-3 - A galectin-3 test may be ordered for the identification of individuals with chronic heart failure at elevated risk of disease progression

Enzyme Linked Immunosorbent Assay (ELISA)

Special test

1. Collect and label sample according to standard protocols.
2. Gently invert tube 5 times immediately after draw.DO NOT SHAKE.
3. Allow blood to clot for 30 minutes.
4. Centrifuge for 10 minutes.
5. Store and transport refrigerated.

Gold or Red Tube

2mL Serum

Not applicable

22 days

22 days

30 days

Transport specimen at 2ºC - 8ºC (with cold packs)

• Insufficient volume
• Improperly labeled specimens
• Markedly lipemic sample
• Hemolyzed sample
• Exceeded sample stability requirement

Batch Running

Monday, 12:00 PM

2 weeks after cut off (excluding saturday, sunday and holidays)

-

• polyps
• porcelain gallbladder
• perforation

• No food intake for at least 6 hours.
• Drinking of water is not prohibited.
• Bring previous ultrasound result for comparison.

-

-

-

Not applicable

Not applicable

• A gallstone is a stone formed within the gallbladder out of bile components. 

• quantitative chemical analysis of total cholesterol bilirubin, calcium, iron and inorganic phosphate in 120 gallstones from haryana.

Colorimetric

Special Test

Not applicable

Sterile clean container

gall bladder

Not applicable

1 year

1 year

1 year

Transport specimen at 15 °C – 25 °C (Room Temperature)

•Gall bladder immersed in any other liquid other than water
• Gall bladder with tape or any type of adhesive
• Gall bladder specimens with non-stone particulates
• Exceeded sample storage and transport temperature requirement
• Improperly labeled specimens
• Insufficient sample quantity

Monday to Friday

4:00 PM

After 3 days (excldiung Satudays,  Sundays and Holidays)

Not applicable

Not applicable

Not applicable

Not applicable

• GM-1 Antibody
• Ganglioside GM-1 Antibodies (IgG/IgM)

• Ganglioside GM-1 Antibody IgG
• Ganglioside GM-1 Antibody IgM

Ganglioside GM-1 Antibodies (IgG, IgM), EIA - Ganglioside GM-1 Antibody IgG is associated with the Guillain-Barre syndrome, particularly the acute motor axonal neuropathy variant. Antibody IgM is associated with chronic multifocal motor neuropathy.

Immunoassay (IA)

Special Test

8 Hours Fasting

Red or Gold Tube

3 mL Serum

Not Applicable

24 Hours

7 Days

28 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Batch Running

Monday, 12:00 PM

3 weeks after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified

Not applicable

Dementia, Guillain–Barre syndrome

Not applicable

Not Applicable

Gastrin regulates the growth of the acid-producing cells of the gastric mucosa. Increased levels are seen in patients with duodenal and pyloric ulcers, and with gastrinoma (Zollinger-Ellison syndrome). The main actions of the hormone are to stimulate gastric acid secretion and contraction of the gastric musculature. Its release is stimulated by distension of the antrum, by the action of peptides at the gastric antrum, and by inadequate acid production. The latter appears to act as a negative feedback controlling gastric acid homeostasis.To determine whether you are producing too mucg gastin; to help diagnose Zollinger-Ellison Syndrome and gastrin-producing tumors (gastrinomas) or G-cell hyperplasia; to monitor for recurrence of a gastrinoma. 

Radioimmunoassay (RIA)

Special Test

• 10 to 12 hours fasting.
• After removing the coagulated mass, quickly centrifuge the sample to separate the serum.

Red or Gold Tube

3 mL Serum

Not Applicable

Not Applicable

24 Hours 

28 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Batch Running

Friday, 12:00 PM

2 weeks after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None Specified.

Q: Why Get Tested?

A:To determine whether you are producing too much gastrin; to help diagnose Zollinger-Ellison syndrome and gastrin-producing tumors (gastrinomas) or G-cell hyperplasia; to monitor for recurrence of a gastrinoma

Q: When To Get Tested?

A:When you have peptic ulcers and/or diarrhea and abdominal pain that your healthcare practitioner suspects is caused by excess gastrin; periodically to monitor for a gastrinoma recurrence

Q: What is being tested?

A:Gastrin is a hormone produced by "G-cells" in the part of the stomach called the antrum. It regulates the production of acid in the body of the stomach during the digestive process. This test measures the amount of gastrin in the blood to help evaluate an individual with recurrent peptic ulcers and/or other serious abdominal symptoms.

When food is eaten, the antrum of the stomach becomes distended and the presence of food stimulates the release of gastrin. Gastrin in turn stimulates parietal cells to produce gastric acid. Acidity helps to digest food and the rise in acidity eventually suppresses gastrin release. This feedback system normally results in low concentrations of gastrin in the blood, especially in the fasting state. Rare conditions such as G-cell hyperplasia and gastrinomas, including Zollinger-Ellison (ZE) syndrome, can cause an overproduction of gastrin and gastric acid. This can lead to aggressive peptic ulcers that can be difficult to treat.

Gastrinomas are gastrin-producing tumors. ZE syndrome is a condition caused by the presence of one or more gastrinomas and is characterized by high gastrin levels, greatly increased gastric acid production, and by peptic ulcers. Gastrinomas usually form in the pancreas, even though the endocrine cells of the pancreas do not normally make gastrin. More than half of them are malignant, causing cancer that can spread to other parts of the body, such as the liver. Even tiny tumors can produce large quantities of gastrin.

Q: How is it used?

A:The gastrin test is primarily used to help detect excess production of gastrin and gastric acid. It is used to help diagnose gastrin-producing tumors called gastrinomas, Zollinger-Ellison (ZE) syndrome, and hyperplasia of G-cells. G-cells are specialized cells in the stomach that produce gastrin, which in turn increases the production of gastric acid.

A gastrin test may also be used to monitor for recurrence following the surgical removal of a gastrinoma.

A gastrin stimulation test therefore may be used to provide additional information if the initial gastrin test result is moderately but not significantly elevated and the healthcare practitioner suspects that a person's symptoms are due to a gastrinoma. This procedure involves collecting a baseline gastrin sample, giving the patient a chemical (typically the hormone secretin) to stimulate gastrin production, and then collecting additional blood samples at timed intervals for gastrin testing. The other (benign) causes of elevated gastrin will not show an increase after secretin administration.

A measurement of gastric acid pH level may sometimes be ordered along with or following a gastrin test to help diagnose ZE syndrome.

Q: When it is ordered?

A:A gastrin test may be ordered when a person has diarrhea, abdominal pain, and/or recurrent peptic ulcers that do not respond to treatment and that the healthcare practitioner suspects are due to excess gastrin production. A gastrin stimulation test may be ordered when a gastrin level is moderately elevated and the healthcare practitioner suspects that a person has a gastrinoma.

When a gastrin-producing tumor has been removed, a gastrin test may be ordered periodically as a screening test to monitor for recurrence.

Q: What is Zollinger – Ellison Syndrome?

A:Zollinger-Ellison (ZE) syndrome is a rare disease of the gastrointestinal tract. It is characterized by severe recurrent peptic ulcers in the stomach, duodenum and/or the upper portion of the small intestine. The ulcers are caused by a greatly increased amount of stomach acid due to high levels of gastrin, the hormone that stimulates stomach acid production. In ZE, high gastrin levels are caused by gastrin-producing tumors called gastrinomas, which usually form in the duodenum but can be found in the pancreas and rarely in other parts of the body. More than half of them are malignant and can metastasize to other parts of the body, such as the liver. The tumors must be removed surgically, and sometimes total removal of the stomach is necessary to control the acid production. For more on this, see the Related Content section.

Gastric acid

• Oral Glucose Challenge Test
• Glucose Challenge Test
• OGCT
• Glucose Load Test
• GLT

Not applicable

• OGTT-Pregnant (100 gms) test is used to detect gestational diabetes.
• Usually done at 24-28 weeks of gestation.
• First step to the Two-step strategy of screening for and diagnosis of Gestational Diabetes Mellitus (GDM).

Hexokinase

Chemistry

• Non-fasting
• Eat generous amounts of carbohydrate on each of the three days before the test. The carbohydrate foods that are recommended are bread, cereal, potatoes, vegetables, and fruit.
• Take your usual amounts of milk, meat, fish, eggs, cheese, butter and margarine and, as well, eat the following foods daily during each of the three days before the test in at least these amounts:
- 3 slices of bread or toast
- 1 serving of breakfast cereal or porridge, spaghetti
- 1 medium potato or one serving of rice
- 3 servings of vegetables
- 3 servings of fruit (fresh, cooked, canned or juice)
- For morning tea and afternoon tea have 2 biscuits or an extra slice of bread or toast.
***NOTE: The 3 day diet is desirable but not essential. For any patient whose doctor indicates that the diet is not required, please follow the doctor’s instructions.
• Take any medications on the same schedule prescribed by your physician, such as blood pressure or heart medication. Do not take any over-the-counter medications for 12 hours before the test, such as cough or cold preparations, vitamins, aspirin, etc.
(The test should be postponed if the patient becomes ill, even with common illnesses such as the flu or a severe cold.)

Note:
• Patient is required to consume the entire amount of the specially-formulated glucose solution within a 5-minute period.
• Note in clinical info if patient drank more than 4 glasses of water during fasting period, ask patient for medical history as this is rather unusual.
• Samples without preservatives (NaF) must be separated from red cells within 30 mins of blood extraction.

Red or Gold tube

1-3 mL Serum

1-3mL Plasma (Li-heparin and K2-EDTA, NaF/Na2 EDTA, KF/Na2 EDTA, NaF/K?Oxalate and NaF/citrate/Na2?EDTA)

Serum (no hemolysis): 8 hours
Plasma (fluoride): 3 days

72 Hours

Not specified

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Daily

Monday to Saturday:10:00 PM

Sunday:6:00PM

RUNNING TIME: 6:00 AM onwards

RELEASING TIME: ROUTINE
• 4 hours after receipt of specimen/ arrival of messenger
RELEASING TIME: STAT
• After 2½ hours from extraction/messenger arrival

< 7.80 mmol/L (< 140.56 mg/dL)

In very rare cases, gammopathy, in particular type IgM (Waldenstrom’s macroglobulinemia), may cause unreliable results.

Not applicable

Diabetes, DM, Pregnancy, Gestational Diabetes

• Gamma-Glutamyl Transferase
• Gamma-Glutamyl Transpeptidase
• GGTP
• Gamma-GT
• GTP

Not applicable

Used in the diagnosis and monitoring of hepatobiliary diseases. Enzymatic activity of GGT is often the only parameter with increased values when testing for such diseases, and is one of the most sensitive indicators known. GGT is also a
sensitive screening test for occult alcoholism.

Enzymatic colorimetric (standardized against Szasz)

Chemistry

8-12 hours fasting.
Note:
• Prolonged fasting is highly discouraged since various metabolic changes associated with starvation may begin to develop. Water intake is acceptable.
• Note in clinical info if patient drank more than 4 glasses of water during fasting period, ask patient for medical history as this is rather unusual.
• Note in clinical info in case patient overfasts and insists on proceeding test.

Red or Gold tube

1-3 mL Serum

1-3mL Plasma (Li?heparin and K2?EDTA)

7 Days

7 Days

1 Year

Transport specimen at 2 – 8 °C (with cold packs)

1. Specimens that failed the serum index criteria
2. Exceeded sample stability requirement
3. Quantity not sufficient
4. Improperly labeled specimen
5. Improper collection tube used

Daily

Monday to Saturday: 6 PM

RUNNING TIME: 6:00 AM onwards

RELEASING TIME: ROUTINE
• 4 hours after receipt of specimen/ arrival of messenger
RELEASING TIME: STAT
• After 2½ hours from extraction/messenger arrival

MALE: 8.00-61.00 U/L
FEMALE: 5.00-36.00 U/L

• In very rare cases, gammopathy, in particular type IgM (Waldenstrom’s macroglobulinemia), may cause unreliable results.

Not applicable

Liver Function, Alcoholism, AST, ALT, ALP, Bilirubin, Liver Panel, Ethanol

not applicable

not applicable

for Giemsa staining used in Hematology to differentiate and count differential blood cell populations in cellular preparations

May-Grünwald Giemsa staining

Hematology

Blood smears should be fixed with methanol

glass slides

Blood smearsfixed with methanol

not applicable

Microscope slides should be placed in slide holders or mailers and should be adequately padded before placing in a shipping/packaging container to prevent breakage.

not applicable

not applicable

15-25°C

blood smears not fixed with methanol

daily

6:00pm

not applicable

not applicable

not applicable

not applicable

PBS, blood smears, smear, CBC, complete blood count, stain, staining

Not Applicable

A marker for Goodpasture's syndrome (severe glomerulonephritis associated with pulmonary infiltration and hemoptysis). The level of these antibodies reflects the extent of the involvement. The efficacy of treatment can be monitored by following the rate of negativation of this marker.

Flow Immunofluorimetry

Special Test

No patient preparation necessary.

Red or Gold tube

3 mL Serum

Not Applicable

24 Hours

7 Days

28 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Batch running

Friday, 12:00 PM

2 weeks after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None Specified.

Not Applicable

Not Applicable

Pancreatic Hypercalcemic Factor

Not applicable

Glucagon measurement is useful primarily when considering a glucagon-secreting tumor of the pancreas. Glucagon is also used to diagnose glucagon deficiency in patients with hypoglycemia.

Radio Immuno Assay (RIA)

Special Test

No patient preparation necessary.

EDTA or Violet Tube

4 mL of Plasma

Not Applicable

24 Hours

24 Hours

30 Days

Transport specimen at 2 – 8 °C (with cold packs)

• Over-filled or Under-filled tube
• Clotted Specimen
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Batch Running

Friday 4:00 PM

2 weeks after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified

Not applicable

Hypoglycemia

• 1,5-anhydroglucitol
• 1,5-AG

Not applicable

GlycoMark test provides quantitative measurement of 1,5-anhydroglucitol (1,5-AG); it is used for intermediate-term monitoring of glycemic control in people with diabetes. GlycoMark test reflect changes in glycemia (glucose in blood) over a 1 to 2-week time period.

Enzymatic

Chemistry

• Refrain from taking nutraceuticals and Chinese medicines( such as Polygala, Tenuifolia, and Senega Syrup), and anti-diabetic drugs like Invokana, and alpha-glucosidase inhibitors, such as Acarbose, 8-12 hours before sample collection.
• Avoid intravenous hyperalimentation (artificial supply of nutrients) 8-12 hours before sample collection.

Red or Gold tube

1-3 mL Serum

1-3mL Plasma (EDTA)

Not Specified

7 Days

Up to 6 freeze-thaw cycles

Transport specimen at 2 – 8 °C (with cold packs)

• Improper collection tube used
• Specimen stored/transported outside the temperature range
• Quantity not sufficient
• Hemolyzed specimen
• Lipemic specimen
• Improperly labeled specimen

Daily

Monday to Saturday: 6:00 PM

ROUTINE (on running day/s)
• 4 hours after receipt of specimen/ arrival of messenger
 STAT(on running day/s)
• After 2½ hours from extraction/messenger arrival

MALE: 10.70~32.00 ug/mL
FEMALE: 6.80~29.30 ug/mL

• Persistently positive urinary glucose levels, or oxyhyperglycemia after gastrectomy, may result in a low 1,5-AG value. Low values have also been observed in pregnancy, terminal stage renal failure, dialysis patients, advanced cirrhosis, and prolonged incapability of oral ingestion of food.
Abnormal values have also been noted in individuals with abnormal glomerular filtration rates.
• For some patients with severe hyperglycemia, the internal pool of 1,5-AG may tend to remain depleted as a result of persistent glucosurea. In these cases, measurements of 1,5-AG may be less indicative of initial recovery following initiation of anti-diabetic treatment.
• 1,5-AG values may be increased when some Chinese medicines, such as Polygala Tenuifolia and Senega syrup, are administered.
• Values may also be increased during intravenous hyperalimentation.
• 1,5-AG values may be lower in patients undergoing therapy with steroids.
• 1,5-AG blood levels are falsely lowered by the diabetes drug INVOKANA which prevents reabsorption of 1,5-AG in the kidneys. INVOKANA is part of a new class of diabetes medications known as sodium-glucose co-transporter 2 (SGLT2) inhibitors, which block reabsorption of glucose in the kidneys, and other SGLT2 inhibitors may have the same effect.
• Some alpha-glucosidase inhibitors, such as Acarbose, may potentially reduce 1,5-AG levels due to interference with intestinal absorption of 1,5-AG.

Q: How do I correlate my FBS and HbA1c results with GlycoMark?
A: The GlycoMark test measures the presence of the “good” glucose-like sugar 1,5-AG in your blood. The higher your blood glucose peaks, the lower the amount of 1,5-AG in your blood. And the lower your GlycoMark test value. With A1C, your score increases when your blood glucose increases. Your GlycoMark result actually decreases when your blood glucose spikes.

DM, Diabetes, Diabetes mellitus

• HbA1c
• Glycated Hemoglobin                                                                                                     •A1c                                                                                                            •Glycohemoglobin                                                                                                     •Glycosylated Hemoglobin

Not applicable

Used for monitoring long-term control of diabetes mellitus and evaluates the effectiveness of diabetes therapy.

High Performance Liquid Chromatography (HPLC)

Hematology

No patient preparation necessary.

EDTA (purple top)

• 2mL EDTA whole blood
Note: 0.250- 0.500 mL EDTA whole blood if microtainer is used

Not applicable

3 Days

7 Days

Not applicable

Transport specimen at 2 – 10 °C (with cold packs)

• Improperly labeled specimen
• Clotted specimen
• Quantity not sufficient
• Insufficient volume of blood to anticoagulant
• Exceed sample stability requirement

Daily

Monday to Saturday
• 6:00 PM

 

ROUTINE
• 3 hours after receipt of specimen/ arrival of messenger
STAT
• After 1½ HOURS from extraction/messenger arrival

Normal : <5.70%
Pre-Diabetes: 5.70% ~ 6.40%
Diabetes : >/= 6.50%
Note: This is in accordance with the American Diabetes Association’s(ADA) recommendation

• Cold agglutinins
• Hemoglobin variants

Not applicable

Diabetes, Glucose, Glucose monitoring, GlycoMark, Fructosamine, Urine Albumin and Albumin to Creatinine Ratio.

Not applicable

Not Applicable

Determines if biological relationship exists between the alleged grandparent and child.

DNA Analysis

Special Test

• Hard copy of RTPCR negative results for BOTH PARTIES are needed 2-3 days from the date of collection.
• Inform Special Test Section before the scheduled sample collection for the collection kit.
• Request DNA Collection Kit to Special test section 3 days prior of swab collection.
• Only trained doctors/RMTs are allowed to collect samples.

Sample collection/handling:

1. Each collection kit (provided by HP Main Lab) includes 4 swabs.
2. Collect sample using the 4 swabs for each patient (i.e. 4 swabs for grandparent, 4 swabs for child)
3. Return swabs to its sterile package and place it inside the provided envelope.
4. Encircle whether sample came from father or child.                  NOTE: Sample from father and child must be placed in separate envelopes.
5. Completely fill up the required information in the envelope.       NOTE: Signatures of patient and collector is required. For minors, legal guardian must sign on the envelope containing the child's sample.
6. Remove adhesive cover and seal the envelope with sample.
7. Send sample immediately to HP Main Lab.

Document Requirements:

• Birth Certificate/School I.D of child, actual and  2 photocopies
• Valid I.D of grandparent, actual and  2 photocopies
• Completely filled up request form
• Completely filled up disclaimer form
• Mother's consent; Valid ID of mother, actual and 2 photocopies
• Valid ID of requesting party (if not the alleged grandparent), actual and 2 photocopies

NOTE: Double check completeness and correctness of information before sending to HP Main Lab to avoid delay ing processing of sample.

DNA Swab Collection Kit - 4 swabs each

4 swabs each from grandparent  and child

Not Applicable

7 Days

Not Applicable

Not Applicable

Transport specimen at 15°C ~25 °C (room temperature)

• Incomplete details of patient
• Unlabelled sample
• Incorrect collection container used
• Incomplete documents needed

Batch Running

Friday, 12:00 PM

2 weeks after cut-off (excluding Saturdays, Sundays and Holidays)

Not Applicable

None Specified

Not Applicable

DNA

• GH
• HGH
• Somatotropin
• Human Growth Hormone

Not applicable

Used in the diagnosis and treatment of various forms of inappropriate growth hormone secretion.

Electrochemiluminescence Immunoassay (ECLIA)

Special Test

• 8 Hours fasting
• Limit physical activity (Must be rested for at least 30 minutes)
• Samples cannot be taken from pregnant women
• Samples should not be taken from patients receiving therapy with high biotin doses (i.e. > 5 mg/day) until at least 8 hours following the last biotin administration.

Red or Gold tube

3 mL Serum

Not Applicable

24 Hours

7 Days

28 Days

Transport specimen at 2°C – 8 °C (with cold packs)

• Hemolyzed specimen
• Markedly lipemic sample
• Exceeded sample stability requirement
• Quantity not sufficient
• Improperly labeled specimen
• Improper collection tube used

Monday to Friday

Monday to Friday, 7:00 AM

3 days after cut-off (excluding Saturdays, Sundays and Holidays)

Available upon request

• Samples should not be taken from patients receiving therapy with high biotin doses (i.e. > 5 mg/day) until at least 8 hours following the last biotin administration.
• In rare cases, interference due to extremely high titers of antibodies to analyte?specific antibodies, streptavidin or ruthenium can occur.
• The assay is affected by pegvisomant (a highly selective GH receptor antagonist) and is therefore not suitable for patients under pegvisomant treatment. There is no interference with Octreotide (somatostatin analogue) or Cabergoline (dopamine agonist).
• The assay is not suitable for the determination of hGH in samples from pregnant women. This is due to a cross-reactivity to placental hGH. Placental hGH is a variant of pituitary hGH36 and its serum levels increase during the course of pregnancy.

Not applicable

IGF-1, Growth Hormone Releasing Hormone, Cortisol, ACTH, Free T4, TSH, Glucose Tests, Prolactin, IGF BP-3