Laboratory Test Preparation

Not applicable

Not applicable

Japanese encephalitis virus (JEV) is the most important cause of viral encephalitis in Asia. It is a mosquito-borne flavivirus, and belongs to the same genus as dengue, yellow fever and West Nile viruses.

Capture ELISA

Special Test

No patient preparation necessary.

Red Tube only (No Gel Separator)

3 mL Serum

2 mL CSF

14 Days

14 Days

30 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

Wednesday 8:00 AM

Tuesday 4:00 PM

After 3 days (excluding Saturdays, Sundays and Holidays)

Available upon request

None specified.

Not applicable

Japanese B encephalitis, mosquito-borne

• JCV-PCR

• John Cunningham Virus

Not applicable

JC virus is the polyomavirus which causes progressive multifocal leukoencephalopathy, a fatal neurological infection which affects patients who are immunodeficient for long periods. In practice, the virus cannot be isolated but a reliable diagnosis can be based on the detection of viral DNA by PCR assay in a CSF specimen or brain biopsy material. No practical serological tests have been developed.

Polymerase Chain Reaction (PCR)

Special Test

Blood sample will be drawn every Wednesday-Thursday  from 8am-6pm.

EDTA or Violet Tube

4 mL whole blood

• 2 ml CSF in Sterile Container
• 100 mL Random Urine

48 Hours

7 Days 

Not Applicable 

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
• Clotted Sample
• Over-filled or Under-filled tube

Batch Running

Friday 4:00 PM

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

Not Applicable

None specified.

Not applicable

John Cunningham virus, progressive multifocal leukoencephalopathy

Total Light Chain
 

Kappa

Lambda

Kappa/Lambda Ratio

•To help detect , diagnose and monitor plasma cell disorders (dyscrasias), including multiple myeloma and primary amyloidosis.
• To monitor effectiveness of treatment

Nephelometry

Special Test

No patient preparation necessary.

Red or Gold Tube

3 mL Serum

Not Applicable

48 Hours

8 Days

30 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

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

Available upon request

None specified.

Not applicable

Free Light Chain

•To help detect , diagnose and monitor plasma cell disorders (dyscrasias), including multiple myeloma and primary amyloidosis.
• To monitor effectiveness of treatment

Electrochemiluminescence Immunoassay (ECLIA)

Special Test

No patient preparation necessary

Red or Gold Tube

3 mL Serum

Not Applicable

48 Hours

21 Days

Not applicable

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

Monday 7am

Friday 7am

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

Levetiracetam

Not applicable

Kepra or Levetiracetam is an anticonvulsant used as adjunct therapy to treat adult partial seizures. As multiple anticonvulsants are administered, it is important to monitor its level to:
(1) optimize therapy
(2) assure compliance
(3) to avoid toxicity

Liquid Chromatography Mass Spectrometry (LCMS)

Special Test

• No patient preparation necessary.

• Note the following info:
- Dosage
- Date and Time of last dose intake
- Date and Time of extraction

Red tube (DO NOT USE GOLD TUBE or any other type of tube with gel separator)

3 mL Serum

Not Applicable

14 Days

28 Days

60 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 4:00 PM

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

Available upon request

None specified.

Not applicable

Used to treat epilepsy

• Serum Ketones
• Beta-hydroxybutyrate
• Ketone Bodies
• Beta-hydroxybutyric Acid
• Acetoacetate
• Acetoacetic Acid
• Acetone

Not applicable

Useful in the diagnosis and monitoring of therapy for diabetic ketoacidosis

Nitroprusside

Special Test

No patient preparation necessary.

Red or Gold Tube

3 mL Serum

Not Applicable

14 Days

14 Days

Not applicable

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

Monday to Friday

Monday to Friday, 7:00 AM

After 3 days(excluding Saturdays, Sundays and Holidays)

Available upon request

None specified.

Not applicable

• Urinary Stone Analysis
• Renal Calculus Analysis
• Stone Analysis

Not applicable

Used to evaluate the composition of kidney stones to determine the cause of formation and subsequent treatment, if possible.

Fourier Transform Infrared Spectroscopy (FTIR)

Clinical Microscopy

Hospital Collections:  as instructed by your physician
Using the HPD Kidney Stone Analysis Specimen Collection Kit:
1. It is very important that you filter your urine using the urinary calculi strainer during your first morning void. If your doctor has given you a diuretic to promote urination, you must start filtering your urine as soon as possible.
2. Filter your urine to catch stones that are small enough to pass out of your body on its own. Please filter each urine collection for at least 24 hours or until the stone has passed.
3. Record the time you started filtering your urine on the label provided.
4. Each time after you filter your urine, check the filter for stone particles. Stones can be as small as a grain of sand, so check carefully.
5. When stones are found on the strainer, wash stones carefully with filtered or deionized water and allow the stones to air dry. Do not use any other liquid other than water to wash the stones. Do not apply heat to dry the stones.
6. When stones are dry, transfer the stones to the specimen container.
7. Repeat steps #5 and #6 until your last urine collection or when no more stones are found.
8. Do not tape the stones to the specimen container as tape affects testing.
9.  Stones should be submitted CLEAN AND DRY as much as possible. Sample  immersed in water can be accepted but other liquid is rejected.
10. Record the time of your last filtered urine collection on the label provided.
11. Write your complete name and affix the label on the body of the specimen container.
12. Store the stones at room temperature. Do not refrigerate or freeze the stones.
13. Submit your stone specimen to any Hi-Precision Diagnostics branch for analysis.

Specimen collection kit provided by HPD or any clean container

20 mg, or at least the size equivalent of 2-3 small grains of rice

Not applicable

1 Year

Unacceptable

Unacceptable

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

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

Daily except Sundays and Holidays

samples received on Sundays will be processed the next day.

1:00 PM

samples received after cut off time will be processed the next day.

1 day  from receipt of specimen / messenger arrival

Not applicable

Presence of water or moisture in sample will cause interference in the spectrum

Q: How is the test being used?

A: A kidney stone analysis is performed to determine the chemical composition of a stone when it is filtered out of the urine or removed from the urinary tract. A laboratory will typically document the physical characteristics of a stone – its size, shape, weight, color, and texture. One or more tests will then be performed to determine the stone's composition.

Urolithiasis, Nephrolithiasis, Urinalysis, Uric Acid, Calcium, Phosphorus, Creatinine, Oxalate, Citrate, Cystine

-

Ultrasound imaging or sonography is considered to be a non-invasive procedure and does not involve ionizing radiation which is usual in X-rays. An ultrasound scan is not only useful in assessing the structure of organs and different internal structures but can also show the movement of organs in real time.

It may be used to assess the size and structures of the following:

• Right Kidney
• Left Kidney

PREPARATION

• No special preparation.
• Full bladder is not required.
• Bring previous ultrasound result for comparison.

-

-

-

Not applicable

Not applicable

This test detects a gene variant associated with increased coronary heart disease (CHD) risk and such CHD event can be reduced from atorvastatin and pravastatin therapy.

Real-Time Polymerase Chain Reaction (RT-PCR)

Special Test

No patient preparation necessary.

EDTA or Violet Tube

2 pcs of 4 mL EDTA whole blood

Not Applicable

8 Days

8 Days

30 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
• Clotted Sample

Batch Running

Monday, 12:00 PM

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

Not Applicable

None specified.

Not applicable

Coronary Heart Disease (CHD)

• KOH prep
• Potassium Hydroxide Preparation
• Fungal smear

Not applicable

• It is used for detecting fungal elements.
• Potassium Hydroxide (KOH) solution is a strong base which can dissolve tissue cells and keratinized material making fungal elements more visible.

Direct Microscopic Examination

Bacteriology

Instructions to Send-in Clients:
• Indicate patient’s diagnosis, medical history and sample type on request forms.

Instructions to Phlebotomists: Sample Collection & Preparation Procedures
A. SKIN / SCALP SCRAPINGS
1. Using a sterile scalpel or edge of a glass slide, gently scrape skin scales from the infected area.
2. Scrapings may be collected in a black paper or directly on to a glass slide.
3. Add at least 2-3 drops of 10% KOH to the scrapings, put a cover slip and place the slide in a moist container to prevent it from drying. (Samples with KOH solution can be stored in a petri dish with moist tissue paper).
4. Label samples properly with patient name, sample type and site of collection.
5. Sample must be transported to Laboratory/Bacteriology section within 24 hours.

B. NAIL CLIPPINGS
1. Using a clean nail cutter, cut off a portion of affected nail. It is important to cut the nails as thin as possible.
2. Nail clippings may be collected in a black paper and transferred to a sterile container.
3. Label samples properly with patient name and source of tissue scraping.

C. HAIR
1. Using clean tweezer, remove hair shafts with follicles from the infected site.
2. Hair samples may be directly placed on to a glass slide.
3. Add at least 2-3 drops of 20% KOH to the hair samples, put a coverslip and place the slide in a moist container. (Samples with KOH solution can be stored in a petri dish with moist tissue paper to prevent it from drying).
4. Label samples properly with patient name and source of tissue scraping.
5. Sample must be transported to Laboratory/Bacteriology section within 24 hours.
6. In case sample needs to be sent to HPD Main lab, place hair strands in sterile container.

NOTE: For fungal culture with KOH requests (skin scraping, nail clippings, hair), follow the collection procedures listed above except that samples must be placed in a sterile container without KOH solution.

Clean dry sterile container, plain tube or any tightly closed container

With visible materials of the following:

• Skin scrapings
• Hair
• Nail clippings

Fluids: 1-3 mL

Not applicable

24 Hours

Not applicable

Not applicable

Transport specimen immediately at room temperature (15°C -25°C).

NOTE: Do not delay transport of samples.

• Dried up prepared slides
• Improperly labeled specimens
• Exceeded sample stability requirement
• Specimen transported outside the temperature requirement

Daily

Monday to Saturday
• 6:00 PM

Sunday
• 3:00 PM

4 hours after receipt of sample in the laboratory

NEGATIVE RESULT:

• No Fungal Elements Seen

POSITIVE RESULT:

• Positive for yeast cells or budding yeast cells or budding yeast cells with hyphae

• Sensitivity is 20-75%
• False positive results may occur if the specimen is contaminated with cotton fibers, cellulose fibers, or cholesterol deposits, which may be mistaken for hyphae.
• If specimen is from mucous membrane, bronchial aspirate or sputum, Gram Stain may be more sensitive

Q: What are the causes of positive KOH result but negative in Fungal Culture?

A: Inoculated fungi are nonviable; Fungi may have dried during sample processing; Inoculated sample was not enough to include causative fungi; sample chosen/collected from non-optimal site.

Fungal test

Not applicable

Not applicable

Activating Ras mutations can be found in human malignancies with overall frequency of 15-20%. A high incidence of Ras gene mutations has been reported in 80-90% malignant tumors of the pancreas, 30-60% in colon rectal carcinomas, and in 18-30% of hematopoietic neoplasia of myeloid origin. Ras proteins were shown to influence proliferation, differentiation, transformation, and apoptosis by relaying mitogenic and growth signals into the cytoplasma and the nucleolus. Mutations leading to an amino acid substitution at positions 12,13 and 61 are the most common in naturally occurring neoplasms and are frequent in adenocarcinomas of the pancreas, colon, and certain types of hematological malignancies.

Polymerase Chain Reaction (PCR)

Special Test

No patient preparation necessary.

Slide holders or mailers for microscope slides; FFPE tissue blocks can either be wrapped in paper or placed in a box.

• Formalin-fixed paraffin-embedded (FFPE) tissue block
• 1 H&E stained slide representative of the submitted tissue block.
• Histopathology report for the submitted tissue block

Not Applicable

Indefinite

Not applicable

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.
• FFPE tissue blocks must be placed in a box and avoid direct sunlight to prevent melting and disorientation during transport or shipping.
• Transport specimen at 15°C ~25 °C (room temperature)

• Incomplete information in the Request Form
• Improper or insufficient labeling of tissue blocks or slides
• Inadequate tissue available on the tissue block

Batch Running

Monday to Friday, 12:00 PM

14 days (excluding Saturdays, Sundays and Holidays)

Not Applicable

None specified.

Not applicable

Oncogenes, Normal cells to cancerous cells

Lactate

Not applicable

An intermediate in the glycolytic pathway. Measuring its level can be helpful in evaluating lactic acidosis observed during intense muscular activity, shock and a variety of different conditions including diabetic ketoacidosis, renal or hepatic insufficiency, drug overdosage and certain genetic diseases.

Spectrophotometry

Special Test

• Avoid any hand or arm exercises before and during the blood extraction
• Blood extraction is done when the patient is at rest and without the use of the tourniquet.NOTE:Do not use tourniquet.
• Extracted blood is cooled in ice and must be immediately forwarded to the laboratory
• No patient preparation necessary.

Note the following info:

• Dosage
• Date and Time of last dose intake
• Date and Time of extraction

Gray Tube

3 mL Plasma

Not Applicable

Not Applicable

7 Days

Not applicable

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
   

Monday to Friday

Monday to Friday, 7:00 AM

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

Available upon request

None specified.

Not applicable

Lactic Acid, L-Lactate, CSF Lactate, Lactate

Lamictal

Not applicable

An antiepileptic drug which can induce allergic reactions, especially when taken at the same time as sodium valproate.

LCMS/MS

Special Test

• No patient preparation necessary.

• Note the following info:

• Dosage
• Date and Time of last dose intake
• Date and Time of extraction
• Diagnosis

NOTE: The therapeutic drug monitoring code suggests that the sample should be carried out at the residual rate (just before taking medication).

Red tube (DO NOT USE GOLD TUBE or any other type of tube with gel separator)

3 mL Serum

Not Applicable

3 Days

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 4:00 PM

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

Available upon request

None specified.

Not applicable

Anti-epileptic medication

Leukocyte alkaline phosphatase

Not applicable

Aid in the differential diagnosis of chronic myelogenous leukemia (CML) versus leukemoid reaction

Aid in the evaluation of polycythemia and myelofibrosis

HPLC/UV Detection

Special Test

Note the following requirements:

• Need requesting physician
• Patient Diagnosis
• License No. of Physician

Slide holders or mailers for microscope slides

10 pcs of Peripheral Blood Smear (Wedge-type) -UNSTAINED

Not Applicable

7 Days

Not applicable

Not applicable

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

• Improper or insufficient labeling of slides
• No requesting physician
• No Patient Diagnosis
• No  License No. of Physician

Batch Running

Monday to Friday, 7:00 AM

1 Month after cut-off (excluding Saturdays, Sundays and Holidays)

Not Applicable

None specified.

Not applicable

Chronic myeloid leukemia