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Newborn Tests: Essential Health Screening Tests Your Baby Needs

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MATERNAL FETAL HEALTH & NEWBORN HEALTH

Since their well-being is your responsibility

• Nearly 2100 babies are born every hour in India1. More than 3400 infants a day – suffer from a congenital abnormality2

• If left undetected and untreated, these disorders will likely claim most of these young lives by age five.3

• If detected in the first few days after birth, those infants may be given a healthy start to life.

 

NEWBORN SCREENING: Restoring the right to a healthy childhood

63 babies saved everyday*

• Suburban Diagnostics in association with PerkinElmer (a global leader in newborn screening with over 30 years of experience) offers Complete Newborn screening range

• Detects over 50 metabolic disorders

• Uses VICTORTM 2D (time resolved Fluorometry) and MS/MS (Tandem Mass Spectroscopy) delivering high sensitivity and reproducibility of results

• Complete solution provider – from sample to result with expert interpretation of results

• Over 500 million babies screened using PerkinElmer solutions worldwide

 

Newborn Screening: Basic Panel

• Can detect metabolic conditions after 48 hours of age and within 15 days

• Sample collection is safe and simple – a heel prick on specially designed DBS card
Congenital Hypothyroidism (CH) • Congenital Adrenal Hyperplasia (CAH) • G6PD Galactosemia • Cystic Fibrosis (CF) • Biotinidase • Phenylketonuria (PKU)

Table 1 - New born screening basic panel

Table 2 - New Born screening basic panel

1 in 1500 to 3000 newborns suffer from Inborn Errors of Metabolism*

 

Newborn Screening: Expanded Panel – Inborn Errors of Metabolism

I. A comprehensive screening program for clinically significant disorders performed using MS/MS (Tandem Mass Spectrometer), the most widely used technique for IEM testing

II. Detects more than 50 disorders which include
•11 Amino Acid disorders
•13 Acylcarnitines (Fatty Acid disorders)
•Organic Acid disorders
•Hemoglobinopathies
•Newborn Screening: Basic Panel

 

Heel prick sample collection technique

New Born Screening LBL_Final

To view the complete sample collection procedure, ask for ‘PerkinElmer’s Newborn Screening on DBS’ DVD.

 

Disorders included in Newborn Screening: Expanded Panel

Table 3 - New born screening expanded panel
Table 4 - New born screening expanded panel

Table 5 - New born screening expanded panel
Table 6 - New born screening expanded panel

Table 7 - New Born Screening Tests

 

Resources

* ICMR 2007-12 report | ** ICMR 2008 report | ^ National Newborn Screening Program – Still a Hype or a Hope Now? | ‘ Epidemiology of Sickle Hemoglobin in India
“http://ghr.nlm.nih.gov/condition/biotinidase deficiency | # Newborn Screening in India: Current Perspectives (Jan 2010) | National Newborn Screening and Genetics Research Center (20002)
1: Anon., “34 Births, 10 Deaths Are Registerd in India Every Minute,” The Indian Express, March 6, 2009, http://archive.indianexpress.com/news/34-births-10-deaths-are-registered-in-india-every-min/431650/, accessed June 20, 2016.

2: Rinhu Shama, “”Birth Defects In India: Hidden Truth, Need For Urgent Attention,” Indian Journal of Human Genetics, Vol. 18, Issue 2, August 5, 2015, http://www.ijhg.com/article.asp?issn=0971-6866;year=2013;volume=19;issue=2;spage=125;epage=129;aulast=Sharma, accessed June 20, 2016.

3: UNICEF, Statistics and Monitoring, State of The World’s Children 2015 Country Statistical Information, http://www.unicef.org/infobycountry/india_statistics.html, accessed February 17, 2016.
4: PerkinElmer Brochure: 1244-1216-16 , November 2015
5: Dave et al. (2010), ‘Newborn Screening – From ‘Guthrie age to Genomic age’ J Obstet Gynecol India Vol. 60, No. 3 : May / June

To book your appointment for screening click here

Prevent Yourself from Polycystic Ovarian Syndrome (PCOS) By Taking Few Important Precautions

PCOS-Blog-Banner

PCOS – is not just a“cosmetic” or “Infertility” condition …………It can be WORSE!!!!

  • Facial Hair Growth in early high school
  • Cannot conceive easily
  • Irregular painful cycles
  • A lot of weight gain which cannot come off easily
  • It is known that women with PCOS are significantly more likely to have type II diabetes, thyroid, heart disease and also appears to have a link to endometrial cancer…
    CAN’T BE WORSE THAN THIS

PCOS IS HETEROGENOUS IN NATURE

Apart from the known co relation of PCOS and increased risk of type 2 Diabetes, there is increasing evidence of link between PCOS and Thyroid disorders as well.

Furthermore study also reveals high prevalence of thyroid disorders in PCOS patients.

Danish Cancer Registry found an almost fourfold increased risk for endometrial cancer in women with PCOS as compared to the normal population

PCOS HAS HIGH PREVALENCE RATE

Despite the high prevalence of PCOS, the diagnosis and differential diagnosis remains confusing.

This is partly due to the lack of a specific single diagnostic test for the disorder.

LAB TESTS ARE THEREFORE SIGNIFICANT IN PCOS

1. Hyperandrogenism
Laboratory features

1. Elevated testosterone

  • Androgen excess can be tested by measuring total and free testosterone levels.
  • An elevated free testosterone level is a sensitive indicator of androgen excess

2. DHEA-S

  • Most normal or slightly high in PCOS
  • If > 800 mcg/dl, consider adrenal tumor.

3. LH/FSH ratio

  • Levels vary over menstrual cycle, released in pulsatile fashion, affected by OCPs
  • LH/FSH ratio > 2 has little diagnostic sensitivity and need not be documented.

2. Absence of other disorders to account for these symptoms

  • Hypothyroidism – TSH
  • Hyperprolactinemia – Prolactin
  • Late onset congenital adrenal hyperplasia – 17 – hydroxyprogresterone (r/o if < 200 ng/dl)
  • Ovarian Tumor – Total Testosterone (esp if > 200 ng/dl)
    – Adrenal Tumor – DHEA-S (esp if > 800 mcg/dl)
    – Cushing’s Syndrome – cortisol

DIAGNOSIS OF PCOS IS INCOMPLETE WITHOUT USG EXAMINATION

3. Ultrasound Criteria for Polycystic Ovaries
PCO morphology:
1. presence of 12 follicles of 2-9 mm diameter and/ or ovarian volume >10 mL without a cyst or dominant follicle > 10mm
2. Polycystic Ovaries not specific for PCOS, & > 20 % normal women have incidental polycystic ovaries

PCOS-Ultrasound

RISK STRATIFICATION OF PCOS PATIENTS

The AE- PCOS SOCIETY recommends all women with PCOS to be assessed for CVD risk; to test for BMI, waist conference and blood pressure at each clinical visit. In women diagnosed with PCOS, a Lipid Profile as well as FBS, PPBS (if BMI > 30 kg/m2, age > 40 yrs, personal history of GDM of family history of T2DM) is recommended.

PCOS-Risk-Factors

References:

1. Sheehan MT et al. Clinical Medicine and Research. 2004;2(1):13-27. Polycystic Ovarian Syndrome: Diagnosis and Management.
2. Sinha Uma et al. Indian J Endocrinol Metab. 2013 Mar-Apr; 17(2): 304–309 Thyroid disorders in polycystic ovarian syndrome subjects: A tertiary hospital based cross-sectional study from Eastern India.
3. Gottschau M et al. Gynecol Oncol. 2015 Jan;136(1):99-103. doi: 10.1016/j.ygyno.2014.11.012. Epub 2014 Nov 20. Risk of cancer among women with polycystic ovary syndrome: a Danish cohort study.

The only diagnostic chain to offer combination of laboratory tests with usg examination
Suburban diagnostics offers comprehensive evaluation of PCOS

PCOS-Evaluation

To book an appointment click here.

CENTRAL PROCESSING LAB

Aston, 2nd floor, Sundervan Complex, Opp. Union Bank, Above Mercedes Showroom, Andheri West, Mumbai – 400053

Detect Antibodies Presence using Antinuclear Antibodies Technique By IFA

I. The Gold Standard technique to detect presence of antibodies

II. Combination of HEp-2010 cells and primate liver cells provides

  • Pattern differentiation which corresponds to particular disease type (centromere, nuclear dots)
  • Provides additional information for ANA -ve cytoplasmic antibodies (liver disease-endomysium, ANCA)

III. Patterns offer clue to which particular autoantibody may be present corresponding to particular disease type:

1. Homogenous – SLE

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2. Speckled – Sjogrens Syndrome

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3. Centromere – Scleroderma

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4. Nucleolar – Scleroderma

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IV. Confirmed by ANA Blot tests or monospecific ELISA
V. An excellent test for patients with:

  • Systemic Lupus Erythematosus (SLE)
  • Other connective tissue diseases

Clinical conditions confirmed by ANA BLOT

Target Antigen Clinical Association
U1-snRNP MCTD, SLE
Sm SLE
SSA/ Ro Sjogren’s Syndome (SS), SLE/Neonatal Lupus
SSB/ La Sjogren’s Syndome ,SLE
Scl 70 PSS (Diffused)
PM- Scl Polymyositis (PM), Dermatomyositis (DM)
Proteins of inetochores (centromeres) CREST syndrome (PSS)
Jo-1 Polymyositis (PM)
Cyclin I (PCNA) SLE
Double strand DNA SLE
Nucleosomes SLE
Histones Drug Induced Lupus Erythematosus (LE)
Ribosome P phosphoprotein SLE
Mitochondrial (AMA- M2) Primary Biliary Cirrhosis (PBC)

Please book your appointment to take this test at our central processing lab.

A Guide About Rheumatoid Arthritis | What Are The Symptoms and How to cure?

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What is Rheumatoid Arthritis?

Rheumatoid arthritis is a type of autoimmune disease that causes joint inflammation leading to redness, warmth, swelling, and pain in the joint. Rheumatoid Arthritis develops when the body fails to differentiate the body’s own tissues from foreign pathogens. This causes immune cells to migrate from the blood into the joints and synovium, the joint-lining tissue. There, they produce inflammatory substances that cause irritation, wearing down of cartilage (the cushioning between joint articulations), swelling, and inflammation of the joint-lining. This results in build-up of fluid in the joint that can lead to bone damage. Unlike other forms of arthritis;
• A distinguishing characteristic of Rheumatoid Arthritis is symmetric inflammation, for instance, inflammation in both hands and both knees.
• On the other hand, osteoarthritis, another common form of arthritis, occurs as a result of physical strain on joint tissues. Consequently, it occurs more prominently on the side of the body incurring the most strain.

How to manage Rheumatoid Arthritis?

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These self-care measures, when used along with your rheumatoid arthritis medications, can help you manage

your signs and symptoms:
• Take control. With your doctor, make a plan for managing your arthritis. This will help you feel in charge of your disease.
• Exercise regularly. Gentle exercise can help strengthen the muscles around your joints, and it can
help fight fatigue you might feel. Check with your doctor before you start exercising. If you’re just getting started, begin by taking a walk. Try swimming or gentle water aerobics. Avoid exercising tender, injured or severely inflamed joints.
• Apply heat or cold. Heat can help ease your pain and relax tense, painful muscles. Cold may dull the
sensation of pain. Cold also has a numbing effect and decreases muscle spasms.
• Relax. Find ways to cope with pain by reducing stress in your life. Techniques such as guided imagery, distraction and muscle relaxation can all be used to control pain.

Symptoms of Rheumatoid Arthritis :

Rheumatoid Arthritis affects everyone differently, so the types and severity of symptoms vary greatly depending on the person. For some patients, Rheumatoid Arthritis symptoms develop gradually over the course of several years while other experience a sudden onset. The most common symptoms of Rheumatoid Arthritis include:

Fatigue | Aprttite loss | Muscles & Joint Bones | Hoarse voice | Rheumatoid Nodules | Symmetric Arthritis | Morning Stiffness | Post-sedentary Stiffness | Red/Swollen Joints | Bone Deformity

Risk Factors of Rheumatoid Arthritis :

Gender : Women are 3 times more likely to develop Rheumatoid Arthritis than men. However, men typically experience more severe symptoms.

Age : Rheumatoid Arthritis most commonly occurs between the ages of 40-60 years old.

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Family History : Women who have never been pregnant and those who have recently given birth have an increased risk. Individuals with first-degree relatives (mother, father, brother, or sister) with Rheumatoid Arthritis have a 2-to-3 fold increased risk for the disease.

Obesity : People who are overweight or obese appear to be at somewhat higher risk of developing rheumatoid arthritis, especially in women diagnosed with the disease when they were 55 or younger.

What are the tests related to Rheumatoid Arthritis?

Blood tests: • Alkaline Phosphatase C-Reactive Protein (CRP) • Antinuclear Antibody (ANA) • Rheumatoid Factor (RF) • Anti-CCP Antibody • Uric Acid • Calcium • Vitamin D

Imaging tests: • BMD (DXA Scan) • Digital X-Ray

Book your appointment to diagnose rheumatoid arthritis at our labs.

How Breast Cancer, Cervical and Ovarian Cancers are Affecting Modern Age Indian Womens.

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BREAST CANCER :

Breast Cancer is the most common cancer among women in India and accounts for 27% of all cancers in women. In urban areas, 1 in 22 women develop breast cancer during her lifetime. 1.45 lakhs of fresh cases diagnosed every year in india

What is Breast Cancer?

Breast cancer starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an X-ray or felt as a lump. The tumor is malignant (cancerous) if the cells can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. Breast cancer occurs almost entirely in women, but men can get it, too.

It’s also important to understand that most breast lumps are not cancerous, they are benign. Benign breast tumors are abnormal growths, but they do not spread outside of the breast and they are not life threatening.

Any breast lump or change needs to be checked by a health care provider to determine whether it is benign or cancer, and whether it might impact your future cancer risk.

Symptoms of Breast Cancer :

Breast Cancer Symptom

Other Symptoms include :

• Breast Pain
• Nipple discharge other than breast milk
• Lump in underarm area

Risk Factors for Breast Cancer :

Cannot be controlled

Can be controlled

Gender

Weight

Age

Diet

Family History

Exercise

Race

Alcohol

Radiation

Smoking

Genetic Factors

Stress & Anxiety

Medication like DES

Obesity

Late / No Pregnancy

Breast Feeding

Hormone Replacement Theropy

Diagnosis of Breast Cancer :

Mammography • CA 15.3 • BRCA 1 & 2 :-
Radiologists today rely on mammography that helps diagnose breast cancer at an early stage before they can be felt by the patient.

Mammography Machine

Breast Self Exam (BSE)

Breast Self-Exam Part 1: TOUCH

• Lie down and place a pillow under your right shoulder. Put your right hand under your head and check the entire breast area with the finger pad of your left hand.

• Use small circles and follow an upand-down pattern. Use light, medium and firm pressure over each area of the breast. Feel the breast with the surface of the second, third and fourth finger, moving systematically and using, circular motions from the outer margin to the nipple.

• When you reach the nipple, remove the pillow and remove your hand from forehead and place the arm at right angle. Check the nipple area using the same circular pressure in an up-and-down pattern as before.

Repeat these steps for left breast using your right hand.

 

Breast Self-Exam Part 2: LOOK

Stand before mirror and see for changes in shape, skin, nipples and vein pattern. Inspect your breast in the following four steps:

  • With your arms at your sides
  • With your arms overhead
  • With your hands on hips
  • Bend forward

 

CERVICAL CANCER :

In India,

  • Cervical cancer is the 2nd most common female cancer in women aged 15 to 65 years.
  • About 122,844 new cervical cancer cases are diagnosed annually.
  • 5% of women in general population harbor HPV-16/18 infection.

What is cervical cancer?

Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.

Various strains of the Human Papilloma Virus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer. When exposed to HPV, a woman’s immune system typically prevents the virus from doing harm. In a small group of women, however, the virus survives for years, contributing to the process that causes some cells on the surface of the cervix to become cancer cells.
Cervical Cancer

 

Risk Factors for Cervical Cancer :

1. Multiple Sexual Partners
2. Having more number of Children
3. Early Marriage
4. Smoking
5. Family History/ Hereditary
6. Oral Contraceptive Pills
7. Unprotected Sex
8. Early Child Birth

Symptoms of Cervical Cancer :

Early-stage cervical cancer generally produces no signs or symptoms.

Signs and symptoms of more-advanced cervical cancer include:

  • Vaginal bleeding after intercourse, between periods or after menopause
  • Watery, bloody vaginal discharge that may be heavy and have a foul odor
  • Pelvic pain or pain during intercourse

Diagnosis of Cervical Cancer :

PAP SMEAR+HPV

Why PAP SMEAR+HPV together is the preferred screening method for women ages 30 to 65*

  • 18.6% cancers missed by HPV-Alone
  • 12.2% cancers missed by PAP (LBC)-Alone
  • 5.5% cancers missed by PAP (LBC)+HPV together

*survey done by largest volume based test laboratory in US.

Leading Health Organisations ACOG, ACS, ASCP & ASCCP* recommend that PAP (LBC)+ HPV together (co-testing) is the preferred approach for cervical cancer screening

*ACOG (American Congress of Obstetricians and Gynecologists), ACS (American Cancer Society), ASCP (American Society of Clinical Pathology), ASCCP (American Society for Colposcopy and Cervical Pathology)

Who should be tested :

  • PAP (LBC) ALONE: AGES 21-29
  • PAP (LBC)+HPV TOGETHER: AGES 30-65

 

OVARIAN CANCER :

Ovary is the third leading site of cancer among women, trailing behind cervix and breast cancer. The age-adjusted incidence rates of ovarian cancer vary between 5 to 8 per 100,000 population in different parts of the country.

Ovarian cancer is a cancer affecting the ovaries; organs responsible for secretion of female hormones and ovulation in women, and situated in the pelvis.
Ovarian Cancer

It is one of the most fatal gynaecological cancers because it remains silent for a long time as the symptoms of ovarian cancer are insidious and non-specific.

Symptoms of Ovarian Cancer :

  • Bloating
  • Pelvic or abdominal pain
  • Trouble eating or feeling full quicky
  • Feeling the need to urinate urgently or often

Diagnosis of Ovarian Cancer :

CA-125 • HE4 • Ultrasound

Therefore,

• Mammography, CA-15.3 & BRCA 1 & 2 for Breast Cancer

• PAP (LBC)+ HPV for Cervical Cancer

• CA-125, HE4 & Ultrasound for Ovarian Cancer

Book Appointment to get yourself tested at Suburban Diagnostics.