The Hemoglobin HPLC/Electrophoresis with CBC test identifies and measures different types of hemoglobin in the blood and assesses blood cell parameters through a CBC to help diagnose and keep track of certain blood disorders. These types of hemoglobin include: adult type (HbA2), fetal type (HbF), hemoglobin S (HbS), hemoglobin C (HbC), and hemoglobin E (HbE), among others.

The CBC measures parameters such as:

• Hemoglobin (Hb): Measures the amount of hemoglobin in the blood.
• Hematocrit (HCT): Measures the proportion of blood made up of red blood cells.
• Red blood cell (RBC) count: Measures the number of red blood cells in the blood.
• Red blood cell indices: Include MCV, MCH, MCHC, and RDW, which provide information about the size, hemoglobin content, and variation in the size of red blood cells.
• White blood cell (WBC) count and platelet count: Provide information about other blood cell types.

Normal hemoglobin types:

• Hemoglobin A (HbA): The main type of hemoglobin in healthy adults.
• Hemoglobin F (HbF): Found in unborn babies and newborns. It is slowly replaced by HbA after birth.

If the levels of HbA or HbF are not normal, it may indicate certain types of anemia. The interpretation depends on the overall hemoglobin pattern and CBC findings.

Abnormal hemoglobin types:

• Hemoglobin S (HbS): Found in people with sickle cell anemia. It causes red blood cells to become stiff and sickle-shaped, leading to pain and other health problems.
• Hemoglobin C (HbC): Linked to a condition called hemolytic anemia, where red blood cells break down faster than normal.
• Hemoglobin E (HbE): Common in people from Southeast Asia. It may cause mild anemia or sometimes no symptoms at all in the heterozygous state.
• Hemoglobin D (HbD): Causes mild hemolytic anemia and mild to moderate spleen enlargement. The Hb D Punjab variant is most commonly seen in people from Gujarat and among Sikhs of Punjab.

The HPLC or electrophoresis pattern, together with CBC findings and clinical history, helps the doctor assess whether further testing is required.

The FBS (Fasting Blood Sugar) test measures the glucose level in the body under overnight fasting conditions. Glucose is the primary energy source and is broken down through metabolism to produce energy. Hormones and enzymes produced by the liver and pancreas control this process. The hormone insulin, produced by the pancreas, regulates blood glucose levels. When these levels are high, such as after a meal, insulin is secreted to transport glucose into cells for energy production. Elevated fasting glucose levels may indicate a risk of developing prediabetes or diabetes. Diabetes is broadly classified into two main types. Type 1 diabetes occurs when the pancreas produces little or no insulin due to autoimmune destruction of insulin-producing cells. Type 2 diabetes develops when the body becomes resistant to insulin or when insulin production is insufficient to meet the body’s needs.

The RPR (Rapid Plasma Reagin) test looks for antibodies (specific proteins) that react to syphilis in the blood. This means the test doesn't find the actual bacteria that cause syphilis. Instead, it looks for antibodies against substances given off by cells that have been harmed by the bacteria.  Antibodies are a specific type of protein produced by your immune system to fight off any invaders, such as bacteria, viruses, or toxins. Detecting these antibodies can help your doctors know if you have syphilis. Untreated syphilis can spread to your eyes, blood vessels, heart, and brain. But it can be easily cured if treated in the early stages.

The TSH (Thyroid Stimulating Hormone) Ultrasensitive test measures the levels of TSH hormone in the blood. TSH is produced by the pituitary gland located at the base of the brain. Its function is to stimulate and regulate the functioning of the thyroid gland. It signals the thyroid gland to increase or decrease the production of thyroid hormones T3 and T4 when their levels are low or high, respectively. Therefore, when the levels of T3 & T4 decrease, the pituitary gland is stimulated to release TSH. This high TSH level, in turn, stimulates the thyroid gland to release more thyroid hormones (T3 & T4). It conversely happens when the levels of thyroid hormones increase.

The Blood Group ABO & Rh Factor determines your blood type and Rh factor. Healthcare providers can ensure compatibility and prevent adverse reactions during medical interventions by identifying an individual's blood type and Rh factor. This test is essential for various medical procedures, including blood transfusions, organ transplants, and prenatal care.

An HIV Combo (Antigen And Antibody) Test simultaneously detects HIV p24 antigen and antibodies associated with HIV 1 & 2. The HIV p24 antigen is the most abundant HIV protein. Its detection is used clinically to diagnose an HIV infection early on since HIV-specific antibodies are not detectable in a very recently acquired infection.

HIV-1 was discovered first and is the most widespread. HIV-2 is more than 55% genetically different from HIV-1. The transmission rate of HIV-2 is also slower than HIV-1. 

The Urine R/M (Urine Routine & Microscopy) test involves gross, chemical, and microscopic evaluation of the urine sample.

1. Gross examination: It involves visually inspecting the urine sample for color and appearance. Typically, the urine color ranges from colorless or pale yellow to deep amber, depending on the urine’s concentration. Things such as medications, supplements, and some foods such as beetroot can affect the color of your urine. However, unusual urine color can also be a sign of disease.

   In appearance, the urine sample may be clear or cloudy. A clear appearance is indicative of healthy urine. However, the presence of red blood cells, white blood cells, bacteria, etc., may result in cloudy urine, indicating conditions such as dehydration, UTIs, kidney stones, etc. Some other factors, such as sperm and skin cells, may also result in a cloudy appearance but are harmless.

2. Chemical examination: It examines the chemical nature of the urine sample using special test strips called dipsticks. These test strips are dipped into the urine sample and change color when they come in contact with specific substances. The degree of color change estimates the amount of the substance present. Some common things detected include protein, urine pH, ketones, glucose, specific gravity, blood, bilirubin, nitrites, and urobilinogen.

3. Microscopic examination: This involves the analysis of the urine sample under the microscope for pus cells, red blood cells, casts, crystals, bacteria, yeast, and other constituents.

The Hepatitis C Virus (HCV) Antibody test determines the status of current hepatitis C virus (HCV) infection or past HCV infection that has been resolved. This test, therefore, helps your doctor to guide an appropriate treatment plan. HCV causes liver inflammation and is classified into acute hepatitis infection and chronic hepatitis infection.

• Acute hepatitis C: This occurs in the first six months after exposure to the hepatitis C virus. In the early stage of the infection, acute hepatitis C is mild and may cause no symptoms. For this reason, most people do not know they have this infection.
• Chronic hepatitis C: If your body is unable to fight off the virus, you can develop a chronic hepatitis C infection. Progression from acute to chronic hepatitis C is common, occurring in about 75-85% of patients. Detecting chronic hepatitis C at the early stage is important to prevent future complications, such as liver failure, and initiate effective treatment.

The Hepatitis C Virus (HCV) Antibody test is used for screening for anti-HCV antibodies. A reactive result needs to be confirmed by other more specific NAT/ nucleic acid tests before final diagnosis.

The Hepatitis B Surface Antigen (HBsAg) test detects HBsAg, a protein on the surface of the hepatitis B virus (HBV), in the blood. It is an important screening test for HBV infection. A reactive result needs follow-up with additional tests, such as anti-HBs and total anti-HBc antibodies, and can be confirmed with HBV DNA testing by PCR. This test helps identify individuals who may need medical treatment and supports measures to prevent the spread of hepatitis B. The test uses automated chemiluminescence immunoassay (CMIA/CLIA) technology, which may vary slightly across laboratories.