Extended Health Check

CBC

Free Thyroid Profile : Thyroid stimulating hormone is the earliest parameter to record variation from normal values in case of Thyroid dysfunction. Thyroid malfunction is an extremely common occurrence and can lead to many unwanted consequences like unexplained and sudden obesity, infertility & menstrual irregularities in women, growth retardation and mental insufficiency in children and general constitutional symptoms like excessive lethargy or anxiety depending upon the basic thyroid disease.

Blood Sugar F : A blood sugar test may sound irrelevant especially to the young but startlingly we discover many young diabetics who are completely asymptomatic.

Lipid Profile : A comprehensive lipid profile including estimation of direct LDL and HDL cholesterol indicates the status of circulating lipids (fat) in our blood. High quantities of harmful lipids like LDL cholesterol Triglycerides and VLDL and low blood levels of protective lipid i.e. HDL cholesterol are one of the most important causes of formation of plaques in our blood vessels and if left uncontrolled can lead to grave consequences like heart attacks, stroke etc.

LFT (Liver Function Test) : Liver is the waste processing unit of our body. Most toxic products consumed or produced due to our body metabolism are detoxified by the liver and then disposed off either through the stools or via the kidneys in urine. A regular scanning of the liver is highly recommended as it can give valuable information about the health of the liver itself and also of many organs in the body whose final products are detoxified in the liver.

KFT (Kidney Function Test) with Electrolytes : Kidneys are the main sanitation unit of the body and most of the toxins produced in the body, after processing by the liver are excreted by the kidneys. Another important function of the kidney is to reabsorb important chemicals from the urine prior to its disposal into the urinary bladder and maintain harmony in the body’s metabolism. Since kidneys are constantly handling toxic waste products, they are highly prone to injury and damage. The kidneys are also the primary target of damage in Diabetes and Hypertension. Constant monitoring of the kidney function is extremely critical for diabetic and Hypertensive patients but is equally recommended in apparently healthy individuals too.

RUA (Routine Urine Analysis) : A routine urine examination allows us to look at the gross health of the entire urinary tract and may reveal hitherto silent stones and other common disorders.

HbA1C (Glycosylated hemoglobin) : Direct assessment of blood sugar levels indicates the level of sugar in the blood of a subject/patient at the time of testing while HbA1C test gives an accurate estimation of the average blood sugar level for a period of 3 months preceding the date of testing.

HbA1C testing is now the global gold standard for monitoring the overall blood sugar control in known diabetics and has replaced blood sugar testing for this purpose. It is a more useful assay for early detection of unknown diabetes too, as it gives an indication of the average blood glucose levels for past three months as against blood sugar which may be normal on the day of testing.

Vitamin D : Vitamin D is a hormone essential for the health of our bones. It is not readily available in food and is synthesized by the body when we are exposed to sunlight. India being a tropical country we are a sun fearing nation. A mild to moderate deficiency of Vit D is detected in nearly 70% of the general Indian population especially pronounced in the affluent as we shunned the sun and embraced the air conditioners. Vit D deficiency in childhood leads to ‘rickets’ causing bony malformation and weakness while deficiency in adults leads to ‘osteomalacia’ or weak bones leading to chronic bone pains and even fracture of hip and spine. Old age induced bone weakness adds insult to pre-existing injury and exacerbated the problem. Vit D estimation is recommended for all groups but becomes increasingly important in the elderly. Supplementation therapy with Vit D and Calcium can prevent many of the ill effects of the deficiency syndrome.

Vitamin 12

Breast & Cervical Cancer Screening Profile

Sono - Mammography

PAP - LBC : Cervical cancer is the most common cancer affecting women in India. It affects a relatively younger age group of patients (typically affects women in 30-50 years of age). Importantly this cancer is invariably preceded by a long and eminently curable pre cancerous phase which can easily be detected by a simple and cheap ‘PAP smear’. This test is most recommended, at least once in 5 years, for all women from 25 yrs to 35 yrs of age and once in 2 years beyond 35 years of age.

Pre - Nuptial

The package is designed for people who are about to tie the knot. It is wise to invest in the health of the family that you are about to start. The conditions screened for in this package directly influence the health of your partner and the offspring that you are likely to bear.

Complete Hemogram

Blood grouping : Recommended for all couples prior to marriage and absolutely essential prior to child birth. A mismatch in the Rh group between the mother and the father (Rh –ve mother and Rh +ve father) can lead to severe consequences for the child, especially the second child (the first child usually gets mild disease). Prior knowledge of the parental mismatch allows the gynecologist to treat the mother and prevent catastrophic consequences for the second born child.

Blood sugar (random) : A screening test for diabetes, it is especially relevant for females prior to marriage as pregnancy induced diabetes is a relatively common occurrence, which often regresses post pregnancy and hence is managed accordingly.

VDRL

HIV 1&2 antibodies, HBsAg : These are increasingly common and potentially life threatening infections of modern times which are amenable to sexual transmission and subsequently capable of crossing the placental barrier and infecting future offspring born to infected mothers. As a ritual pregnant couples are tested for these diseases at the time of the first visit to the gynecologist during pregnancy. However getting tested prior to pregnancy and preferably prior to marriage are more suitable as is evident from what has been written above.

Hb HPLC : India is an endemic zone for Beta Thalassemia, a disease of the genes encoding for the hemoglobin molecule. This disease can be present as intermediate or major form wherein it is severe and is diagnosed in childhood itself. The more dangerous form is a trait or minor disease that is completely silent clinically. The carriers of this disease grow up normally and are apparently healthy. In case such a person gets married to a partner who also is carrying the silent forms of the disease there are high chances that the children born to such couples may suffer from the more severe form of the disease. However if such a person marries a normal person the children will either be born normal or at worse may carry the silent form of the disease. A simple blood test on potentially marriageable partners can identify the risks an prevent or even eradicate this common but extremely painful disease from our society.

Pre - Conception (Wife)

Pre - Conception Profile (Wife) : Recommended for married couples who are planning a baby. The package is aimed at a healthy couple and a healthy offspring.

Complete Hemogram

Blood grouping : Recommended for all couples prior to marriage and absolutely essential prior to child birth. A mismatch in the Rh group between the mother and the father (Rh –ve mother and Rh +ve father) can lead to severe consequences for the child, especially the second child (the first child usually gets mild disease). Prior knowledge of the parental mismatch allows the gynecologist to treat the mother and prevent catastrophic consequences for the second born child.

Blood sugar (random) : A screening test for diabetes, it is especially relevant for females prior to marriage as pregnancy induced diabetes is a relatively common occurrence, which often regresses post pregnancy and hence is managed accordingly.

VDRL

HIV 1&2 antibodies, HBsAg, Anti HCV antibodies : These are increasingly common and potentially life threatening infections of modern times which are amenable to sexual transmission and subsequently capable of crossing the placental barrier and infecting future offspring born to infected mothers. As a ritual pregnant couples are tested for these diseases at the time of the first visit to the gynecologist during pregnancy. However getting tested prior to pregnancy and preferably prior to marriage are more suitable as is evident from what has been written above.

Hb HPLC : India is an endemic zone for Beta Thalassemia, a disease of the genes encoding for the hemoglobin molecule. This disease can be present as intermediate or major form wherein it is severe and is diagnosed in childhood itself. The more dangerous form is a trait or minor disease that is completely silent clinically. The carriers of this disease grow up normally and are apparently healthy. In case such a person gets married to a partner who also is carrying the silent forms of the disease there are high chances that the children born to such couples may suffer from the more severe form of the disease. However if such a person marries a normal person the children will either be born normal or at worse may carry the silent form of the disease. A simple blood test on potentially marriageable partners can identify the risks an prevent or even eradicate this common but extremely painful disease from our society.

TORCH lgG : This test is aimed at the identification of a group of diseases which includes Toxoplasma, Rubella, Herpes and Cytomegalovirus. Toxoplasma is rare in India but the remaining three are rampant and infect almost 80% of our population. All of these diseases can lead to abortion or may cause severe congenital malformations in the unborn child if the mother acquires a fresh infection from any of these organisms during her pregnancy.Toxoplasma and Rubella are only once in a life time infections and a single episode of the disease offer lifelong immunity to the patient. Cytomegalovirus and Herpes can cause recurrent infections but are most damaging if a fresh first time infection is acquired during an ongoing pregnancy. In case the patient has been exposed to the infection prior to pregnancy a repeat Cytomegalovirus or Herpes infection during pregnancy is not likely to cause any serious damage to the unborn baby.

As our body's natural immune response to infections we produce antibodies to limit or fight an infection. IgM class of antibodies is formed in the immediate post infection period as first line of defense. Over a period of time the IgM antibodies fade away and IgG antibodies are formed which stay in our blood for the rest of our life offering immunity against the infection and are also useful to identify past exposure to the disease.

An assessment of the presence the IgG class of antibodies in a female patient who is planning a baby in the near future thus becomes a valuable assay. If IgG antibodies are present in the blood prior to pregnancy it indicates past infection with the diseases included in this group. This means that the person is forever immunized against Rubella and Toxoplasma and even if she contracts secondary infection with Cytomegalovirus or HSV during pregnancy there is no need to panic as the baby is safe from ill effects of the infection. If the IgG antibodies are not present and the patients becomes positive for the disease during future pregnancy then effective treatment including abortion may be contemplated in order to bear a healthy child.

If the test is performed during an ongoing pregnancy then we need to look for the IgM class of antibodies as we are looking for a recent or fresh infection only and IgM antibodies are the early antibodies formed by the body against an infection as already explained. Background knowledge of past infection is still helpful as already explained because if the patient has been exposed prior to pregnancy, a fresh secondary infection indicated by presence of IgM antibodies need not necessitate any action as the child is safe. In case no background information of past infection is available (i.e. the patient has not been tested for IgG antibodies prior to pregnancy) then IgM positivity for any of the four parameters is to be viewed seriously. IgM positivity for Rubella and Toxoplasma infections is a definite indication for aborting the child, while IgM positivity for CMV or Herpes requires close follow up with repeated high resolution ultrasound scans and may even require testing on amniotic fluid that is drawn from the pregnant woman’s womb to test for presence or absence of infection in the unborn child. Results of the Ultrasound and if required the tests on amniotic fluid are together used to decide the future course of the pregnancy. In case of the slightest doubt it is safer to opt for abortion rather than face the trauma of bearing and raising a child that may be seriously malformed.

Pre - Conception (Husband)

Pre - Conception Profile (Husband) : Recommended for married couples who are planning a baby. The package is aimed at a healthy couple and a healthy offspring.

Complete Hemogram

Blood grouping : Recommended for all couples prior to marriage and absolutely essential prior to child birth. A mismatch in the Rh group between the mother and the father (Rh –ve mother and Rh +ve father) can lead to severe consequences for the child, especially the second child (the first child usually gets mild disease). Prior knowledge of the parental mismatch allows the gynecologist to treat the mother and prevent catastrophic consequences for the second born child.

Blood sugar (random) : A screening test for diabetes, it is especially relevant for females prior to marriage as pregnancy induced diabetes is a relatively common occurrence, which often regresses post pregnancy and hence is managed accordingly.

VDRL

HIV 1&2 antibodies, HBsAg, Anti HCV antibodies : These are increasingly common and potentially life threatening infections of modern times which are amenable to sexual transmission and subsequently capable of crossing the placental barrier and infecting future offspring born to infected mothers. As a ritual pregnant couples are tested for these diseases at the time of the first visit to the gynecologist during pregnancy. However getting tested prior to pregnancy and preferably prior to marriage are more suitable as is evident from what has been written above.

House Maid's Profile

Chest X-Ray(CXR) : Primary investigation to rule out tuberculosis of the lungs. The disease is at its maximum infective potential when present in this location as the bacteria get coughed out and may infect people in immediate vicinity of the infected individual.

Mantoux test : A simple, cheap and age old test to screen for tuberculosis infection.

Stool Routine : As the house maid becomes the primary food handler of the house hold, this basic screen to rule out any parasitic infestation or bacterial infection of the stool becomes extremely relevant in order to prevent spread of the infection to your family members.

Complete Hemogram

Urine Routine : A simple and cheap baseline test to assess presence of any infective pathology in the urinary tract.