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April 2022

Tuberculosis and COVID: Can There Be Some Associations

Ever since WHO declared coronavirus disease 2019 (COVID-19) as pandemic we have seen the virus upending everyday life across the globe and affecting everyone as we speak. The prolonged periods of social isolation have changed the way we live our everyday lives.While it continues to mutate and produce successive waves of infection, it persists to pose a great threat to mankind across the globe. Even with a great global initiative of vaccinating billions of people, experts aren’t sure as to what we should expect next.The COVID virus is still finding its way into our lives. Get tested if you doubt having symptoms. Book COVID RT-PCR here. Over the past couple of years global efforts have been put forward to understand the pathogenesis, diagnosis and management of covid19. It is caused by severe acute respiratory syndrome (SARS) coronavirus-2 (SARS-CoV2), a member of the SARS-associated coronavirus (SARS-CoV) family. The members of this viral family, have been known to produce respiratory, enteric, hepatic and neurological disease in several animals and on occasions have shown ability to cross species and affect humans. To date only 7 types of coronaviruses have been found to cause disease in humans. The members of this viral family are a common pathogen to cause common cold in humans. The symptoms in affected individuals are mostly limited to respiratory tracts with fever, sore throat, and body aches being common. Some individuals may even remain asymptomatic or may have mild abdominal discomfort. Studies have shown that in most asymptomatic individuals and those recovering after milder symptoms, the virus remains localised to the upper respiratory tract and seldom reaches the lung. However, in the lungs, the virus attacks the type 2 epithelial cells hampering normal gas exchange and causing oxygen desaturation in the body. Still, why some individuals develop the pulmonary phase of disease or develop massive cytokine storm whereas most others get away with much milder courses of disease is less understood. COVID and TB As COVID 19 presents with predominant respiratory symptoms, it becomes imperative to keep another older airborne disease of tuberculosis in mind. Both of them affect the lungs and have overlapping symptoms like fever, weight loss and sore throat such that at times distinguishing tuberculosis symptoms from COVID-19 becomes difficult.Think that long-standing coughs are due to exposure to TB bacteria? Book a Genexpert test and clear all doubts.    Apart from the various clinical similarities in presentation, both the diseases are also affected by identical social determinants like overcrowding, poor hygiene and comorbidities. So we should always keep TB symptoms and treatment in mind while treating COVID-19 patients. Certain studies suggest that patients affected with TB are not only more likely to be infected with COVID-19 but are also more susceptible to adverse COVID outcomes. So it becomes imperative to identify both the clinical entities separately although both of them affect the lungs but they have separate tests with Tuberculosis treatment entirely separate from protocols for managing COVID-19 along with distinct clinical outcomes. TB treatment might involve taking a number of medications for 6 to 12 months and needs strict adherence to the medicine schedule. In recent times diagnosis of TB have seen a paramount shift and Genexpert mtb is the most commonly performed test. The Genexpert test is a fully automated advanced genetic method for diagnosis of TB using relatively small quantities of sample in a relatively small span of time. It not only allows rapid diagnosis but also provides information regarding rifampicin resistance, so it’s also called MTB rif commonly. Genexpert TB test detects both live and dead TB bacilli as well as distinguishes them from the non-tubercular bacilli. With global efforts likely diverted to tackle this pandemic it is expected to have a huge and everlasting impact on global tuberculosis control targets, meaning millions of new cases may go undiagnosed globally. Need to book a test and know the TB test price? Check at metropolis.com.Some experts and studies have recommended routine screening for TB among suspected or confirmed cases of COVID-19 in countries with high TB burden. It is pivotal that the world does not take its eyes off TB during the pandemic.As TB still remains to be a leading cause of death globally, efforts need to be redirected in missing out on diagnosis of these new cases with help of tuberculosis tests as well as providing support to existing ones. Take a little extra care ThoughCOVID is caused by a virus and TB due to a bacteria, the risk of both infections can be reduced by using a few simple precautions: ● Good ventilation in the residential area and indoors ● Maintain personal hygiene. Cover the mouth and nose when coughing or sneezing reduces the spread of germs ● Get tested and consult a doctor on suspecting symptoms.

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April 2022

Seasonal Allergies: Symptoms, Causes, and Treatment

The constant sneezing, running nose, congestion, etc. have just begun with this phase; and you are just one among hundreds of those who suffer from seasonal allergies. Just like other kinds of allergies, when the immune system is not able to grasp the external environmental changes and ends up overreacting to the outdoor allergens during spring, summer or fall, it leads to seasonal allergies i.e allergic rhinitis, or in layman’s terms hay fever. One can experience seasonal allergies in more than one season which can also be determined by where you live. How can I get my allergy diagnosed? While there might not be any certain treatment for such seasonal allergies, one can consult with the doctor for ease with the bothersome symptoms. If the symptoms are troublesome, the doctor might refer to an allergy test for better treatment. They will check the nose, ears, or throat. The allergy specialist can also conduct a skin test by pricking the surface of the skin with the allergen to understand the allergy and the cause, or may also order a blood test. Another resource to find out the cause of the suffering can be to opt for some of the best health checkup packages. Though the best cure would be to avoid contact with allergens that can be triggering, it may not always be possible. While there are certain medications such as over-the-counter decongestants and antihistamines or nasal sprays available for the cure, you can also get a health check-up done, the price for full medical checkup has now become affordable too. Some people may develop allergies to specific food items too. Book an allergy test- Food panel here.   Symptoms to watch out for While a few may suffer from mild symptoms, some others can have severe allergic reactions, a few common ones include: Congestion Itchy or watery eyes Constant sneezing Runny nose Itchy throat or ear canals Sometimes headache, wheezing and coughing or the formation of dark circles under the eye can also be the signs of allergic reactions. Causes behind seasonal allergies While we now know the symptoms to watch for, it is also important to understand what might be causing these. Symptoms of seasonal allergies vary from one season to another just like their triggers. We catch allergies when the immune system takes an airborne particle to be dangerous; in order to prevent and respond to the particle, the body system releases chemicals called histamines in the bloodstream which are said to produce the symptoms of allergy. So when the pollens or tiny dust particles or grains are present in the air, the body’s defence mechanism goes for a toss, thereby giving itchy throat, runny nose, watery eyes, etc. While in the summer season, the hay cuttings and grasses are responsible, in fall, the plants drop their pollen, the leaves shed, making it one of the worst seasons for allergic sensitive people. Winter comes as a respite for such people unless they also react to dust mites, mould, cockroaches, etc. staying indoors. Pollen is found highest during the morning, whereas trees, grass, and ragweed pollen are more common during warmer days or colder nights. They increase when the day is windy. Apart from pollen, grass, mould, smoke, insect bites or sting, chlorine in swimming pools, etc. can also cause allergies. What treatments work? In case of mild symptoms, one can also take precautionary basic steps, such as using air purifiers, staying indoors, keeping the windows covered, wearing a mask or scarf when stepping outside etc.The year-round allergic rhinitis can best be treated by avoiding getting in contact with the allergens as much as possible. If you are unable to avoid such allergens, there are other cures available such as going for over-the-counter medicines as mentioned, in severe cases; however, the expert may suggest allergy shots, which are basically immunotherapy to desensitize the immune system to these foreign particles. While the treatment works, most often these unnatural ways can have side effects such as dizziness, confusion, or drowsiness throughout the day. Some other effective steps can be- Stay indoors in the peak allergies season: You can take precautionary medicines to ease the symptoms, or if possible best would be to stay indoors. Avoid triggers: Wearing a mask if venturing outside works; avoid mowing lawns or other gardening activities. The best time to venture outside is after rains when the pollen from the air is clean, and the worst time is during the early morning when the pollen counts are highest. Maintain clean indoors: If you have forced temperature maintenance in your house, like air heating or cooling, it is advisable to use high-efficiency filters and call for regular maintenance and cleaning of these. Using a highly efficient particulate air filter in the bedroom and cleaning the house with a vacuum equipped with this HEPA filter also works. Cure for the itchy and runny nose: A quick cure to get rid of the nasal congestion is to rinse it with saline solution. This inexpensive cure can help get rid of the mucus and allergens from the nose, thus giving it relief from the constant itches and irritation. A few not-so-common natural remedies: Also include quercetin, a nutrient that can be found in onions, apples, and black tea that is effective in blocking histamines. Another cure is stinging nettle leaves, using dried and cold leaves for treating allergies and calming the affected area, while some also suggest going for acupuncture, though little evidence is there that supports the same, nonetheless these are all inexpensive and harmless treatments that can be opted for carefully. Symptoms of seasonal allergies can be irritating and uncomfortable. While much of these can be avoided, visiting and taking an expert’s opinion never hurts, they will help chart out the correct treatment plan and point out effective steps that can help ease the allergy and provide relief. There might not be any permanent solution, but these allergies can certainly be curbed following prescribed medications or home remedies as needed.

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April 2022

Get Sick of Changing Seasons Too Easily? This Could Be the Cause

Every time we observe a change in seasons, many of you may complain of stuffy nose, scratchy or sore throat, constant sneezing, watery eyes, mucus draining from your nose into your throat, high fever, muscle aches etc. There may be multiple causes to it. However, experts say a favorable environment for microbial growth and possible reduction in your immunity levels are the two important reasons. Surge of viruses and allergens in the air: We come down with a cold or flu with seasonal change and this temperature shift makes way for viruses to flourish. While we think the change in the temperature is the cause behind it, changes in the weather conditions accompanied by the growth of certain viruses during this time is primarily responsible for the increasing rate of illness. The weather itself does not make you fall sick; the germs do. For example, seasonal allergies due to weeds like mugwort or ragweed etc. are due to conditional occurrences and not related to drop in temperatures that cause us to be sick. Make sure to get a fever panel test done for correct diagnosis when you notice symptoms. Immune system being too busy: With the onset of summer, people are generally hit a little harder as all the flower pollen gets released in the air. The immune system in such cases gets occupied with fighting and reacting to these allergies, thereby leaving the body more vulnerable to other viruses. Fluctuating temperatures may reduce the resistance of the immune system, making people fall sick frequently. During winter months: We are more confined indoors, which increases chances of disease transmission due to low and dry heating and poor ventilation, making us susceptible to diseases. Likewise, working indoors, such as confined office spaces, schools, office buildings, restaurants etc., also makes it easy for the viruses to spread. In the winter months, the level of vitamin D intake reduces, which is considered an important element for a healthy immune system, but again it gets compromised, leaving doors for viruses to enter. The most common of these viruses being the Human Rhinovirus (HRV) found predominantly during spring and winter. The flu-causing influenza virus spreads when the air is dry and cold, especially during winters. Breathing in cold and harsh dry air can also result in narrowing of blood vessels in the upper respiratory tract that conserves heat, resulting in the white blood cells unable to reach the mucous membrane and harder for us to fight these germs and viruses. How to keep safe from seasonal sickness during weather changes? Being precautious by following certain lifestyle changes can help dodge that running nose, sneezes, rashes etc. There are a lot of ways that can either help prevent or decrease the chances of seasonal illness. Some of them being, Drink plenty of liquids: Staying hydrated at most times is vital. Keep yourselves properly hydrated because we may not realize it as the air is drier; hydration helps in the long run. Drinking enough water helps you flush out all the toxins, clear out mucus from your body, and keep your nasal passage and throat moist, giving less chance for bacteria to stick around. Getting a diagnosis on time: Most diseases that cause inflammation can result in fever. It becomes important to find out the real cause behind it, and get started on treatment accordingly. Every year with seasonal changes hitting different parts of India, people suffer from fevers including Dengue, Malaria etc. Getting a fever panel test package helps in identifying the cause and getting to the right treatment. Fever panel test price is affordable for all; one should consult an expert and get the basic fever tests done. Regular exercise: Exercising improves blood circulation and helps keep the immune system strong, which in turn helps combat the viruses and lowers the risk of getting infected with seasonal changes, sickness or fever. Well balanced diet and rest: Incorporating fresh fruits and vegetables in the meal, taking the ideal amount of vitamins and minerals followed by plenty of restorative sleep and rest, helps keep the body in check and gives it the power to fight off diseases. Practice proper hygiene: The global pandemic has already taught us the importance of good hygiene, washing hands regularly, avoiding touching surfaces such as door knobs or switches, covering your face while coughing or sneezing etc. This helps reduce the potential risk of infections for us as well as others around us. Another habit raised from the pandemic is the use of masks as a beneficial preventive measure to avoid catching viruses and falling sick frequently. Get vaccinated: With the shift from one season to another, the viruses constantly change and are often unknown, it is best advised to get a flu shot for prevention. Apart from these, get 8-hour sleep, stay indoors when sick, consult a doctor when allergies persist for longer durations etc. are some measures that can help prevent you and your family from getting stuck in this maze of seasonal changes. While these certainly can’t control the cold or the warm temperatures, they can at least ensure healthy living that will keep diseases at bay. Each season is unique and is looked forward to for different reasons. Don’t be just stuck with the thought of getting sick with cold, coughs, sniffles etc.

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April 2022

Top tests for sexual health check up

Human sexuality is the very pillar of human society and one cannot assume life without it, however it continues to remain a taboo across societies, cultures, religion and borders. Even in this age and times, discussion on sexual health and sexuality continues to remain incredibly private and awkward. It is not untrue to say that even with the best of efforts, there exists a clear lack of understanding and guidance so much so that even parents and schools refrain from discussing the topic. It has led to spread of misinformation especially among the young and vulnerable. What does sexual health mean? Ever since WHO first defined sexual health in 1975, it has been continuously modified to provide a better understanding of challenges faced and to guide a desired approach. The most widely accepted definition however is the one provided by WHO in 2002, it stated “Sexual health is a state of physical, emotional, mental, and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction, or infirmity”. In simpler terms, it ensures a person enjoys a satisfying sexual life with a freedom to choose safe and effective contraceptive method which ensures protection from STD’s as well as empowers them the freedom to decide when to conceive providing better family planning. The path to better sexual health starts with better recognition of underlying issues. Here, we have covered top tests for sexual health-related problems. SHBG test: SHBG stands for sex-hormone binding globulin, that is a protein made by your liver. As the name suggests, it binds to 3 sex hormones (estrogen, dihydrotestosterone (DHT), and testosterone) found in both men and women and help carry these throughout your blood to the body tissues. Hence, SHBG controls the testosterone levels that your body tissues can use. Too little testosterone in men and too much testosterone in women can cause problems. Is it better to have high or low SHBG? You should have optimum levels. If your SHBG is higher, the fewer sex hormones are available to the body. On the other hand, if SHBG is low, sex hormones are available to the body in abundance which can give certain physical symptoms.For men, SHBG is mostly ordered if a person experiences symptoms of low testosterone levels like low sex drive or fertility issues. For women, it's mostly ordered if there are symptoms of high testosterone levels like excessive body hair, acne, or fertility problems.Book your SHBG blood test here. Testosterone blood test: Testosterone is a male sex hormone produced from testis. Low blood levels of testosterone causes male sex problems with decreased libido, subnormal muscle mass, increases body fat content and decreased bone mass. So diagnosing low testosterone levels and treatment is very important. For evaluation of male sexual health disorders like erectile dysfunction (ED), premature ejaculation, loss of libido evaluating physician may require detailed history along with physical examination and a wide array of blood investigations to measure levels of blood sugar, cholesterol, thyroid hormones and sex hormone levels in males which includes testosterone test and SHBG test. Diminished testosterone levels either alone or in association with excessive SHBG may be a cause of sexual problems. Apart from these physicians may order penile blood flow ultrasound after medications to induce penile erection. Tests for Sexually transmitted infections (STDs): HIV and hepatitis B and C are infections that can spread from having unprotected sex with infected individual. Between 5 and 10% of people living with HIV also have hepatitis B virus, known as co-infection. Hepatitis B and C along with testing for HIV can be done usually as a part of a single viral marker test at a nominal price. Spectrum of sexual health diseases is quite wide! As with other non-communicable diseases, the incidence and prevalence of sexual health disorders are on a rise attributed to lifestyle modifications, smoking and alcohol consumption, diabetes mellitus, psychiatric disorders and heart conditions. Sexual health disorders include but are not limited to sexually transmitted infections like Bacterial vaginosis, chlamydia, gonorrhoea, Genital herpes, hepatitis, Human Papilloma virus (HPV), HIV/AIDS and syphilis. The spectrum of sexual disorder also includes erectile dysfunction(ED), loss of libido, nocturnal emission, premature ejaculation, impotency and infertility in males. For females it includes lack of sexual arousal, decrease libido, excessive dryness and discomfort. In addition to it women may also suffer from unintended pregnancies, inadequate spacing and complications associated with child births.  How to ensure a healthy sexually active life? Any sexually active adult should embrace healthy sexual practices, maintain basic hygiene and use proper contraceptives. One should undergo regular sexual health check-up and avoid unprotected intercourse. The risk of sexually transmitted infections is said to increase with     Multiple sexual partners     Unprotected intercourse including vaginal, oral or anal intercourse     Partners having history of STD’s     Partners having history of multiple sexual partners     Drug abusers with history of needles sharing The prevention of STDs involve practising safe sexual practices which involve use of condoms each time you have sex. Make sure to use a condom for the entirety of the act. Although condoms aren’t 100% effective by themselves, they remain to be the most effective and convenient method for prevention of STDs when used properly. Apart from it one should ensure thorough washing of genitals before and after intercourse, maintain complete vaccination for void being under the influence of alcohol or drugs as studies show they often lead to unsafe sex.Even though you practice all these, always be vigilant to suspect an STD when you see a genital sore or rash, discharge and swelling. Avoid sex with your partner on suspicion of an STD and ensure getting tested before resuming sexual activity. Although no unprotected sex is fully safe but it’s considered relatively safe only once at least 6 months have lapsed since you both tested negative for STD’s. Ensure testing for it when you get into a new sexual relationship. Efforts to destigmatise the talks regarding sexual health and dysfunction, sexually transmitted disease (STD’s), safe contraceptive methods and teenage pregnancy are the need of hour.

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April 2022

Ferritin Test: Purpose and Making Sense of Results

Ferritin test is a type of blood test that measures ferritin level in the blood and provides important information about a person's iron levels and overall health. What is Ferritin? Ferritin is an intracellular protein present in most tissues which plays an important role in the storage of intracellular iron, however being a subject of extensive research recently, various other roles have also been ascribed to it. Ferritin is produced by the liver and is stored in cells throughout the body, including in the liver, spleen, bone marrow, and muscle tissue. It is released into the bloodstream as needed to provide iron to the body. This protein plays a crucial role in the body's oxygen transport system as iron is a component of haemoglobin - the protein in red blood cells that carries oxygen to the body's tissues. Low levels of ferritin can lead to iron deficiency anaemia, a condition in which the body does not have enough red blood cells to deliver oxygen to the body's tissues.  Testing for ferritin is integral to evaluate a person's iron status and can help diagnose and monitor conditions such as iron deficiency anaemia. How Does Ferritin Help? The serum ferritin is an indirect measure of the total body iron stores and makes a very effective iron delivery system.Ferritin test is a valuable tool for the clinician, both for evaluation of iron-deficiency anemia, and also for evaluation of iron-overload conditions, such as hereditary hemochromatosis and chronic transfusion therapy. Factors That Can Affect Ferritin Levels Ferritin levels can be affected by a variety of factors, including: Age: Ferritin levels typically decline with age, especially in older men. Gender: Ferritin levels are generally higher in men than in women due in part to the difference in body size and muscle mass between the sexes. Diet: A diet low in iron can lead to low ferritin levels. In addition, certain substances in the diet, such as tannins in tea and coffee, can interfere with iron absorption. Alcohol consumption: Excessive alcohol consumption can lead to low ferritin levels due to poor nutrition and damage to the liver, which is responsible for producing ferritin. Certain medications: Some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, can interfere with iron absorption and lead to low ferritin levels. These factors can affect ferritin levels independently or in combination, and it is crucial to discuss any concerns about ferritin levels with a healthcare provider. Reasons to Test for Ferritin There are several reasons why a healthcare provider may recommend testing for ferritin: To diagnose iron deficiency anaemia To monitor treatment for iron deficiency anaemia  To evaluate the cause of abnormal ferritin levels How Ferritin is Tested Ferritin is typically tested using a blood test, which measures the level of this protein in the blood. The test is usually done in a healthcare provider's office or at a laboratory and involves taking a small sample of blood from a vein in the arm using a needle. Other tests that may be done in conjunction with a ferritin test include: Haemoglobin test: This test measures the level of haemoglobin. A low haemoglobin level can indicate anaemia, including iron deficiency anaemia. Complete blood count (CBC): This test measures the number and types of cells in the blood, including red blood cells, white blood cells, and platelets. A CBC can help to diagnose anaemia and determine the cause of anaemia. Iron studies: Iron studies are a group of tests that measure the level of iron in the body and the body's ability to use iron. These tests may include measuring the iron level in the blood, the transferrin saturation (the amount of iron bound to a protein called transferrin), and the total iron-binding capacity (the amount of iron that can be bound to transferrin). It is vital to note that ferritin levels can be affected by other factors, such as inflammation and certain medications, and may not always accurately reflect the body's iron status. Therefore, ferritin testing should be combined with other tests to evaluate a person's iron status. Ferritin Test: Making Sense of the Results The normal range for ferritin levels in the blood may vary depending on the laboratory, but generally, normal ferritin levels are considered to be: For men: 30-400 ng/mL For women: 12-150 ng/mL For children: 12-120 ng/mL Ferritin Test for Iron levels Ferritin serum test is usually a part of a panel of several blood tests routinely ordered to diagnose and manage iron deficiency anemia.  If a ferritin test indicates that your level is lower than normal ferritin levels, it indicates your body's iron stores are low and you may have iron deficiency. You could be anemic. However as normal ferritin levels change according to various physiological and pathological conditions, its values must be judged with caution.Low serum ferritin is highly specific for iron deficiency anemia, and is much more convenient than the gold standard method of obtaining a bone marrow biopsy to assess stainable iron. Ferritin normal range varies across laboratories, but levels of 30 to 300 ng/ml are considered normal for men, and 10–200 ng/ml for women. Studies suggested that a level higher than approximately 40 ng/ml should be used to exclude iron deficiency in most patients, whereas a level higher than 70 ng/ml is more appropriate to exclude iron deficiency in patients with inflammation or liver disease where serum ferritin levels are raised as a nonspecific marker of illness. Common Iron Deficiency Anemia Symptoms to Look for: Iron deficiency anaemia is a common condition that occurs when the body does not have enough iron to produce enough red blood cells. It can be caused by various factors, including inadequate intake of iron in the diet, blood loss (such as due to heavy periods or gastrointestinal bleeding), and poor absorption of iron from the digestive tract. It is important to note that these symptoms can also be caused by other conditions, and a diagnosis of iron deficiency anaemia should be confirmed through laboratory testing. Fatigue: Iron deficiency anaemia can cause fatigue due to the lack of oxygen delivered to the body's tissues. Weakness: Iron deficiency anaemia can cause weakness due to the lack of oxygen delivered to the muscles. Headaches: Iron deficiency anaemia can cause headaches due to the lack of oxygen delivered to the brain. Pale skin: Iron deficiency anaemia can cause pale skin due to the lack of oxygen delivered to the skin and the reduced number of red blood cells in the body. Running out of breath when doing even easy daily tasks like walking, climbing stairs, or working out. Irregular heartbeats Dry mouth or a swollen, inflamed, pale, or strangely smooth tongue. Ferritin Test in COVID Ferritin test, in the light of COVID-19 pandemic, has also emerged as an important diagnostic marker. As a mediator of cytokine storm, a form of extreme immune dysregulation associated with fatal outcomes, it is usually ordered as a part of a panel along with other inflammatory markers like ESR, CRP, D dimer and IL-10. Many studies have correlated high ferritin levels with severe COVID disease. In a small study with 20 people with COVID-19, it was found that individuals with severe and very severe COVID-19 exhibited increased serum ferritin level. However, your doctor is the guide here, always follow diagnostic and treatment related guidelines advised to you. Ferritin Test for kidney Conditions In patients with chronic kidney disease serum ferritin is a less robust marker of bioavailable iron. Although most patients on maintenance haemodialysis have a serum ferritin >500 ng/ml, this level does not represent the bioavailable iron and guidelines propose a serum ferritin level of 800 ng/ml as an upper limit for intravenous iron therapy whereas absolute iron deficiency is defined using another laboratory measure (transferrin saturation <20%) or serum ferritin <100 ng/ml. Other Conditions Serum ferritin has been shown to predict the risk of cirrhosis, in patients with hemochromatosis. The risk is extremely low for patients with serum ferritin levels less than 1000 micrograms/litre. Elevated serum ferritin also predicts end-organ involvement in iron overload conditions, such as transfusion-associated iron overload in myelodysplastic syndromes, thalassemia and hemoglobinopathies. Levels less than 1500 ng/ml indicated mostly acceptable iron overload; levels greater than or equal to 3000 ng/ml were specific for significant iron-overload and were associated with liver injury. (Accurate assessment of iron levels is required in those with levels between 1500 and 3000 ng/ml.).Serum ferritin levels may also be raised in many malignancies like neuroblastoma and breast cancer. Exact reason is however unknown but studies suggest that ferritin is merely being a serum maker and does not contribute to cancer etiology.Book your test with us, know the ferritin test cost and access results from the ease of your home. IMPORTANT TO NOTEAlways get your results interpreted through a medical professional. Test results may need to be evaluated alongside the clinical symptoms and can require other lab tests as well. 

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April 2022

What you must know about asthma in kids

Asthma, is a common medical condition which affects the respiratory tracts making breathing more laborious and difficult. Kids can get asthma too, however, the symptoms can be a little different. Worldwide, more than 6 million children below 18 years of age are affected by it. In fact, the condition affects about 15% of growing children, with boys more commonly affected than girls. How do kids get asthma? Asthma primarily results from airway hypersensitivity to common household allergens, and the most commonly implicated allergen is house dust mites, tiny bugs that live in house dust. Hyper-responsiveness to any allergen over a period of time leads to chronic inflammation followed by variable airflow obstruction. However why some children are more susceptible over others is not clearly understood, although a genetic cause (chromosome 5q polymorphism) is postulated to be associated with it. Apart from it, second hand smoke, obesity, maternal vitamin D deficiency and poor hygiene are also some of the associated predisposing factors. The exposure of allergen produces a hypersensitivity reaction, which in turn increases levels of serum immunoglobulin (IgE and IgG4) in blood. Immunoglobulins are a class of proteins which are produced by the body as a natural defence against foreign pathogens. Apart from these immunoglobulins, the body produces an excess of blood cells known as Eosinophils. Although both immunoglobulins and eosinophils are increased in blood, these are not specific to Asthma and are raised in many other allergic conditions. Looking for a blood test at home? Don’t look further! Book at Metropolis.  What symptoms the child might show? To begin with, a child may present with difficulty in breathing, slight chest tightness and a peculiar breathing sound known as wheeze. Initially these symptoms may last for a few minutes, but on repeated exposure to allergens these symptoms may increase in duration as well as severity. The disease also has a seasonal variation with increased disease severity in winter. The affected children are also prone to other allergic conditions affecting skin and common cold. So suspect the disease in children already having symptoms of other allergic conditions. The spectrum of disease may range from intermittent bouts of acute attacks well controlled with medications to more persistent symptoms affecting day to day life of child as well as night time sleep. In very severe cases the child may go into acute respiratory failure and a medical emergency. But for most children with asthma, it improves as they get older, and progressive worsening of symptoms is rather an exception than a rule. There are certain clues which may alert you of a severe form of asthma in your child. These include extreme respiratory discomfort with inability to speak, agitated child, loud wheeze, high respiratory rate of above 30 per min, and high heart rate of over 120 beats per min. Diagnosis and specific investigations your doctor might ask for? Just like adults, kids need investigations under expert guidance too. The diagnosis of asthma requires Pulmonary function Tests (PFT). These tests mainly look for airflow compared to normal individuals. However these tests require voluntary breath holding and forceful expiration on command which may not be possible in very small children. So in a child younger than 5 years the diagnosis is mainly clinical, and may require 3 or more bouts of breathing difficulty without any other accountable cause for the same. Apart from the pulmonary function tests (PFT), various other blood parameters are crucial in identifying the severity and associated prognosis of disease. These blood parameters include ESR blood test (ESR stands for Erythrocyte sedimentation rate), Serum levels of IgG4 and IgE, serum levels of Interleukins (IL 4 and IL 5). Apart from the above investigations the doctor may prescribe routine blood investigations which may include complete blood count with differential count (also called complete hemogram test), blood electrolyte level measurements, vitamin and mineral assessment. All these tests may be conducted as a part of full body checkup and blood samples be either collected at home or lab. Check out the full body checkup cost here. Possible medications your doctor might prescribe Well the treatment is mostly directed to counter excessive inflammation and associated narrowing of airways, which mostly includes inhaled corticosteroids and long acting Beta 2 agonists respectively. Apart from these some newer advancement includes agents directed against Ig E and IL 4 & 5.  How to care for an asthmatic child? As asthma makes breathing laborious, a lot of energy is consumed for breathing itself. We recommend a protein and calorie rich diet with a catch. As most treatment protocols include inhaled steroids as part of management strategy which increases blood sugar levels, ensure to give a balanced diet to keep blood sugar in check. The following preventive measures are recommended Limiting exposure to asthma triggers and helps your child avoid the possible allergens that trigger symptoms. Don't allow smoking around your child. Encourage your child to be active. Speak with an expert about what activities can be done safely. Help your child maintain a healthy weight. Do not panic. Keep in touch with a medical specialist.