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Mumbai May 7, 2015: Ovarian cancer has emerged as one of the most common cancer affecting women in India. An analysis of samples collected over the past two years (2013-2014) by Metropolis Healthcare Ltd reveals that a total of 7945 tested positive for high CA125 levelsout of the 36,515samples processed at Metropolis Healthcare in Mumbai. According to Indian Journal of Cancer, 1 out of 5 women are prone to ovarian cancer. The majority of ovarian cancers arise from the epithelium (outer lining) of the ovary. 9 out of 10 ovarian cancers are epithelial ovarian cancers.A host of factors affects female ovaries such as family history, age, obesity, fertility drugs, personal history and hormone replacement therapy (HRT). Ovarian cancer is a highly aggressive cancer and is one of the leading causes of women’s death. It is an important cause of morbidity and mortality, especially in the middle aged women. Development of cancer cells in ovary accounts for about 4% per cent of all cancers in women.Certain inherited gene changes (mutations) can increase the risk of ovarian cancer. These include changes in the BRCA1 and BRCA2 genes. If you have inherited a mutation of one of these genes from either parent, your chances of getting breast and/or ovarian cancer increases. Ovarian cancer is difficult to pick up as symptoms like abdominal pain, persistent bloating and difficulty while eating are extremely common conditions in the disease.Accurate ways to detect ovarian cancer early could have a great impact on the cure rate. If a woman has these symptoms more than 12 times a month, she should see her doctor, preferably a gynecologist. Cancer Antigen – 125 test or popularly known as CA-125, assesses the concentration of this protein in the blood.Doctors may suggest a CA-125 test if they suspect ovarian cancer, endometrial, peritoneal or fallopian tube cancer. CA – 125 is a screening and monitoring test marker. However CA-125 has a low specificity & positive predictive value as it can be elevated in other cancers involving pancreas, breast, bladder, lung, and liver & in benign conditions like diverticulitis, endometriosis, pelvic tuberculosis, pleural effusion. Combining other detection methods like transvaginalsonography and rectovaginal pelvic examination increases the accuracy of detecting ovarian cancer. A CA-125 test result of greater than 35 U/ml is generally accepted as being elevated.CA125 test is one of the first tests doctor orders if he suspects early symptoms of Ovarian Cancer. In an analysis of data of over 2 years (2013-14), Metropolis Healthcare has analyzed the risk of ovarian cancer in Mumbai Of all the 7945 samples that tested abnormal, the following is the pattern of abnormality within age groups Commenting on the study, Dr.DeepakSanghavi, Deputy Chief of Lab Services, Metropolis Healthcare said “In ovarian cancer, cells in the ovary start to change and grow abnormally. If the cancer isn’t identified at an early stage, it can spread to the abdomen and pelvis, including other parts of the female reproductive system. Women who have their first full-term pregnancy after age 35 or who never carried a pregnancy to term have a higher risk of ovarian cancer.Breastfeeding may lower the risk even further. Fertility drugs with no outcome or hormone therapy after menopause is also linked to the disease. Mutations in BRCA1 and BRCA2 are also responsible for most inherited ovarian cancers.” Several advances in biomarker discovery and development have now led to additional tools that may be useful in the clinical management of women with adnexal masses, with recent FDA approval of Risk of Ovarian Malignancy Algorithm index popularly known as ROMA index gives a fair indication for the risk of ovarian cancer in pre- and post-menopausal women with a pelvic mass.The ROMA test is intended for use in women who meet the following criteria such as over 18 years of age, have an ovarian mass, surgery is planned or not yet referred to an oncologist (Source: Indian Journal of Cancer, American Cancer Society) *CA-125 (Reference range: All values between 0-35 U/ml is considered normal and values above 35 are out of the normal range. Clinical correlation is suggested

*Keeping pace with newer biomarkers in Autoimmunity- new antibody test launched for renal disease* 11th March 2015: One of the major kidney diseases, Nephrotic Syndrome is defined by massive continued loss of urinary proteins and edema (water retention). One of the major causes of Nephrotic Syndrome is Membranous Nephropathy or Membranous Glomerulonephritis which is a chronic inflammatory disease of the glomeruli (the network of capillaries in kidneys that perform the first step in filtering blood). In Membranous Nephropathy, an antibody-antigen complex otherwise called as the immune complex is formed in the glomerulus. This eventually leads to loss in kidney function and kidney failure. Membranous Nephropathy can be primary (where cause of the disease is not known; idiopathic) or could be secondary (as a result of an underlying condition like prolonged infection, tumor, cancer and even certain medications etc). It is important to differentiate primary and secondary since the treatment and disease management varies. In Primary Membranous Nephropathy, an individual undergoes an immunosuppressive therapy or kidney transplant), whereas in secondary, the underlying disease is treated. PLA2R Antibody Test is used to correctly differentiate the two kinds of disease, evaluate the intensity of the disease, monitor therapy and risk assessment after kidney transplant. Advantages of the test Serum based test and requires only a blood sample Easy to perform Presents a non-invasive alternative to the common biopsy. Anti-PLA2R autoantibodies are a highly specific and sensitive marker for primary MN. Additionally to its usage in differentiation of primary and secondary MN, the anti-PLA2R titer reveals a high predictive value for: Disease evaluation Anti-PLA2R autoantibody results correlate with disease activity (proteinuria). High titers are directly proportional with a severe course of primary MN. Therapy monitoring The anti-PLA2R autoantibody titer decreases in patients undergoing successful immunosuppressive therapy. A relapse of disease is associated with a recurrence of the antibodies. Furthermore, a high anti-PLA2R titer was identified as a considerable risk factor for primary MN patients to not achieve a remission of proteinuria.  Risk assessment Up to 40 % of patients with primary MN experience a relapse after kidney transplantation. This risk is particularly high if anti-PLA2R autoantibodies are persistently found during the six months after organ transplantation. Therefore, the titer can be useful to assess the necessity and intensity of an immunosuppressive therapy after transplantation to avoid relapses. Commenting on the test, Dr Deepak Sanghavi who heads the Immunochemistry section at Metropolis Healthcare said “It is an important test that will help improve outcomes and disease management in such a chronic kidney disease. We have tied up with few hospitals and Institute of Kidney Diseases and offer this test at INR 4,500. Out of the suspected samples that we receive, almost 4 out of 10 returns positive”

Mumbai December 2015:Metropolis Healthcare Ltd, The Pathology Specialist haslaunched ‘The Metropolis Marathon Package’ a comprehensive diagnostic package comprising 20 distinct tests to screen the complete health of a marathoner. The first of its kind diagnostic initiative will be available across Metropolis centers in Mumbai. The sheer number of Indian runners participating in marathons continues to grow and new half marathons and full marathons are being added every year. Marathon is considered as the ultimate running challenge and marathon enthusiasts train for over a year before the grand finale. Training for a marathon can be just as strenuous as running a marathon. It is important to understand that running for 42kms (full marathon) or 21kms (half-marathon) needs a different conditioning for the body and muscles. ‘The Metropolis Marathon Package’ is a comprehensive health package comprising a group of tests to screen the complete health of individuals taking part in the marathon which includes an in-depth cardiac risk analysis and an overall assessment of kidney and liver function. Whether you are a novice or a seasoned marathon runner, it is important to know your physical limits and capabilities. Prolong running may cause difficulties to heart in refilling chambers and abnormalities in pumping blood from the right side of the heart to the lungs. Health checks every runner must undergo Are you fit enough to run a Marathon? Do you have a family history of Diabetes/Blood pressure/Heart Attack? Need for medical clearance before a marathon? What are the risks associated with a Marathon? General Body Check–Test Name: CBC- To check anaemia, infection and measure cell count of various blood components.Result: Good haemoglobin levels are very important for marathon runners. Diabetes Check –Test Name: HBA1c, Glucose Fasting, D3 HydroxyButarate.Result: Endurance training lowers blood sugar. May lead to diabetic ketoacidosis which is life-threatening. The above tests will help diabetics plan their insulin doses and also screen general mass of diabetes. Cardiac Check – Test Name: Lipid Profile Mini, CPK-Total, Stress test, ECG, Blood Pressure.Result: High levels of HDL cholesterol are generally observed in endurance / marathon trainers. HDL facilitates fibrinolysis and prevents the occurrence of coronary heart disease. Abnormally high levels of LDL may require further testing before the run. Test Name: CPKResult:High CPK suggests muscle / heart / brain injury which may be aggravated because of endurance training. Hence it becomes important to monitor CPK. Test Name:ECG/Stress TestResult: Important test to monitor the functioning of heart in order to prevent sudden heart failure post marathon. Bone Health Check –Test Name: Calcium / Vit DResult: People with low calcium and Vit D are more prone to ligament / muscular/ bone injuries. Such deficiencies prolong the process of healing of injuries. Kidney Health Check –Test Name: Kidney Function TestResult: Kidneys help regulate blood pressure and plays a vital role in the production of RBCs. Normal kidneys is required for high level endurance training. Liver Health Check –Test Name: Liver function TestResult: Liver plays a vital role in digestion, metabolism and detoxification. Hence it is important to monitor this organ before a marathon as during the run large toxins are produced in the body. Speaking on the launch, Dr Nilesh Shah, Group President & SBU Head, West India, Metropolis Healthcare said, “We have seen and heard of instances where athletes collapse during marathon due to sudden cardiac arrest or shooting up of blood pressure etc. The body undergoes various changes with the age and one must not take it for granted; a thorough check-up should be carried out before undertaking any such activity under the supervision of a qualified physician and one should also understand one’s physical limitation. Nothing is more precious than life. Also patients suffering from asthma, lung or kidney issues, diabetes should be extremely cautious before undertaking the marathon.” With the huge growing popularity of marathon running, it’s important to make sure that the body is up for the challenge.Getting acquainted of personal health records, heart rate and blood sugar level, is the best way to safeguard long-term health issues by classifying troublesome concerns at the earliest.