Sometimes the odds are against you (a troubled family medical history), sometimes you bring it on yourself because of poor lifestyle choices. Either way, we live in a time when lifestyle diseases have taken on epidemic proportions, and India is among the worst-affected countries. The International Diabetes Federation (IDF), for example, states that in 2009 India had the maximum number of diabetics in the world, 50.8 million, followed by China with 43.2 million. In 2011, the IDF estimated that the number of diabetics in India had gone up to 61.3 million (of the total of 71.4 million people with diabetes in South-East Asia), and that India would face one of the toughest struggles against diabetes in the region.
So it is critical to get all the help you can. It pays to be aware of the newer, better ways to get tested for diseases and disorders. Here’s a round-up of the advanced diagnostic tests now available in India, both for lifestyle diseases and other common, but serious ailments. Of course, arbitrary testing is not recommended. Consult your family doctor or a specialist about a test and follow their advice.
The Pap smear is still the standard test. But now a new, more efficient technology—the BD SurePath™ liquid-based Pap Test, approved by the US food and drug administration—is also available. According to Vani Ravi Kumar, coordinator, telemedicine, Bowring and Lady Curzon Hospital, Bangalore: “LBC (liquid-based cytology) is a new, advanced technology for processing these samples. It makes testing faster, which means quicker reports, and unlike Pap, you don’t need to give repeat samples.”
“In a conventional Pap test, only 30% of the cells reach the lab, 70% are simply discarded. The chances of high-risk pre-cancer (HRP) detection rate and diagnostic accuracy also increase substantially with this technique,” says Manu Noatay, principal consultant, Niche Theranostics and IndiPath Diagnostics, New Delhi.
Test right: Newer testing techniques can help your doctor treat your illness more accurately
Cost*: Approximately Rs 1,200 compared with Rs 500 for a conventional Pap smear. In Delhi the test is available at Sir Ganga Ram Hospital, Star Imaging and Path Labs, Dr Suri Lab Pvt. Ltd, and Niche Theranostics; and in Bangalore, at Bowring and Lady Curzon Hospital.
Traditionally diabetes has been diagnosed on fasting blood sugar value or blood sugar taken 2 hours after an oral glucose drink. Now, Glycosylated haemoglobin, commonly known as HbA1c, a new blood test which gives an average of blood sugar levels over a period of three months, has been introduced in India. According to Anoop Misra, chairman, Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, New Delhi, this is better because in a single blood sample, this test provides far more revealing information about the average blood sugar levels than a fasting blood sugar value. “Since this gives you an average blood sugar value over three months, you can’t get false values depending on the patient’s condition on the day of the test,” says Dr Misra. “This test also correlates better with complications of diabetes.”
The downside, Dr Misra points out, is that the test can throw up false values if a person is suffering from anaemia, or genetic haemoglobin abnormalities.
Cost:Rs 400-600; fasting blood tests usually cost about Rs 250-300. Available widely.
Ajay Aggarwal, senior consultant, department of endocrinology, Fortis hospital, New Delhi, says the ideal candidates for screening are women over 35, those with a family history of thyroid diseases, patients with goitre and those with other autoimmune disorders. “Usually the diagnostics involves measurement of total T4, total T3 and TSH (thyroid-stimulating hormone). Thyroid autoantibodies are also measured often for proper diagnosis,” says Dr Aggarwal. “But now you have better assays like Clia (chemiluminescence immunoassay) to do the same tests, which are very sensitive and detect small variations in thyroid functioning.”
Cost:Thyroid function testing, Rs 600-800, where all three—T3, T4 and TSH—are measured, and thyroid antibody panel for Rs 2,000-2,500. Antithyroid peroxidase antibody (anti-TPO) costs Rs 1,100. In the beginning all three—T3, T4 and TSH —need to be measured to decide if thyroid malfunction is there and then later only TSH can be measured to decide the medications (TSH costs about Rs 300). Available widely.
While osteoporosis is still usually diagnosed via dual-energy X-ray absorptiometry (Dexa) scan or bone mineral density (BMD) scan, quantitative ultrasound is also now available. “Quantitative ultrasonography is less expensive and more portable than Dexa and does not expose patients to ionizing radiation. It predicts fractures of the femoral neck, hip and spine as effectively as Dexa,” says Ramneek Mahajan, senior orthopaedic, Orthonova Hospital, Delhi.
Cost:BMD Dexa for the complete body, Rs 3,000; just spine, Rs 1,500, while quantitative ultrasonography costs Rs 1,000 (for one body part). It depends on family history, but usually after the age of 40 doctors advise checking for osteoporosis. Available in almost all multi-speciality hospitals that offer orthopaedic services.
*Test costs could vary.
Already in use elsewhere, these tests are expected to become popular in India soon:
u Bladder-tumour-associated antigen test (BTA) for detection of bladder cancer. The usual screening test is PSA (prostate-specific antigen). The new one is particularly useful for patients with normal prostate functioning, and also removes the diagnostic grey areas of the PSA test.
u Anti-malignin antibody screen test (Amas) is another new test to pick up cancers well in advance of other signs and symptoms, months before conventional medical tests can detect them. Positive tests only suggest that there is a possibility of cancer in the body, but do not specifically indicate the site of the cancer.
u DR-70 is a simple blood test that screens for 13 different cancers at the same time. It is highly specific and catches cancer long before you would suspect anything was amiss. Cancers that can be detected are of the lung, colon, breast, stomach, liver, rectum, ovary, cervix, esophagus, thyroid and pancreas, and trophoblast and malignant lymphoma.
—Arpit Jain, consultant, internal medicine, Artemis Health Institute, New Delhi.
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