Rapporteurs Report of the keynote address by DR.T A VARKEY on the role of lab tests in disease diagnosis , treatment and monitoring at the 164th seminar of GMF and SDF held at Mel Mana Gardens—Ooramana –Kerala India on 28th April 2024 Prepared by Dr. PO Abraham—Executive Secretary of GMF

In the olden days doctors used to diagnose the diseases by physical examination like palpation,examination of conjunctival mucous membrane ,pulse etc. But there occured a rapid advancement in the health sector and at present pinpoint indications can be obtained from labtests and more than 70% of disease diagnosis,treatment and monitoring is based on lab tests.


•             ●  blood test

•             ●  urine test

•             ●  sputum test

Blood tests are usually done for complete blood cell count (CBC),blood sugar ,cholesterol,liver function test,kidney function test .

Urine tests are usually done for protein,sugar,stone.

General blood tests are done for annual checkup.There are 10 important blood tests and the complete blood count checks for levels of 10 different components of every major cell in the blood ie:WBC,RBC and platelets.



For fasting blood sugar test we need to collect the blood after 8 hours of fasting .This

is because everything we eat and drink contains vitamins,proteins and other nutrients that can cause related levels in the blood to temporarily spike or drop.

Here,one important point to note is ; sometimes the PPBS will be lower than FBS.People suspect the authenticity of the result and the credibility of the lab .But it is possible because after fasting the energy level maybe lowered to such an extent that the patient feels drowsy and inactive.To compensate the situation the normal body mechanism ie:alpha cells of the pancreas produces a hormone called glucagon which helps to convert the glycogen stored in the liver to glucose and provides sufficient energy.This is called DAWN PHENOMENON.After taking food insulin starts acting and the sugar level maybe lowered .

There are other mechanisms also which contribute to develop this condition.During fasting we can consume water .


•  smoking

• alcohol

•  Cola

•   fried items

QUALITY CHECKS IN LAB TESTS :Accuracy in the interpretation of result is important .Sometimes it so happens that the result of the same test on the same sample at different labs differs.So also repeated tests on the same sample in the same lab shows different results.On such occasions it is advisable to take the average of the repeated tests,leaving due allowance for standard deviation. 10% variation is normally permissible.Biological range variation may also be taken into account while assessing the quality check.


  • choose labs with credibility,preferably accredited labs.The first accredited lab in Kerala is Medi Lab Kochi.
  • Proper calibration
  • Qualification
  • Sanitation
  • Continuing medical education (CME)
  • Avoid pre analytical mistakes eg- collecting and despatching urine to detect the

presence of bilirubin for a suspected case of jaundice.Bilirubin is photosensitive and if any laxity happens on storage and transportation the result will be incorrect.70% of lab errors may be attributed to pre analytical errors .7% for analytical errors and 23% for post analytical errors .

•    Avoid transmission errors- correct reporting is an important component in the diagnosis of the disease.For example: if the reading of cholesterol and fasting blood sugar are reported interchangingly the entire exercise will be upset .That will create unnecessary anxiety to the patient.

• Cortisone aggravates diabetes .

•  HBA1C:It is always desirable to check the HBA1C level once in 3 months for

diabetic patients.This is because glucose molecules are bounded to RBCs and the lifespan of RBC is 120 days(4 months).It is advisable to do the test before the terminal period of lifespan of RBC.The optimal level of HBA1C is considered to be ‘7’.


  • PSA(prostate specific antigen) test to detect prostate cancer.
  • PAP smear test to detect cervical cancer.
  • Mammogram to detect mammary cancer.


  • CBC
  • Blood protein testing
  • Circulating tumour cell test
  • Tumour markers like CA 125 for ovary,AFP(alpha fetoprotein ) for

liver,LDH(lactate dehydrogenase) for blood cancer.

Other advanced technologies like Artificial Intelligence,Machine Learning,Automation,Robotics,Mobile Technology like smart toilets are also available.Smart toilets are in practice in Japan.

23rd April is celebrated as world Lab Day.

Ultimately Dr.Varkey was of the opinion that the future of health technology is lab centered.

Hon.Justice Rtd Dr Narayana Kurup informed that there are about 200 million people in India with diabetes.

This was followed by a very interesting and active interactive session wherein so many doubts were aired and all of them were meticulously answered by Dr.Mathew Abraham, the Moderator of the session and Dr.T A Varkey.

Dr. Nambiar the Executive Chairman and Shri P V Thomas were all praise to Dr.T A Varkey for the sincere ,unbiased and most competent services they had from him and a standing ovation was rendered to honour him.

Dr.  KM George


30th  April–2024

Leave a Reply