Chemical Pathology

General information:

1. Chemical pathology services are divided into:

A. Integrated Laboratory that offers:

a. Routine Biochemistry

b. Endocrine & Metabolic Medicine

c. Tumor Markers

d. Protein

e. Therapeutic Drug Monitoring (TDM) & Clinical Toxicology

B. Chemical Pathology Unit that offers Protein Electrophoresis test and Referral section.

C. Makmal Pengesanan Dadah that offers screening and confirmatory for Drug of Abuse (DOA).

2. Integrated Laboratory located at the second floor, Twin Tower building. Extension 8241/8242.

3. Chemical Pathology Unit located at the first floor, Complex D (Pathology Department). Extension 7280/7136.

4. Makmal Pengesanan Dadah located at the second floor, Twin Tower building next to Integrated Laboratory and Chemical Pathology unit. Extension 8239.

5. Tests that are offered as 24 hours service are:

   • 1. 1. Blood gases (Arterial blood gases/venous blood gases)

        2. Albumin

        3. Amylase

        4. Ammonia

        5. Alanine Transaminase (ALT)

        6. Aspartate Transaminase (AST)

        7. Alkaline Phosphatase (ALP)

        8. Bilirubin (Total and Direct)

        9. BUSE (Sodium, Potassium, Chloride, Urea)

        10. Calcium

        11. Creatine Kinase (CK)

        12. Creatinine

        13. C-Reactive Protein (CRP)

        14. CSF Biochemistry (Glucose and Protein)

        15. Fasting Lipid Profile

        16. Gamma-Glutamyl Transferase (GGT)

        17. Glucose

        18. Ketone (Beta-Hydroxybutyrate)

        19. Lactate

        20. Lactate Dehydrogenase (LDH)

        21. Magnesium

        22. Phosphate, inorganic

        23. Troponin I (High Sensitivity)

        24. Total Protein

        25. Uric Acid

        26. Urine Fluid Examination and Microscopic Examination (UFEME)

        27. Urine Paraquat

        28. Urine Pregnancy Test

        29. Suspected Therapeutic Drug Toxicity (except Tacrolimus and Cyclosporin) and clinical Toxicology (Acetaminophen and Salicylate).

        30. Total Beta human Chorionic Gonadotrophin (B-hCG)

6. Tests that are offered during office hours are:

6. • A. Specialised Biochemistry

1. Thyroid Function Test (TSH, fT4, fT3)

2. Cortisol

3. Intact Parathyroid Hormone (iPTH)

4. Estradiol, Progesterone, FSH, LH, Prolactin, Total Testosterone

5. Tumor Markers (AFP, CA-125, CA 19-9, CEA, PSA, CA 15-3)

6. Hematological Markers (Iron studies, Vitamin B12, Folate, Ferritin)

7. Serum Immunoglobulin level (IgG/A/M), Complement C3, C4, Procalcitonin, Rheumatoid Factor

8. Serum dan Urine Protein Electrophoresis.

9. Serum dan Urine Osmolality

10. Creatinine Clearance

11. Urine Albumin:Creatinine Ratio (UACR)

12. Urine Calcium:Creatinine Ratio (UCCR)

13. Urine Protein:Creatinine Ratio (UPCR)

14. Dexamethasone Suppresion Test

15. (ACTH) Synacthen Stimulation Test

16. Fluid for Biochemistry (Albumin, Protein & LDH)

• B. Hemoglobin A1c (HbA1c)

• C. Therapeutic Drug Monitoring: 'Outside office hours' testing MUST be requested through TDM pharmacist. 

  1. 1. Amikacin

     2. Gentamicin

     3. Vancomycin

     4. Sodium Valproate

     5. Phenytoin

     6. Carbamazepine

     7. Phenobarbitone

     8. Digoxin

     9. Theophylline (Aminophylline)

     10. Methotrexate

     11. Lithium

     12. Tacrolimus

     13. Cyclosporine

• D. Drug of Abuse Testing

  1. 1. Amphetamine Type Stimulants (screening)

     2. Amphetamine / Methamphetamine / MDA [3,4-Methylenedioxyamphetamine] / MDMA [3,4-Methylenedioxymethamphetamine] / Phentermine / Ephedrine (confirmation)

     3. Opiate (screening)

     4. Morphine / Codeine (confirmation)

     5. Cannabis (screening)

     6. THC [11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid] (confirmation)

     7. Ketamine (screening)

     8. Ketamine / Norketamine (confirmation)

7. For Drug of Abuse testing:

• We are only reporting detected or not detected in clinical request.

• Results are reported based on the cut-off for medicolegal purposes.

• Specimen MUST BE accompanied by Borang UPD 1 (pindaan 2020)

• Methodology: Immunoassay for screening; Thin Layer Chromatography (TLC) for Morphine/Codeine and THC.

• Methodology: Gas Chromatography Mass Spectrometry (GCMS) for amphetamine group and ketamine confirmation.