Archived Revised Rates for Investigations and Operative Procedures
OUTPATIENT CHARGES &
INPATIENT HOSPITALIZATION CHARGES
- Outpatient Charges
New Registration Rs 10/-
(Valid for current calendar year)
- Inpatient Hospitalization Charges
- General Wards
- Admission charges (Non-refundable) Rs.25/- at the time of admission.
- Hospitalization charges Rs.35/- per day
Patients being admitted in General ward will pay an advance
for 10 days charges at the time of admission, i.e. Rs 375/-
(Rs 35 per day for 10 days + Rs 25 admission charges).
These charges are inclusive of routine basic investigations and routine procedures.
- Private Wards Click Here for details ...
MISCELLANEOUS:
Treatment in Intensive Care Areas (Pvt. Ward patients) 1000.00
which includes:- (per day over and above the daily room charge)
All ICUs
CCU
Neonatal Nursery
***********************************************
LABORATORY INVESTIGATIONS
Blood Chemistry
Acid phosphatase : 25.00
Alkaline phosphatase : 25.00
Amylase : 25.00
Augmented Histamine Test : 50.00
B.E.I. (Bilirubin total and/or) : 25.00
Barbiturates : 25.00
Blood Sugar (micro method) : 50.00
Calcium : 25.00
Chlorides : 0.00
Cholesterol total and/or free ester cholesterol : 25.00
Creatinine : 25.00
Creatinine - phosphokinase : 25.00
Creatinine clearance test : 50.00
Direct/indirect bilirubin : 25.00
D-xylose Absorption : 50.00
Glucose tolerance Test : 250.00
Intravenous Glucose Tolerance Test: 250.00
LDH Total : 50.00
Lactose Tolerance Test : 50.00
Lithium : 25.00
Magnésium : 25.00
Muscle enzyme test : 25.00
Non-proteins Nitrogène : 25.00
PCO2 and/or PH : 50.00
Phosphorus : 25.00
Plasma Bicarbonates : 50.00
Plasma Cortisol : 450.00
Plasma Testosterone : 450.00
Protein Bound Iodine (PBI) : 50.00
Proteins and Albumin Globulin : 25.00
SGOT and/or SGPT : 25.00
Serum CRP : 25.00
Serum Catecholamines : 250.00
Serum Digoxin : 250.00
Serum Electrophoresis : 50.00
Serum Iron : 25.00
Sodium and/or Potassium : 25.00
Sugar (Glucose) [Random] : 0.00
T3 AND T4 : 200.00
TSH : 200.00
Triglycerides : 50.00
Urea : 0.00
Uric Acid : 25.00
LFT : 220.00
KFT/RFT : 400.00
CLINICAL HAEMATOLOGY
ABO & RH GROUPING 50
ABO ANTIBODY TITRE : 50
APTT : 50
BLOOD CELL CYTOCHEMISTRY : 50
BLOOD FILM MORPHOLOGY : 25
CLOT RETRACTION +BLEEDING TIME : 25
CLOTTING TIME :00.00
CROSS MATCHING : 25
FACTOR VIII ESSAY/INHIBITOR : 50
GENOTYPING : 100
GLYCOLATED HAEMOGLOBIN : 25
HAEMOGLOBIN ( HbA1C) : 25
HAEMOGLOBIN ELECTROPHORESIS/A2 : 50
HAEMOGRAM (HB,PCV,TLC,DLC,ESR) : 0.00
HAMS ACID TEST : 25
HIV (AIDS) PER TEST : 100
INCUBATION FRAGILITY : 25
L.E. CELLS/LUPUS ANTICOGULANT : 100
PLATELETS FUNCTION TEST/ PLATELETS ASSOCIATED ANTIBODY : 100
PRESUMPTIVE TEST OF HAEMOLYSIS : 50
RH ANTIBODIES TITRE : 50
SCHILLING TEST RBC LIFESPAN, PROTEIN LESS ESTIMATION SERUM : 250
SCREENING COAGULATION STUDIES : 100
SERUM B12 ASSAY : 100
SUGAR WALER TEST : 25
TEST FOR FIBRINOLYSIS : 250
UNSATURATED B12 BINDING PROTEINS : 100
Carrier detection of haemophilia - A : 2000
Prenatal diagnosis of haemophilia - A : 2000
HAEMATOLOGY INVESTIGATIONS
APC R : 300
AT-III : 400
Beta Glycoprotein : 500
Carrier detection haemophilia : 2000
Carrier detection prenatal : 2000
Cytogenetic Studies for tranplocation by RT-PCR for Leukimia (-)
D- Dimer : 200
ELISA for Beta Glycoprotein : 500
ELISA for Protein C : 0
ELISA for Protein S : 0
Factor assays : 1200
Heparin assay : 250
Homocysteine : 0
HPLC : 300
HPLC Hbelectrophoresis : 300
Immunoelectrophoresis per antibody : 300
Immunophenotype - 1 antibody : 300
Immunophenotype - 5 antibody :1500
Immunophenotype five antibodies : 1500
Immunophenotype one antibody : 300
IV Leiden (-)
Molecular genetic studies by RQ-RT-PCR : 3000
Molecular tests for Thalessamia
MTHFR : 1000
Mutation Detection - FV Leiden : 1000
Mutation Detection - MTHFR : 1000
Mutation Detection - P20210 : 1000
ProglobalC : 500
Protein C Clotting assay : 500
Protein S Clotting assay : 600
Prothrombin 20210 : 1000
vWD-Ristocetin co factor assays : 150
vWD-vWF antigen : 250
Urine Clinical Chemistry
17-Ketosteroids (24 hrs.) : 50.00
5-H.I.A.A. (24 hrs. quantitative) : 25.00
Ammonium Chloride loading test : 50.00
Beta 2 Microglobinuriatest : 50.00
Microalbuminuria test : 50.00
OsmolarityUrine : 50.00
Urinary 7 Ketogenic and HydroxySteroids : 250.00
Urinary Catecholamines : 25.00
Urinary Chlorides (24 hrs. quantitatives) : 25.00
Urinary Creatinine (24 hrs. quantitative) : 25.00
Urinary Diastase (24 hrs. quantitative) : 25.00
Urinary dilution & concentration studies : 25.00
Urinary Glucose (Quantitative) :00.00
Urinary Metanephrine : 250.00
Urinary Paul BunnelTest : 25.00
Urinary Phospho-Bilinogen : 50.00
Urinary Phosphorus (24 hrs. quantitative) : 25.00
Urinary Sodium and or Potassium : 25.00
Urine Albumin (24 hrs. quantitative) : 25.00
Urine Barbiturate : 25.00
Urine Calcium (24 hrs. quantitative) : 25.00
Urine Estriol Estimation during pregnancy : 250.00
Urine Oxalate : 25.00
Urine Pregnancy Test : 250.00
Urine Routine and Microscopic Examination : 0.00
Urine for Mucopoly Saccharides Qualitative : 50.00
Urine for sugar Chromatography : 100.00
Urobilinogen : 50.00
Fluid & Excreta (CSF,Stool,Semen)
CSF Chlorides :00.00
CSF Globulin (quantitative) : 00.00
CSF Glucose : 25.00
CSF Proteins : 25.00
CSF, Cell count and Microscopic Benz Jones Proteins : 25.00
Faeces for Ova and Cysts and Occult Blood : 0.00
Semen complete examination routine and microscopic : 25.00
Sweat Chloride Estimation : 50.00
Radio Diagnosis
|
|
|
OPD/General Ward |
Private Ward |
|
1. |
Plain X-Ray (per film)
|
30/- 30/- 30/- 30/- 30/- 30/- 30/- 30/- 30/- 200/- |
50/- 50/- 50/- 50/- 50/- 50/- 50/- 50/- 50/- 250/- |
|
2. |
Gastro Intestinal & Hepatobiliary
|
200/- 300/- 300/- 200/- 300/- |
250/- 350/- 350/- 250/- 350/- |
|
3. |
Urinary
|
300/- 300/- 200/- |
350/- 350/- 250/- |
|
4. |
Mammography i). Standard 4 film |
300/- |
350/- |
|
5. |
Miscellaneous
|
200/- 200/- 200/- 500/- |
250/- 250/- 250/- 600/- |
|
6. |
Ultrasound
|
200/- 300/- |
250/- 350/- |
|
7. |
C.T. and C.T. Guided Interventions
|
200/- 750/- 1000/- |
750/- 1000/- 1100/- |
**********************************
Clinical Pathology
Fat Balance Study : 100.00
PancrozymineSecretion : 100.00
Pyogentesting : 25.00
Serum Iron - binding capacity : 25.00
Thymol Turbidity : 00.00
Bacteriology
Antibiotic Sensitivity Test : 50.00
Blood Culture : 50.00
C.S.F. Culture : 50.00
Culture Pus Cervical, Urethral : 50.00
Pus Culture for pyogenic organism : 25.00
Pus for Smear Examination : 25.00
Stool Culture (enteric pathogen) : 50.00
Throat Swab Culture : 25.00
Throat Swab Smear (Diphtheria etc.) : 25.00
Urine ATO (smear concentration method) : 25.00
Urine Culture : 25.00
Mycobacteriology
Pus AFB (Smear culture) : 50.00
Sputum concentration and culture : 50.00
Urine for AFB smear and culture :50.00
Anaerobic Bacteriology
Culture for Gonococci Bodetella, Brucella Listeria : 50.00
Culture for anaerobic bacteria : 50.00
Mycology
Any work involving animal inoculation per specimen : 250.00
Culture for Mycoplasma : 250.00
Culture for skin scrapping swab and pus fungus : 25.00
Pus swab for Microscopic examination for Fungus : 00.00
Skin scrapping and Hair etc. for microscopic examination for : 00.00
Parasitology
Animal Inoculation for Toxoplasmosis : 250.00
Blood amoebiasis (IHA Test) : 50.00
Blood for Toxoplasmosis (IHA Test) : 50.00
Blood smear for parasites : 50.00
Casoni's skin test : 50.00
Mouse Inoculation for Toxoplasmosis : 250.00
Stool Culture for Amoebae : 50.00
Virology
|
ANTI HCV HEPATITIS C |
0 |
|
ANTI-HBc IgM ANTIBODY |
0 |
|
ANTI-HBs ANTIBODY |
100 |
CD8 + CD4 1000
CMV IgG/IgM 0
COMPLETE PANEL OF VIRAL MARKERS (HBsAg, ANTI HCV, ANTI HEV, - ANTI HAV, ANTI HIV) 0
HBsAg (AUSTRALIA ANTIGEN) 0
HCV-RIBA TEST (FOR CONFIRMATION) 0
HEPATITIS A IgM ANTIBODY 0
HEPATITIS C VIRUS ANTIBODY 0
HEPATITIS E IgM ANTIBODY 0
HEPATITS B “E” ANTIGEN/ANTIBODY 0
HIV 1 & 2 ANTIBODY RAPID/SPOT TEST 0
HIV 1 & 2 ELISA (4TH GENERATION) 0
HIV LINE IMMUNOASSAY/WESTERN BLOT 0
HIV PCR (qualitative) 800
HIV Plasma load 6000
HIV SEROLOGY (4TH GENERATION)P-24 Ag DETECTION 0
HIV WESTERN BLOT/LINE IMMUNO ASSAY (CONFIRMATORY TEST) 0
HSV-1 & HSV-2 IgG/IgM 0
MOUSE INOCULATION TEST FOR RABIES 0
NESTED PCR FOR CMV 0
PARVO B 19 VIRUS IgG/IgM 0
PCR for CMV 600
PCR for HSV (1&2) 600
PCR for TB Immunophenotping Lymphocytes 600
RT-PCR for enteroviruses 600
RT-PCR for HCV 1500
RUBELLA, IgG/IgM 0
SEROLOGICAL TEST FOR VIRUS INFECTION 25
SMEAR EXAMINATION FOR NEGRI BODIES 25
TEST FOR VIRUS ISOLATION 250
**********************************
Serology
Aldehyde test for Kalazar : 25.00
Anti Nuclear antibody test : 50.00
Antibody Test : 250.00
Antistreptolysin : 50.00
Antithyroid Antibody (Microsomal) : 50.00
Antithyroid Antibody (PTC) : 50.00
Brucella Agglutination : 25.00
ELISA for cyclosporinlevels : 250.00
Evaluation kit for antibody testing : 600.00
Fluroscent Antibody Test : 50.00
HCG assays : 225.00
Serum ASLO : 50.00
Serum Aldosterone : 250.00
Serum CK-MB (isoenzyme) : 100.00
Serum Guinidine : 250.00
Serum Hormones by Radio Immuno-assay : 250.00
Serum Insulin by Radio-Immuno-assay : 250.00
Serum Testosterone : 450.00
Serum free thyroxin : 100.00
Sterility test : 25.00
V.D.R.L. : 50.00
WESTERN BLOT TEST : 0.00
WidalAgglutination : 25.00
**********************************
Histopathology
Histopathology : 00.00
**********************************
Cytopathology
Cytopathologicalexamination :00.00
**********************************
Nuclear Medicine
CNS: SpectHMPO :4500.00
CNS: Spect Tc 99 M : 3500.00
CVS: PYP Imaging : 750.00
CVS: Planner RNV : 1500.00
CVS: Pulmonary Scan : 750.00
CVS: Shein&Other : 750.00
Cardiac spect : 6000.00
DTPA Renogram for renal Artery stenosis : 600.00
Lung Scan : 1200.00
Neuro spect (HMPAO) : 6000.00
PYP : 200.00
Resting RNV : 750.00
Scan Brain : 250.00
Scan CSF : 250.00
Scan Liver : 250.00
Scan Renal : 250.00
Scan Thyroid : 250.00
Sequential Scan : 250.00
Spect Imaging of Brain : 4450.00
Spect Imaging of Heart : 2250.00
Stress RNV : 1050.00
TechnitiumStudy : 500.00
Thallium Study : 2000.00
**********************************
HLA
|
Name of the Test |
AIIMS OPD Patients |
AIIMS Pvt. Ward & Other Pvt. Hospital |
Overseas Patient |
|
I.Serology based
|
|
|
|
|
HLA B 27 |
500/- |
800/- |
1000/- |
|
HLA -ABC |
800/- |
1500/- |
3000/- |
|
HLA-DR.DQ |
800/- |
1500/- |
3000/- |
|
HLA-ABC &DR/DQ |
1200/- |
2500/- |
5000/- |
|
Cross Matching(serology) |
300/- |
500/- |
1000/- |
|
PRA |
500/- |
1500/- |
2000/- |
|
Flowcytometric(cross matching) |
500/- |
1500/- |
1500/- |
|
II.Paternity/Immigratilon cases |
|
|
|
|
HLA-DNA Class-I&DRBI low resolution |
10000/- |
10000/- |
15000/- |
|
HLA DQ Alpha |
4000/- |
- |
- |
|
III.Molecular Biology Test |
|
|
|
|
HLA-Class I |
3000/- |
4000/- |
6000/- |
|
HLA- Class II(low resolution) DRBI DR 52, DR53 |
3000/- |
4000/- |
6000/- |
|
HLA Class II (high resolution)( DRBI B3, B4, 5) |
3000/- |
4000/- |
7000/- |
|
HLA-DQ Beta |
3000/- |
4000/- |
6000/- |
**********************************
MICROBIOLOGY
PCR for CMV 600
PCR for HSV (1&2) 600
RT-PCR for enteroviruses 900
RT-PCR for HCV 1500
Diagnostic Seriological assays For syphilis 50
Diagnostic Seriological assays 50 For Anti-streptolysine O Antibodies
NMR
|
S.No. |
Type of Investigation &Category of patients.
|
Charges for each item |
|
1. |
M.R.I. Scan Charges |
Rs. 3000/- |
|
2. |
Additional MRI Study Charges |
Rs. 1500/- |
|
3. |
MR Contrast Charges for Children |
Rs. 1000/- |
|
4. |
MR Contrast Charges for Adults (routine) |
Rs. 2000/-
|
|
5. |
MR high contrast charges
|
Rs. 3000/- |
|
6. |
Additional MRI Film charges ( If required)
|
Rs. 500/- |
**********************************
Psychiatry
Ability Assessment : 100.00
Aptitude Assessment : 100.00
Interest Assessment : 100.00
Memory Function test : 100.00
Organic Brain Damage Battery : 100.00
Personality Assessment (Full) : 100.00
Projective test (single) : 100.00
Questionnaire test (single) : 100.00
Test for Attention and concentration : 100.00
Test for Intelligence : 100.00
Test for thinking function : 100.00
**********************************
GENETIC
Amniotic fluid AFP assay :200.00
Amniotic fluid or urine 2 D :750.00
Blood/Bone marrow for chromosomes : 750.00
Buccal Smear for Sex Chromatin : 25.00
CVS for sexing for X-linked disease : 1500.00
Carrier Screening for thalassemia Nestroff and HbA2 : 300.00
Carrier detection of DMD/Hemophillia/DNA diagnosis : 6000.00
Chemical test in urine : 150.00
Chromosomal study of blood/bone marrow : 500.00
Chromosomes from CVS by culture, or by amninoticculture : 3500.00
DNA based mutation Detection in thalassemia : 3500.00
DNA based mutation detection on DMD or other diseases : 3500.00
Electronic Cell Count : 150.00
Electrophoresis for MPS Amniotic fluid acetyle : 750.00
Galactosemia quantitative enzyme assay : 750.00
Galactosemiascreening : 300.00
Genetic Karyotyping : 500.00
Leucocyte enzyme assay Arylsulfatase A, Hemosamindase : 750.00
MPS 24 Hrs,estimation with creatinine : 300.00
MPS spot test on urine : 150.00
Maternal serum AFP assay : 200.00
Maternal serum HCG assay : 300.00
Plasma/urine Quantitative Aminoscids : 1500.00
Prenatal diagnosis of Ataxia Telengiectasia or Fragile X : 6000.00
Prenatal diagnosis of thalassemia DMD Hemophilia, or Enzyme : 4500.00
Urine/plasma aminoacidscreening : 300.00
Miscellaneous tests sent abroad
Miscellaneous - special diet / Drug / Injection.
PAEDIATRICS [GENETICS]
BIOCHEMICAL TESTS
|
D-xylose &24 hour Fecal Fat Diagnosis Test : 50.00 |
|
Aminoacid chromatography of urine/ plasma : 200.00 |
|
Amniotic fluid or urine 2D for MPS : 750.00 |
|
Chemical Test in urine : 75.00 |
|
Glactosemia screening (Beutler spot fluorescence test) : 300.00 |
|
Leucocyte enzyme assay (with control enzymes) : 500.00 |
|
MPS spot test on urine : 75.00 |
|
Triple marker screen (antenatal) : 850.00 |
|
Prenatal diagnosis by enzyme assay : 500.00 |
|
Leucocyte enzyme assay for Hurler (MPS) : 1000.00 |
|
Celaic Serology : 500.00 |
DNA DIAGNOSTIC TESTS
|
DNA based mutation detection in Thalassemia : 2000.00 |
|
Prenatal diagnosis of Thalassemia :2000.00 |
|
Xmm Polymorphism study : 1000.00 |
|
Deletion studies in DMD : 2000.00 |
|
Prenatal diagnosis of DMD by deletion studies : 2000.00 |
|
Carrier screening by linkage studies in DMD : 2000.00 |
|
DNA studies in SMA : 1500.00 |
|
Prenatal diagnosis of SMA : 1500.00 |
|
Carrier detection of Hemophilia A/B : 2000.00 |
|
Prenatal diagnosis of Hemophilia A/B : 2000.00 |
|
Fragile X PCR study : 1000.00 |
|
4 connexin 26 mutations : 1000.00 |
|
Rh genotyping of Blood /AF : 1000.00 |
CYTOGENETIC TESTS
|
Prenatal diagnosis of cord blood sampling : 750.00 (Karyotyping + Klehaur’s tests |
|
Chromosomal study of blood Karyotyping : 500.00 |
|
Chromosomes from CVS culture : 2500.00 |
|
Chromosomes from Abortus tissue : 2500.00 |
**********************************
Otorhinolaryngology
B.M. Test for Eustachian Tube Function : 50.00
Bekesy Audiometry : 50.00
Caloric Test : 50.00
Electrogenstometry : 50.00
Olfactometry : 50.00
**********************************
Rep. Biology
AFP :200.00
Beta Heg : 450.00
CEA : 450.00
Estrogenreceptor : 900.00
Progestronreceptor : 900.00
RIA FACILITY
T3 : 200
T4 : 200
TSH : 200
LH :200
FSH :200
Prolactin :200
Estradiol : 225
Progesterone : 225
Alpha FP : 225
Testosterone :200
HCG : 225
PSA : 275
DHEA : 300
DHEA-S :200
Cortisol :200
CA-125 : 500
b HCG : 250
Andrological Tests:-
Routine Semen Analysis : 40
Seminal Fructose (Quantitative) : 40 (Qualitative) : 20
Seminal Citric Acid : 25
Hypoosmatic Swelling Test (HOS) : 20
Acrosome intactness : 50
Sperm nuclear chromatin decondensation : 50
Sperm Mitochondrial Activity index : 50
Sperm Glyceryl Phosphoryl choline (GPC) : 250
Immunobead test IgG : 615
Complete sperm morphology : 50
**********************************
ENDOCRINOLOGY
T3 : 200
T4 : 200
TSH : 200
LH :200
FSH : 200
PROLACTIN :200
TESTOSTERONE :200
DHEA-S :200
CORTISOL :200
INSULIN : 225
C PEPTIDE : 300
G H : 250
IGF-I : 1000
ISLET CELL ANTIBODY : 1000
MICRO ALBUMIN : 300
ANDROSTEREDIONE : 300
DHT : 1000
ACTH + CORTISOL : 1000
ALDOSTERONE : 400
17-OHP : 400
PTH-C TERMINAL with Calcium : 1000
VIT. D 25, OH : 1000
THYROID ANTIBODY (TPO) : 300
ANATOMY
Embalming of ordinary (non-autopsied) bodies : 2000
Embalming of autopsied bodies : 4000
Prenatal Diagnostic services for Chromosomal abnormalities using amniotic cultures and conventional Karyotyping : 7000
Fluoride Test : 25
ConventioalCytogenetics : 500
FISH (Molecular Cytogenetics) : 4000
BONE DENSIOMETERY
|
Single site study |
400 |
|
Two sites study |
600 |
|
Three sites study |
800 |
|
Whole body study |
1000 |
Immunology
|
ANTISMOOTH MUSCLE ANTIBODY BY IMMUNOFLUORESCENCE METHOD |
0 |
|
Agl - I gG |
100 |
|
Agl - I gM |
100 |
|
ANTI ds DNA |
100 |
|
ANCA |
50 |
|
ANA (HEP-2) |
100 |
|
ANTI-LKM-1 |
200 |
|
ANTINUCLEAR ANTIBODY TEST |
50 |
|
ANTITHYROID ANTIBODY TEST |
50 |
|
APCR |
300 |
|
AT III |
400 |
|
BETA 2 GLYCOPROTEIN |
0 |
|
C-3 QUANTIFICATION IN SERUM/ OTHER FLUIDS |
50 |
|
CARRIER DETECTION HAEMOPHILLIA |
2000 |
|
CARRIER DETECTION PRENATAL |
2000 |
|
CRP &PCT FOR SEPSIS- CRP QUALITATIVE KIT |
0 |
|
CRP &PCT FOR SEPSIS -CRP QUANTITATIVE KIT |
0 |
|
CRYOGLOBULINS |
50 |
|
D-XYLOSE &24 HR FECAL FAT ESTIMATION |
0 |
|
FACTOR ASSAY |
1200 |
|
HEPARIN ASSAY |
250 |
|
HEPATITIS ANTIGEN TEST |
50 |
|
HOMOCYSTEIN |
0 |
|
HPLC |
300 |
|
IMMUNOELECTROPHORESIS PER ANTIBODY |
0 |
|
IMMUNOPHLOROSCENCE ASSAY(IFA)&TTG ELISA FOR DIAGNOSIS OF - CELIAC DISEASE |
0 |
|
IMMUNNOGLOBULINS A |
100 |
|
IMMUNNOGLOBULINS G |
100 |
|
IMMUNNOGLOBULINS M |
100 |
|
IMMUNOTYPING FIVE ANTIBODY |
0 |
|
IMMUNOTYPING ONE ANTIBODY |
0 |
|
LATEX RHEUMTOID FACTOR TEST |
50 |
|
MOLECULAR GENETIC STUDIES BY RQ –RT PCR |
3000 |
|
MUTATION DETECTION F V LAIDEN |
0 |
|
MUTATION DETECTION MTHFR |
0 |
|
MUTATION DETECTION P 20210 |
0 |
|
NITRO BLUE TETRAZOLIUM TEST FOR CHRONIC GRANULOMATOUS - DISEASE |
0 |
|
PCT QUANTITATIVE KIT |
0 |
|
PRO C GLOBAL |
500 |
|
PROTEIN C CLOTTING |
0 |
|
PROTEIN C ELISA |
0 |
|
PROTEIN S CLOTTING |
0 |
|
PROTEIN S ELISA |
0 |
|
RA |
0 |
|
RISTOCETIN |
0 |
|
VWD |
0 |
|
IGMACL |
100 |
*********************************
Medicine:
Pulmonary Function Test 250
************************************
Blood Bank
Supply of one unit Blood (Pvt. Ward) 250.00
**********************************
OPERATIVE PROCEDURES
DENTAL SURGERY
Abscess incision : 250.00
Acrylic Full Crown : 100.00
Activator : 250.00
All extractions in one Jaw : 250.00
Alveolectomy : 250.00
Apical Curettage : 250.00
Biopsy : 250.00
Cast Inlay per tooth (Non-precious alloy) : 100.00
Complete Denture Acrylic - One jaw : 500.00
Complete Denture Acrylic - both jaws : 1000.00
Complete Denture with metal basis-both jaws : 2000.00
Condylectomy : 1000.00
Cysectomy : 250.00
Definitive Obturator with teeth : 500.00
Dental Restoration Class-I with AG amalgam/composite : 50.00
Dental Restoration Class-II with AG amalgam composite : 100.00
Expansion plate (excluding screw to be brought by patient : 250.00
Extraction per tooth : 25.00
Fistula closure : 250.00
Fistulectomy : 250.00
Fixation of Fracture of Jaw : 1000.00
Fixed Appliances both jaw : 1000.00
Fixed Applicances one jaw : 500.00
Fixed Partial Denture 3 units with Porcelain : 250.00
Fixed Partial Denture 3 units with : 2000.00
porcelainveenering - Non-precious alloy
Fixed Partial Denture per additional tooth with : 250.00
porcelainveenering - semi precious alloy
Fixed partial denture - 3 units with acrylic veneering : 1000.00
Fixed partial denture 3 units in gold alloy (excluding gold : 500.00
Fixed partial denture per additional tooth in gold alloy : 250.00
Fixed partial denture per additional unit with acrilic : 500.00
Fracture Jaws closed reduction : 500.00
Fracture Jaws open reduction : 1000.00
Frenectomy :rown (Nickel Chrome) : 200.00
Gingivectomy full mouth : 1000.00
Gingivectomy per segment : 250.00
Growth removal : 250.00
Head Gear (excluding sctraps to be brought by patients : 250.00
Inclined plane/repair of plane : 100.00
Mandibulectomy : 2000.00
Nasal/Auricular/Orbital Prosthesis : 250.00
Orthodontic Appliance, Bite plates, Retraction plate : 250.00
Osteotomy : 1000.00
Pericoronotomy : 150.00
Peripheral Neurectomy : 500.00
Porcelain Full Crown : 250.00
Porcelain to metal crown : 500.00
Pulpotomy : 250.00
Removable Acrylic Partial Denture per additional tooth : 50.00
Removable Acrylic Partial Denture with one tooth : 100.00
Removable Cast Partial Denture (Chromecobalt) per additional : 50.00
Removable Cast Partial Denture (Chromecobalt) with one tooth : 500.00
Removal of Impaction : 250.00
Repairing/ Relining Denture : 100.00
Resection of jaw : 2000.00
Rochett's (Maryland) Bridge 3 units : 250.00
Root Planning : 250.00
Root amputation : 250.00
Root canal treatment : 250.00
Segmental resection of jaw : 1000.00
Sequestrectomy : 250.00
Sialolithotomy : 250.00
Silver cast splint per dental arch : 250.00
Single Jacket Crown/Dowel crowh in non precious alloy with : 250.00
Single three quarter crown (Nickel - Chrome) : 250.00
Surgical Obturator/Intermediate obturator (without teeth) : 100.00
Total extraction both jaws : 1000.00
Tumour Excision : 1000.00
Veneering - Non precious alloy : 1000.00
**********************************
GENERAL AND PLASTIC SURGERY
Abscess Drainage under G.A. : 250.00
Aspiration of cold abscess/cysts : 250.00
Biopsy (Punch/ Excision/ Cervical cone/Endometrial : 250.00
Bone Tumor/Testicular--)
Cervical sympathectomy : 2000.00
Circumcision : 250.00
Colostomy closure : 5000.00
Excision and skin graft of contracture : 1000.00
Excision benign breast lumps : 250.00
Excision of cheek cancer : 2000.00
Excision of Small tumour : 250.00
Excision of rectum : 2000.00
Feeding Jejunostomy/ Gastrostomy : 250.00
Fissurectomy : 250.00
Fistulectomy : 250.00
Fractional Curettage : 500.00
Haemorrhoids : 250.00
Hemicollectomy : 5000.00
Incision & Drainage : 250.00
Injection of keloids : 250.00
Intestinal biopsy : 250.00
Kidney transplant : 8000.00
Laceration suture abscess drainage under local anaesthesia :100.00
Laparoscopy : 500.00
Laprotomy + Additional procedure : 2000.00
Oopherectomy : 2000.00
Operation for gall stones : 2000.00
Operations for Intestinal obstruction : 5000.00
Operations for pancreas : 5000.00
Operations for peptic ulcer/ stomach cancer : 5000.00
Operations for surgical jaundice : 2000.00
Operations for tuberculosis cancer of the Bowel : 2000.00
Partial Amputation Penis : 250.00
Preparation and transfer of tube pedicles and flap : 250.00
Radical Amputation Penis : 2000.00
Radical mastectomy : 2000.00
Repair of External Hernia : 1000.00
Repair of facial fracture : 1000.00
Sequestrectomy : 250.00
Simple mastectomy : 1000.00
Surgery for portation : 8000.00
Thyroidectomy : 5000.00
Trachectomy : 1000.00
Tracheostomy : 500.00
Undescended testis operative procedure : 1000.00
**********************************
NEPHROLOGY
A.V. Shunt : 1000.00
CAPD (Tenkoff) Cathetreimplantation : 1000.00
CAVH : 2000.00
CAVHD : 2000.00
CVVH : 2000.00
CVVHD : 2000.00
Femoral Vein cathetrisation : 500.00
Haemodialysis on keildialyser : 2000.00
Insertion of A.V. Canula for Acute Haemodialysis : 500.00
Peritoneal dialysis cathetrisation (intermittent) : 1000.00
Plasmapheresis : 1000.00
Subclavian vein perm cathetreimplantation : 1000.00
**********************************
OBST. AND GYNAECOLOGY
Abdominal perineal Ext.Hysterectomy : 2000.00
Abdominal perineal neo construction Cx+Uteria+Vagina : 5000.00
CaesaerianHysterectomy : 2000.00
Cervical Biopsy : 250.00
Colopotomy : 500.00
Colpollaisis/Colporrhophy : 2000.00
Cone Biopsy Cervix : 500.00
Cryosurgery : 250.00
D & C : 500.00
Deliveries Normal : 2000.00
Dilatation of Cervix : 250.00
Electro Cauterization : 250.00
Endometrial Biopsy : 250.00
Evacuation : 500.00
Fractional Curettage : 500.00
Gynaecography : 1000.00
H/C V.V.F. & R.V.F. : 2000.00
Hydrotubation : 250.00
Hymenectomy : 250.00
Hysterectomy (Abdominal) : 2000.00
Hysterectomy (Wertheims) : 5000.00
Normal R/o Placenta : 1000.00
Operation for stress incontinence : 2000.00
OvarionCystectomy : 2000.00
Ovaritomy : 2000.00
Pelvic Exenteration : 5000.00
Plastic Operation on uterus : 2000.00
Radical Vulvectomy : 5000.00
Repair of Perineal Tear : 250.00
Salpingectomy : 1000.00
Salpingostomy : 1000.00
Schauha'sOperation : 5000.00
Tubal Insufflation : 250.00
Tuboplasty : 5000.00
Vaginal Hysterectomy : 2000.00
VaginoPlasty : 2000.00
Wedge Resection of Ovary : 1000.00
Wertheim's Hysterectomy : 5000.00
**********************************
ORTHOPAEDICS
Amputations :-
Amputations through Arm/Forearm : 2000.00
Amputations through Hand/Foot : 1000.00
Amputations through Thigh/Leg : 2000.00
Disarticulation through major joints of the limb : 2000.00
Disarticulation through small joints of Hand/Foot : 500.00
Excision of supernumerydigit : 500.00
Fore Quarter amputation : 5000.00
Hind Quarter amputation : 5000.00
Arthrodesis:-
Arthrodesis of large joints : 2000.00
(Hip, Knee, Shoulder, Ankle, Wrist)
Arthrodesis of small joints of hand/foot : 1000.00
Arthroscopy:-
Arthroscopic surgery
lavage : 2000.00
menisectomy (partial/total) : 2000.00
ligament reconstruction : 2000.00
Removal of loose body : 2000.00
Synovial biopsy : 2000.00
Diagnostic arthroscopy of large joints : 500.00
Diagnostic arthroscopy of small joints : 500.00
Biopsy
C.T. Guided biopsy : 1000.00
Excisional biopsy : 1000.00
Needle biopsy : 500.00
Open biopsy : 500.00
Bone Grafting:-
(To be added up with any operation of internal or external
fixation)
Composite grafting : 2000.00
Fibular/tibialgrafting : 1000.00
Iliac crest grafting : 1000.00
Phemestergrafting : 2000.00
Rib grafting : 1000.00
Dressings, Debridement:-
Debridement & Repair : 250.00
Fasciectomy : 250.00
Sloughectomy : 250.00
Wound inspection : 250.00
Excision of bone
Patellectomy (Partial/total) : 1000.00
Talectomy : 1000.00
Excision of Accessory bone (Navicular) : 1000.00
Proximal row carpectomy : 1000.00
Fibulectomy : 1000.00
Excisional arthroplasty of:-
Elbow : 2000.00
Hip : 2000.00
Small joints of hand/foot : 2000.00
TM joint : 2000.00
External fixation of fractures:-
External fixation with soft tissue Reconstruc. : 5000.00
procedures
Mini Fixator : 2000.00
Pin and Plaster application : 2000.00
Ring fixator : 5000.00
Tubular external fixator : 2000.00
Internal Fixation of fractures:-
Interlocking nailing : 2000.00
K. Wire fixation : 2000.00
Meyer's Procedure : 5000.00
Nailing : 2000.00
Neck Reconstruction : 5000.00
Plating : 2000.00
Screw fixation : 5000.00
Special plating procedures : 5000.00
S.P. Nail plate : 5000.00
Dynamic Hip Screw : 5000.00
Dynamic Compression Screw : 5000.00
Condylar blade plate :5000.00
Tension Band Wiring : 1000.00
Joint replacements:-
Partial (Hemi) hip replacement : 5000.00
Replacement of small joints of Hand or foot : 5000.00
Total Hip replacement : 8000.00
Total Knee replacement : 8000.00
Total Shoulder/Elbow replacement : 5000.00
Limb lengthening:-
Femoral lengthening : 5000.00
Humeral Lengthening : 5000.00
Metacarpal/Phalangeal lengthening : 5000.00
Tibiallengthening : 5000.00
Manipulations:-
Closed reductions of fractures and : Dislocations : 1000.00
Correction of deformities : 1000.00
Manipulation under G.A. : 1000.00
Muscle/Tendon transfer
Steindler's flexoroplasty : 1000.00
Tendon transfers (Hand &foot):-
Oponensplasty : 1000.00
Egger's procedure : 1000.00
Trapezius transfer : 2000.00
Nerve repair/grafting : 5000.00
Open reduction/dislocations:-
Open reduction of C.D.H. (Cong. Dis. Hip) : 1000.00
Open reduction of C.D.H. with Osteotomy : 2000.00
Open reduction of dislocation : 1000.00
Operations for infection:-
Sequestrectomy : 500.00
Saucerization : 500.00
Sinus tract excision : 50.00
Orthoses/Splints:-
Body jacket (PVC) : 500.00
Cast brace : 500.00
Floor reaction orthosis (FRO) : 1000.00
Hand Splints : 250.00
Osteotomy:-
Corrective osteotomy of long bones : 2000.00
Corrective osteotomy of small bones : 2000.00
French Osteotomy : 2000.00
High tibialosteotomy : 2000.00
MC Murray's Osteotomy
Osteotomy of the pelvis (Salter's
Chiary, pembertion) : 2000.00
Valgus/Varus Osteotomy : 2000.00
Replantation : 8000.00
Skeletal traction:-
Halo Traction/Distraction : 2000.00
Skull Traction : 500.00
Traction through tibia, femur, olecranon, Calcaneum : 250.00
Skin Coverage:-
Abdomenalflap : 2000.00
Cross finger flap : 2000.00
Cross leg flap : 2000.00
Free flap : 5000.00
Full thickness skin grafting : 500.00
Groin flap : 2000.00
Myocutaneousflap : 2000.00
Myoplasty with/without skin grafting : 2000.00
Redicledflap : 2000.00
Rotation flap : 2000.00
Split thickness skin grafting : 500.00
Soft tissue reconstructive procedures:-
Anterior transposition of ulnar nerve : 2000.00
Bankart'soperation : 2000.00
Bristwo'soperation : 2000.00
Joint Debridement : 2000.00
Ligament reconstruction of the knee,elbow, ankle : 2000.00
Mc Bride procedure : 2000.00
Neurolysis : 2000.00
Putti plat operation : 2000.00
Reconstruction surgery of the hand : 2000.00
(for post-traumatic &Congenital anomalies/deformities) : 2000.00
Synovectomy : 2000.00
Soft tissue release Operations:-
Carpal tunnel release : 1000.00
Defatting operation : 1000.00
Dequervam'srelease : 1000.00
Dupuytren's soft tissue release : 1000.00
Max page release : 1000.00
Postero medial soft tissue release : 1000.00
Soutter's and younts soft tissue release : 1000.00
Steindler's release : 1000.00
Subcutaneous tenotomy : 1000.00
Syndactyly release : 1000.00
T.A. lengthening : 1000.00
Tenotomy-open : 1000.00
Torticollis release : 1000.00
Trigger finger/thumb release : 1000.00
Wilson's Soft tissue release : 1000.00
Z-plasty for contractures : 1000.00
Spine:-
Anteriorolateraldecompression : 5000.00
Anterior loosening : 8000.00
Anterior loosening with instrumentation : 8000.00
Anterior Spinal fusion : 5000.00
Discetomy : 5000.00
Excision of diastematomyelia : 8000.00
Laminectomy : 5000.00
Posterolateral Spinal fusion : 5000.00
Posterior Spinal fusion with instrumentation : 5000.00
Posterolateral Spinal fusion with instrumentation : 5000.00
Spinal fusion (posterior) : 5000.00
Spinal instrumentation (Without fusion) : 5000.00
Transthoracic decompression : 8000.00
Tendon repair/grafting : 2000.00
Tumour Surgery:-
Curettage : 500.00
Curettage with bone grafting : 1000.00
Curettagre with bone cement : 1000.00
Debulking of the tumour : 2000.00
Excision of the tumours of the hand or foot : 1000.00
Radical resection of the large tumour : 2000.00
Resection Arthrodesis (with internal or external fixation) : 5000.00
********************************
OTORHINOLARYNGOLOGY
Adenoidectomy : 500.00
Antral Biopsy : 500.00
Antrum Wash : 250.00
Audiometry : 250.00
Aural Polypectomy : 250.00
Block Dissection of neck : 5000.00
Bronchoscopy : 500.00
C.W.L.(Rt) (Minor) : 1000.00
Caldwell Luc's Operation : 500.00
Direct Laryngoscopy : 500.00
Ethmoidectomy : 2000.00
Excision of Temporal Bone : 5000.00
Foreign Body ear and nose removal : 250.00
Frontal Sinus Operation : 2000.00
Intranasal Antrostomy : 250.00
Laryngectomy : 5000.00
Laryngofissure : 2000.00
Laryngophayryngectomy : 5000.00
Laryngoscopy : 500.00
Lateral Pharyngotomy : 2000.00
Lateral Rhinotomy : 2000.00
Mastoidectomy : 2000.00
Maxillectomy : 2000.00
Meatoplasty : 500.00
Microlaryngoscopy : 500.00
Myringoplasty : 500.00
Myringotomy : 250.00
Nasal Cautery : 250.00
Nasal Polypectomy : 500.00
Oesphagoscopy : 500.00
Ossioloplasty : 2000.00
Partial Glossectomy : 5000.00
Pinnaplasty : 2000.00
Plastopharyngoplasty for Rhinolalia Absenta : 5000.00
R.N.D.: 5000.00
Rhinoplasty (M.R.M.) : 2000.00
Septoplasty : 500.00
Stapedectomy : 5000.00
Submucus Resection of Septum : 500.00
Tonsillectomy : 500.00
Trachesostomy : 500.00
TranspalatalOperation : 2000.00
Turbinectomy : 250.00
Tympanoplasty : 5000.00
**********************************
PAEDIATRIC SURGERY
Abdominoperineal pull through : 5000.00
Anoplasty for imperforate anus : 2000.00
Appendicectomy : 1000.00
Biopsy of Ulcer : 250.00
Brachial sinus excision : 1000.00
Change of suprapubic cystostomytube : 100.00
Circumcision : 250.00
Cleft lip (complete repair) : 5000.00
Cleft palate repair : 5000.00
Colonic transplant : 5000.00
Corn excision : 100.00
Corrective procedure for biliary atresia : 5000.00
Cystopanendoscopy : 500.00
Cystolithotomy : 1000.00
Cystostomy : 250.00
Drainage of an abscess suturing of minor laceration under : 250.00
Electrocoagulation : 250.00
Epispadiasrepair : 1000.00
Examination under G.A. : 250.00
Excision of omphalomesentricduct : 2000.00
Excision of posterior uretheralvalve : 2000.00
Excision of rectal polyp : 1000.00
Excision of small cysts Ganglia etc. : 250.00
Gastrostomy : 1000.00
Gut back operation for imperforate anus : 1000.00
Hemihepatectomy : 5000.00
Hydrocortisone Injection of Peyroniesdisease : 250.00
Ileal or colon conduct : 5000.00
Intercostal drainage : 250.00
Intussusception : 2000.00
Laparotomy with additional procedures like resection &ana : 2000.00
Ligation of umblicalpolyp : 250.00
LymphnodeBiopsy : 250.00
Meatotomy under G
.A. : 250.00
Minor correction of repaired lip or palate : 250.00
Minor urethroplasty : 250.00
Nephrectomy : 2000.00
Nephrostomy tube change : 250.00
Oesophagostomy : 2000.00
Orchectomy and Orchiopexy : 1000.00
Parotid fistula closure : 1000.00
Pelvic osteotomy : 1000.00
Perineal urethrostomy : 1000.00
Preauricular sinus excision : 1000.00
Prepucial advancement and chordecorrection : 1000.00
Prepucialdilatation : 250.00
Primary reconstruction for extrophy of Bladder : 5000.00
Pyelolithotomy : 2000.00
Pyeloplasty : 2000.00
Pyeloroplasty with or without vagotomy : 2000.00
Pyloromyotomy : 2000.00
Repair of hiatus hernia : 2000.00
Repair of partial cleft lip : 1000.00
Retrograde seminal vesiculography : 250.00
Revision/dilatation of ileostomy/colostomy : 250.00
Rib resection and drainage : 1000.00
Scar excision under G.A. : 250.00
Secondary procedure for extrophy of the bladder : 1000.00
Sigmodioscopy under G.A. : 500.00
Skin tag excision under G.A. : 250.00
Spleenectomy : 2000.00
Stitch removal under G.A. : 250.00
Surgical separation of conjoined siamesetwins : 8000.00
Syndactyle : 250.00
Tapping of hydrocele : 250.00
Testicular biopsy : 250.00
Thyroglossal duct excision : 1000.00
Thyroglossal sinus and fistula excision : 1000.00
Total correction of extrophy of urinary bladder : 5000.00
Tracheo-oesophageal fistula with Oesophagealatresia : 5000.00
Transposition of anus for ectopic anus : 2000.00
Ureterostomy or ureters sigmoidostomy : 5000.00
Urethroplasty for penile or penoscrotal type hypospadias : 5000.00
Urinary diversion e.g. cutaneous : 2000.00
Ventriculoatrialshunt : 2000.00
**********************************
UROLOGY
CystolithotripsyEndoscopic : 2000.00
Davis intubated ureterostomy : 2000.00
Dilatation of Urethra : 250.00
ESWL Procedure (Lithotripsy) : 9000.00
Endoscopic Basketing : 1000.00
Excision of Renal Cyst : 2000.00
Excision of Stricture : 2000.00
Excision of Suprapubic Fistula : 2000.00
Excision of adrenal cyst : 2000.00
Excision of pheochromocytoma or Adrenal tumours : 5000.00
Excision of suprapubic fitula : 1000.00
Exploration of Kidney : 2000.00
Fulguration of bladder tumour : 2000.00
Ileal loop diversion : 5000.00
Internal ureterotomy : 1000.00
Nephrectomy : 2000.00
Nephrolithotomy : 2000.00
Nephrostomy : 1000.00
Radical Prostatectomy : 5000.00
Retrograde Pyelography : 1000.00
Retropublicprostatectomy : 2000.00
Suprapublictransvesical bladder neck Resection : 2000.00
Supreapubictransvesical excision of bladder tumour : 2000.00
Supreapublictransvesicalprostatectomy : 2000.00
Total cystotomy : 5000.00
Total uretherectomy with pelvic exentiration : 5000.00
Transurethral resection of bladder neck : 2000.00
Transurethral resection of bladder tumour : 2000.00
Ureterolithotomy : 2000.00
Ureteroneocystostomy : 5000.00
Ureterorolysis : 2000.00
Vaginal cystolithotomy : 5000.00
Vesicoepidydimalanastomosis :5000.00
**********************************
Patient Education
Avian influenza : Frequently Asked Questions
-
What is Avian Influenza?
Avian influenza, or “bird flu” or “avian flu” is an infection caused by avian (bird) influenza (flu) viruses. These flu viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, bird flu is very contagious among birds and can make some domesticated birds, including chickens and ducks, very sick and kill them.
-
Do avian flu viruses infect humans?
Bird flu viruses do not usually infect humans, but several cases of human infection with bird flu viruses have occurred since 1997.
-
How does avian flu spread in birds?
Infected birds shed flu virus in their saliva, nasal secretions, and feces (droppings). Susceptible birds become infected when they have contact with contaminated excretions or surfaces that are contaminated with excretions.
-
How does avian flu spread in humans?
It is believed that most cases of bird flu infection in humans have resulted from contact with infected poultry or contaminated surfaces. There is no evidence of human-to-human transmission so far.
-
What is a pandemic?
A pandemic is an epidemic that usually affects a large proportion of the population, occurring over a wide geographic area such as a section of a nation, the entire nation, a continent or the world.
-
should be done if migratory birds are sighted near one’s house?
Migratory birds may or may not carry the avian flu virus. It depends on whether these birds have flown from a region where avian flu is prevalent. This can be determined only by an expert. Therefore in case a migratory bird is sighted, it should not be killed. However, as a precaution, one should stay away from these birds and their droppings. The municipal authorities should be informed immediately.
-
What should be done if one sight’s a dead bird?
If the cause of death of the bird is not certain, the municipal authorities should be informed immediately. They may send the bird for testing to find out whether or not it was infected with the avian influenza virus.In case of unusual death of poultry, the civic authorities must be informed immediately.
-
Can avian flu be contracted by visiting a shop that is next to a shop that sells chicken?
In the event of a pandemic of avian flu, it is possible
-
Is it safe to eat poultry and poultry products?
Poultry and poultry products can be prepared and consumed as usual, with no fear of acquiring infection with the avian flu virus.One should continue to follow good hygienic and cooking practices.The virus is destroyed at a temperature of 70o C for 30 minutes. After handling poultry and eggs, one should wash hands and other exposed parts with soap and water.
-
Are the chicken droppings on eggs infective?
As it is likely that the eggs that reach the consumer were laid several hours ago, the likelihood of infection is low, even if the droppings were carrying the avian flu virus. The avian flu virus is destroyed by drying, and exposure to sunlight for a few hours.
However, in the event of a pandemic, recent droppings are to be considered infective unless proven otherwise.
-
Is it safe to use chicken-droppings as manure?
During a pandemic, do not come in contact with fresh droppings. Use some other manure until such time the pandemic has cleared
-
How can avian flu be controlled in poultry?
At present, culling is the only way to contain avian flu in poultry.
-
Can domestic normal-appearing ducks spread avian flu?
Yes they can. In fact, waterfowls are known to be reservoirs of infection. The avian flu virus does not harm these waterfowls. However the waterfowls can spread the avian flu virus to humans. These waterfowls are therefore “carriers” of avian flu.
-
Can a person suffering from influenza suffer from avian flu at the same time?
Yes, it is possible. Neither suffering from influenza, nor vaccination against human influenza offers protection against avian flu. However, health care providers and others who are at high risk of infection should get themselves vaccinated against human influenza virus so that they are at least protected against one of them.
-
What are the symptoms and signs of avian flu in humans?
Cough, fever, sore throat, muscle aches, pneumonia and other complications
-
What is the test for avian flu?
A throat swab is taken from the patient to test for avian flu.
-
Which are the places where such testing is done?
The testing facilities are currently available at All India Institute of Medical Sciences, New Delhi, and National Institute of Virology, Pune.
-
Is there a vaccine for humans against avian flu?
There is no vaccine for humans against avian flu. The vaccine against human influenza virus does not protect against avian flu.
-
Are any medicines available to prevent bird flu in humans?
There is no recommendation for the routine use of medicines for the prevention of bird flu in humans.
Dr.S.K.Kabra and G.C.Khilnani
Management protocol for bird flu cases
When to suspect:
Patents presenting with Fever (body temperature of 38o Celsius or high) with one of the following symptoms:
Muscle ache, cough, abnormal breathing (unusual breathing difficulty) or suspected pneumonia by the physician, or influenza
in addition to
History of direct contact with infected / dead birds in past 7 days or
Occurrence of unusual death of birds in the community within the past 14 days; or
Contact with a pneumonia patient or another patient suspected of avian influenza
Case definition of probable case:symptoms of suspected case and Preliminary test shows infection of influenza group A, but cannot yet be confirmed whether it is from human or birds or
Respiratory failure or
Death
Case definition of Confirmed cases: A suspected or probable case with at least one of the following:
- Positive viral culture for influenza A/H5
- Positive RT PCR for influenza A/H5
- Positive IFA for influenza A/H5
- A 4 fold rise in influenza A/H5 specific antibody titers.
Management guideline for all suspected cases of avian flu:
Obtain NP swabs from all the patients (see annexure 1)
Assess severity of illness: Look for presence of following:
Respiratory distress as indicated by: increased respiratory rates, chest indrawing, dehydration, hypotension, altered sensorium or oxygen saturation of less than 93% in room air. If any of these are present patient should be admitted to ward in designated area and manage on following principles
- Isolate cases
- Monitor vital signs every 1-2 hours
- Maintain air way breathing and circulation (ABC)
- Maintain hydration, electrolyte balance, and nutrition
- Provide oxygen and assisted ventilation when indicated
- Manage fever with paracetamol
- Give antiviral Oseltamivir (For doses see annexure 2)
- Broad spectrum antibiotics for treatment of secondary pulmonary infection
- Avoid giving nebulized medications: chances of spread
Management of non severe cases
If patient is stable: (absence of above clinical features): take NP aspirate from all the patients and isolate them in the designated area identified for them and Start on Oseltamivir
Obtain lab results and see clinical course. If lab tests negative: discontinue Oseltamivir and provide supportive care, shift them to regular wards if hospitalization indicated otherwise send them home
If lab test is positive: Transfer to designated in patient area and continue supportive care and oseltamivir
Discharge policy
Adult patients: Infection control precautions for 7 days after resolution of fever
Children: Infection control measures for 21 days after onset of illness.
If discharged earlier: child should not attend school and parents should be educated to observe infection control measures at home.
Precautions for health care workers handling cases of avian flu Wear personal protective equipments
- Protective clothings:
- Overall plus an impermeable apron or surgical gown with long cuffed sleeves plus impermeable apron
- Heavy duty rubber work gloves that may be disinfected
- Standard well fitted surgical masks should be used if N 95 respiratory masks are not available.
- Goggles
- Rubber or polyurethane boots or protective foot cover
- Chemoprophylaxis:
For close contacts: Oseltamivir 75 mg daily for 7 days
Persons at risk: Oseltamivir 75 mg daily for the entire epidemic
- Monitoring of close contacts and health care workers exposed: observe for fever of >38 Celsius, watery diarrhoea, pain abdomen, headache, cough, rhinorrhoea, sore throat, shortness of breath and CNS manifestations. Check for them daily till 14 days of last exposure
Annexure 1
Collection and transport of samples
Samples from upper respiratory tract include
- Nsopharyngeal aspirate
- Nasal wash
- Throat swab
From lower respiratory tract samples >include :
- Transtracheal aspirate
- Bronchoalveolar lavage
- Lung biopsy
- Post-mortem lung or tracheal tissue
Specimens for the laboratory diagnosis of avian influenza A should be collected in the following order of priority:
- nasopharyngeal aspirate/swab
- acute serum
- convalescent serum.
The sample collection should be done with all the necessary biosafety precautions including use of gowns, gloves and masks
The samples should be kept on ice and transported to virology laboratory as soon as possible
Annexure II
Antiviral drugs and their doses
Oseltamivir: is the only drug effective against H5N1 virus Doses are:
- Adults: 75 mg twice a day for adults,
- Children weighing
< 15 Kg: 30 mg twice a day
15-23 Kgs: 45 mg twice a day
23-40 kgs: 60 mg twice a day
> 40 kg: 75 mg twice a day
Adverse effects of oseltamivir
Nausea and vomiting: transient and occur in the beginning and are self limiting
Abdominal pain, epistaxis, conjuctivitis
Should be used in pregnancy with caution
Contraindications:Hypersensitivity to drug
Algorithm for management of Avian flu patients
Suspect case of Avian flu
(Patents presenting with Fever (body temperature of 38o Celsius or high) with one of the following symptoms: Muscle ache, cough, abnormal breathing (unusual breathing difficulty) or suspected pneumonia by the physician, or influenza in addition to History of direct contact with infected / dead birds in past 7 days >or Occurrence of unusual death of birds in the community within the past 14 days; or Contact with a pneumonia patient or another patient suspected of avian influenza)
Obtain NP aspirates and send to lab
Asses severity of illness
(Look for presence of following Respiratory distress as indicated by: increased respiratory rates, chest indrawing, dehydration, hypotension, altered sensorium or oxygen saturation of less than 93% in room air)
Any one of the above present
Admit in designated area and treat as follows
Isolate cases
Monitor vital signs every 1-2 hours
Maintain air way breathing and circulation (ABC)
Maintain hydration, electrolyte balance, and nutrition
Provide oxygen and assisted ventilation when indicated
Manage fever with paracetamol
Give antiviral Oseltamivir (For doses see annexure 2)
Broad spectrum antibiotics for treatment of secondary pulmonary infection
Avoid giving nebulized medications: chances of spread
None of the above present
Keep the patient in designated out patient area, start oseltamivir and collect lab report reportresults
Send home with supportive care
Transfer to general ward and manage according to
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