Toxicology

We are one of the very few labs in India to offer toxicology services. Our state of the art laboratory carries out a wide range of tests involving identification of poisoning, industrial chemicals and pharmaceuticals, pesticides etc.

We offer routine tests to detect the presence of common pharmaceuticals, drugs of abuse, chemicals and metabolites from urine or gastric lavage samples.

These tests include:

• Nine-drug Screen: Nine drugs of abuse screening is carried out on urine samples using lateral flow immunoassay cassettes which include: Amphetamine, Barbiturates, Benzodiazepines, Cocaine, Opiates, Marijuana (THC), Methamphetamine, Phencyclidine and Methadone.
• 26-drugs Screen (on Toxilab A system, Varian): Used for unknown drug exposure
• Color Tests: Used to trace the presence of common drugs and pesticides often present in commonly available over-the-counter (OTC) preparations and can produce severe toxicity which can be treated if detected early.
• Paracetamol, Salicylates, Phenothiazines, Imipramine and related compounds in urine.
• Detection of Paraquat in urine/G. lavage.
• Differentiation between Mercury tablets (Grain preservative) and Phosphides from Gastric lavage sample.
• Detection of Common Steroids such as Prednisolone, Methyl prednisolone, Betamethasone, Dexamethasone.
• Detection of Common Pesticides such as Chlorpyrifos, profenfos, dimethoate, monocrotophos, endosulphan, quinalphos, fenvalerat, dichlorvos, baygon, malathion, cypermethrin, deltamethrin, carbofuran in gastric lavage.

These tests are required only when blood vessels show signs of subsequent toxicity. The tests also rely on biomarkers of toxic effect such as cholinesterase activity or coagulation profile.

These tests include:

• Serum cholinesterase and RBC cholinesterase activity for Organophosphate or carbamate pesticide poisoning.
• Blood methemoglobin level
• Serum Paracetamol (acetaminophen) level.
• Serum Salicylate level.
• Detection of Thiocyanate in Urine and Estimation of Blood Thiocyanate Level.
• Urinary total Porphyrins, δ-amino levulinic acid (δ-ALA) and Porphobilinogen:
• Blood Lead level.

High Performance Liquid Chromatography (HPLC), a Gold Standard among analytical techniques, is used in measuring the following drugs at our laboratory:

• Antiepileptic drugs (like Phenobarbitone, Phenytoin, Carbamazepine & its epoxide, Oxcarbazepine & its mono-Hydroxy metabolite, Ethosuximide, Lamotrigine, Primidone, Sulthiame, Lacosamide, Zonisamide, Felbamate, Rufinamide, N-Desmethylmethsuximide and Levetiracetam)
• Antifungal drugs (like Voriconazole, Posaconazole)
• Antibiotics (like Vancomycin)
• Anticancer drug (like Methotrexate)

Environmental or occupational exposures to heavy metals like Lead, Arsenic or Mercury and their bio-accumulation in the body may lead to chronic toxicity. At Unipath, we have the potential to analyze different toxicants present in occupational set ups.

These tests include:

• Urinary Phenol Level by spectrophotometry is used for assessment occupational exposure of benzene or phenol
• Urinary tt-MA (trans, trans-Muconic acid) by HPLC is used for assessment of occupational exposure of benzene. tt-MA is considered to be more sensitive and specific parameter for benzene exposure
• Blood Methemoglobin is used for Dyes and dye intermediate industries
• Blood Lead and Urinary delta-aminolevulinic acid (dALA): are used for Battery recycling workers, Industries related to production of Lead based chemicals, lead mining
• Plasma & RBC cholinesterase are used for Pesticide manufacturing/formulating industry
• Urinary cotinine by HPLC is under the pipeline which is useful for the assessment Tobacco handling workers