Delta Medical Est.
Suppliers of medical, health & beauty care products and equipment to hospitals, clinics, wholesalers, supermarkets and retail outlets; also runs Al Manara, a retail pharmacy network in Abu Dhabi, Dubai and Al Ain; and the Ibn Sina Medical Centre
Medical Equipment Medical Stores Personal Care Products Clinics 2 Dubai Gynaecology & Fertility Centre
Collaborative venture between the Department of Health & Medical Services (government of Dubai) and the London Fertility Centre; objective is to provide specialised fertility and gynaecological services comparable to those found in the West
Clinics 3 Fujairah Port Clinic
Medical institution located within the premises of the Port of Fujairah; services: medical treatment, orthopaedics, surgery, pathological investigations, dental services, x-ray and other radiological services; run by the Fujairah National Group
Clinics 4 Laser Eye Centre
Eye clinic in Dubai; services: eye consultation, full retinal examination, contact lenses clinic, orthoptic tests, optical tests, laser treatment, surgeries, treatment for cataract, glaucoma, retinal detachments etc
Clinics 5 Shaikh Khalifa Medical City
Medical complex consisting of the Sheikh Khalifa Medical Pavilion, the Al Jazeira Pavilion, the Central Pavilion, the Behavioural Sciences Pavilion, and National Rehabilitation Centre
Hospitals Clinics 6 The Manchester Clinic
Clinic in Jumeirah; specialities: urology, laser surgery, internal medicine, general surgery, plastic surgery, treatment of cellulite, obstetrics and gynaecology, paediatrics, psychiatry, dental surgery, executive health check-up etc
Clinics 7 Abu Dhabi Knee & Sports Medicine Centre (ADKSMC)
First specialised orthopaedic centre in the Middle East & North African (MENA) region specialising in the diagnosis & treatment of patients with knee, shoulder & other sports-related injuries; located on Electra Street, Abu Dhabi
Clinics 8 Al Salam Clinic
Dermatology clinic located in Rolla, Sharjah; offers treatment for skin, hair & nail ailments, sexually transmitted diseases, erectile dysfunction etc; also offers cosmetology treatment including UVB treatment, removing warts etc
Clinics 9 Chiropractic Specialty Clinics
Clinic in Abu Dhabi offering chiropractic care, therapeutic massage, professional acupuncture services, postural training, stress reduction, nutrition counselling, weight loss programmes, etc
Clinics 10 Dr Kamkar Medical & Physiotherapy Centre
Clinic in Dubai offering services in physiotherapy, acupuncture, general medicine, paediatrics and dentistry
Clinics Dentists
Monday, April 14, 2008
Al Zahra Private Hospital
Hospital in Sharjah with an associated medical centre in Dubai; departments: anaesthesiology, cardiology, cosmetic and reconstructive surgery, dentistry, dermatology, ENT, audiology, gastroenterology, internal medicine, neurosurgery, nuclear medicine
Hospitals
2 American Hospital
100-bed, acute care, general medical/surgical hospital in Dubai; expertise in total joint replacement and diabetes; accredited by the Joint Commission International Accreditation ( JCIA )
Hospitals
3 Department of Health and Medical Services
Health authority in the emirate of Dubai set up to provide preventive and curative health services; runs Dubai Hospital, Rashid Hospital, Al Wasl Hospital, blood donation centre, thalassemia centre, fertility centre, and Al Maktoum health care centre
Government of Dubai Hospitals
4 Emirates Hospital
Specialist surgical hospital in Dubai; services: plastic surgery, obstetrics & gynaecology, ENT (ear, nose, throat), general surgery, urology, endoscopic surgery, breast surgery, orthopaedics, endocrinology, paediatric services, internal medicine etc
Hospitals
5 Gulf Medical College Hospital and Research Centre
University hospital based in Ajman, UAE; departments: internal medicine, surgery, anaesthesiology, ophthalmology, orthopaedics, paediatrics, dermatology, obstetrics/gynaecology, ENT, dental, radiology, pathology, physiotherapy etc
Hospitals
6 Iranian Hospital
Hospital in Jumeirah, Dubai; departments: paediatrics, dentistry, internal medicine, obstetrics and gynaecology, laboratory and radiology, cardiac care, etc
Hospitals
7 Mafraq Hospital
500-bed tertiary hospital 35 km from Abu Dhabi; commissioned by the Ministry of Health in 1983; caters to approximately 1,000 outpatients a day; departments: medical, surgery, cardiology, renal transplantation, oncology etc
Hospitals
8 New Medical Centre Group (NMC)
Business group engaged in many businesses; runs hospitals, food companies, distributes pharmaceuticals, laboratory equipment, medical equipment, fast moving consumer goods, commodities (agricultural products, cement), runs restaurants etc
Business Groups Hospitals Restaurants Medical Equipment Food Trading Laboratory Equipment
9 Shaikh Khalifa Medical City
Medical complex consisting of the Sheikh Khalifa Medical Pavilion, the Al Jazeira Pavilion, the Central Pavilion, the Behavioural Sciences Pavilion, and National Rehabilitation Centre
Hospitals Clinics
10 Welcare Hospital
Hospital in the Al Garhoud area of Dubai; departments: accident & emergency, critical care, endoscopy, maternity complex, medical imaging, cardiology, pulmonology, nephrology, ophthalmology, orthopedic and physiotherapy, urology, endocrinology etc
Hospitals
Hospital in Sharjah with an associated medical centre in Dubai; departments: anaesthesiology, cardiology, cosmetic and reconstructive surgery, dentistry, dermatology, ENT, audiology, gastroenterology, internal medicine, neurosurgery, nuclear medicine
Hospitals
2 American Hospital
100-bed, acute care, general medical/surgical hospital in Dubai; expertise in total joint replacement and diabetes; accredited by the Joint Commission International Accreditation ( JCIA )
Hospitals
3 Department of Health and Medical Services
Health authority in the emirate of Dubai set up to provide preventive and curative health services; runs Dubai Hospital, Rashid Hospital, Al Wasl Hospital, blood donation centre, thalassemia centre, fertility centre, and Al Maktoum health care centre
Government of Dubai Hospitals
4 Emirates Hospital
Specialist surgical hospital in Dubai; services: plastic surgery, obstetrics & gynaecology, ENT (ear, nose, throat), general surgery, urology, endoscopic surgery, breast surgery, orthopaedics, endocrinology, paediatric services, internal medicine etc
Hospitals
5 Gulf Medical College Hospital and Research Centre
University hospital based in Ajman, UAE; departments: internal medicine, surgery, anaesthesiology, ophthalmology, orthopaedics, paediatrics, dermatology, obstetrics/gynaecology, ENT, dental, radiology, pathology, physiotherapy etc
Hospitals
6 Iranian Hospital
Hospital in Jumeirah, Dubai; departments: paediatrics, dentistry, internal medicine, obstetrics and gynaecology, laboratory and radiology, cardiac care, etc
Hospitals
7 Mafraq Hospital
500-bed tertiary hospital 35 km from Abu Dhabi; commissioned by the Ministry of Health in 1983; caters to approximately 1,000 outpatients a day; departments: medical, surgery, cardiology, renal transplantation, oncology etc
Hospitals
8 New Medical Centre Group (NMC)
Business group engaged in many businesses; runs hospitals, food companies, distributes pharmaceuticals, laboratory equipment, medical equipment, fast moving consumer goods, commodities (agricultural products, cement), runs restaurants etc
Business Groups Hospitals Restaurants Medical Equipment Food Trading Laboratory Equipment
9 Shaikh Khalifa Medical City
Medical complex consisting of the Sheikh Khalifa Medical Pavilion, the Al Jazeira Pavilion, the Central Pavilion, the Behavioural Sciences Pavilion, and National Rehabilitation Centre
Hospitals Clinics
10 Welcare Hospital
Hospital in the Al Garhoud area of Dubai; departments: accident & emergency, critical care, endoscopy, maternity complex, medical imaging, cardiology, pulmonology, nephrology, ophthalmology, orthopedic and physiotherapy, urology, endocrinology etc
Hospitals
Saturday, April 12, 2008
LABORETORY RESULT GIVE AGOOD RESUME
Write a resume that generates results.
This award-winning guide to resume writing will teach you to write a resume equal to one done by a top-notch professional writer. It offers examples, format choices, help writing the objective, the summary and other sections, as well as samples of excellent resume writing.
Writing a great resume does not necessarily mean you should follow the rules you hear through the grapevine. It does not have to be one page or follow a specific resume format. Every resume is a one-of-a-kind marketing communication. It should be appropriate to your situation and do exactly what you want it to do. Instead of a bunch of rules and tips, we are going to cut to the chase in this brief guide and offer you the most basic principles of writing a highly effective resume.
Who are we to be telling you how to write your resume? As part of our career consulting practice, we wrote and produced resumes for several Fortune 500 C.E.O.s, senior members of the last few presidential administrations, and thousands of professionals in nearly every field of endeavor. We also wrote resumes for young people just starting out.
We concentrate on helping people choose and change to careers that fit them perfectly. We have not employed resume writers for several years. If you are trying to decide what to do with your life, we can help you. That is our one and only specialty. Please don't ask us to write your resume. We offer this resume writing guide to you because most of the resume books out there are so primitive.
This guide is especially for people looking for a job in the United States. In the U.S., the rules of job hunting are much more relaxed than they are in Europe and Asia. You can do a lot more active personal marketing here. You may have to tone down our advice a few notches and follow the traditional, conservative format accepted in your field if you live elsewhere or are in law, academia or a technical engineering, computer or scientific field. But even when your presentation must fit a narrow set of rules, you can still use the principles we will present to make your presentation more effective than your competition's.
THE GOOD NEWS AND THE BAD
The good news is that, with a little extra effort, you can create a resume that makes you stand out as a superior candidate for a job you are seeking. Not one resume in a hundred follows the principles that stir the interest of prospective employers. So, even if you face fierce competition, with a well written resume you should be invited to interview more often than many people more qualified than you.
The bad news is that your present resume is probably much more inadequate than you now realize. You will have to learn how to think and write in a style that will be completely new to you.
To understand what I mean, let's take a look at the purpose of your resume. Why do you have a resume in the first place? What is it supposed to do for you?
Here's an imaginary scenario. You apply for a job that seems absolutely perfect for you. You send your resume with a cover letter to the prospective employer. Plenty of other people think the job sounds great too and apply for the job. A few days later, the employer is staring at a pile of several hundred resumes. Several hundred? you ask. Isn't that an inflated number? Not really. A job offer often attracts between 100 and 1000 resumes these days, so you are facing a great deal of competition.
Back to the fantasy and the prospective employer staring at the huge stack of resumes: This person isn't any more excited about going through this pile of dry, boring documents than you would be. But they have to do it, so they dig in. After a few minutes, they are getting sleepy. They are not really focusing any more. Then, they run across your resume. As soon as they start reading it, they perk up. The more they read, the more interested, awake and turned on they become.
Most resumes in the pile have only gotten a quick glance. But yours gets read, from beginning to end. Then, it gets put on top of the tiny pile of resumes that make the first cut. These are the people who will be asked in to interview. In this mini resume writing guide, what we hope to do is to give you the basic tools to take this out of the realm of fantasy and into your everyday life.» » top
THE NUMBER ONE PURPOSE OF A RESUME
The resume is a tool with one specific purpose: to win an interview. If it does what the fantasy resume did, it works. If it doesn't, it isn't an effective resume. A resume is an advertisement, nothing more, nothing less.
A great resume doesn't just tell them what you have done but makes the same assertion that all good ads do: If you buy this product, you will get these specific, direct benefits. It presents you in the best light. It convinces the employer that you have what it takes to be successful in this new position or career.
It is so pleasing to the eye that the reader is enticed to pick it up and read it. It "whets the appetite," stimulates interest in meeting you and learning more about you. It inspires the prospective employer to pick up the phone and ask you to come in for an interview.» top
OTHER POSSIBLE REASONS TO HAVE A RESUME
To pass the employer's screening process (requisite educational level, number years' experience, etc.), to give basic facts which might favorably influence the employer (companies worked for, political affiliations, racial minority, etc.). To provide contact information: an up-to-date address and a telephone number (a telephone number which will always be answered during business hours).
To establish you as a professional person with high standards and excellent writing skills, based on the fact that the resume is so well done (clear, well-organized, well-written, well-designed, of the highest professional grades of printing and paper). For persons in the art, advertising, marketing, or writing professions, the resume can serve as a sample of their skills.
To have something to give to potential employers, your job-hunting contacts and professional references, to provide background information, to give out in "informational interviews" with the request for a critique (a concrete creative way to cultivate the support of this new person), to send a contact as an excuse for follow-up contact, and to keep in your briefcase to give to people you meet casually - as another form of "business card."
To use as a covering piece or addendum to another form of job application, as part of a grant or contract proposal, as an accompaniment to graduate school or other application.
To put in an employer's personnel files.
To help you clarify your direction, qualifications, and strengths, boost your confidence, or to start the process of commiting to a job or career change. » top
WHAT IT ISN'T
It is a mistake to think of your resume as a history of your past, as a personal statement or as some sort of self expression. Sure, most of the content of any resume is focused on your job history. But write from the intention to create interest, to persuade the employer to call you. If you write with that goal, your final product will be very different than if you write to inform or catalog your job history.
Most people write a resume because everyone knows that you have to have one to get a job. They write their resume grudgingly, to fulfill this obligation. Writing the resume is only slightly above filling out income tax forms in the hierarchy of worldly delights. If you realize that a great resume can be your ticket to getting exactly the job you want, you may be able to muster some genuine enthusiasm for creating a real masterpiece, rather than the feeble products most people turn out.» top
WHAT IF I'M NOT SURE OF MY JOB TARGET?
If you are hunting for a job but are not sure you are on a career path that is perfect for you, you are probably going to wind up doing something that doesn't fit you very well, that you are not going to find fulfilling, and that you will most likely leave within five years. Doesn't sound like much of a life to me. How about you? Are you willing to keep putting up with pinning your fate on the random turnings of the wheel?» top
This award-winning guide to resume writing will teach you to write a resume equal to one done by a top-notch professional writer. It offers examples, format choices, help writing the objective, the summary and other sections, as well as samples of excellent resume writing.
Writing a great resume does not necessarily mean you should follow the rules you hear through the grapevine. It does not have to be one page or follow a specific resume format. Every resume is a one-of-a-kind marketing communication. It should be appropriate to your situation and do exactly what you want it to do. Instead of a bunch of rules and tips, we are going to cut to the chase in this brief guide and offer you the most basic principles of writing a highly effective resume.
Who are we to be telling you how to write your resume? As part of our career consulting practice, we wrote and produced resumes for several Fortune 500 C.E.O.s, senior members of the last few presidential administrations, and thousands of professionals in nearly every field of endeavor. We also wrote resumes for young people just starting out.
We concentrate on helping people choose and change to careers that fit them perfectly. We have not employed resume writers for several years. If you are trying to decide what to do with your life, we can help you. That is our one and only specialty. Please don't ask us to write your resume. We offer this resume writing guide to you because most of the resume books out there are so primitive.
This guide is especially for people looking for a job in the United States. In the U.S., the rules of job hunting are much more relaxed than they are in Europe and Asia. You can do a lot more active personal marketing here. You may have to tone down our advice a few notches and follow the traditional, conservative format accepted in your field if you live elsewhere or are in law, academia or a technical engineering, computer or scientific field. But even when your presentation must fit a narrow set of rules, you can still use the principles we will present to make your presentation more effective than your competition's.
THE GOOD NEWS AND THE BAD
The good news is that, with a little extra effort, you can create a resume that makes you stand out as a superior candidate for a job you are seeking. Not one resume in a hundred follows the principles that stir the interest of prospective employers. So, even if you face fierce competition, with a well written resume you should be invited to interview more often than many people more qualified than you.
The bad news is that your present resume is probably much more inadequate than you now realize. You will have to learn how to think and write in a style that will be completely new to you.
To understand what I mean, let's take a look at the purpose of your resume. Why do you have a resume in the first place? What is it supposed to do for you?
Here's an imaginary scenario. You apply for a job that seems absolutely perfect for you. You send your resume with a cover letter to the prospective employer. Plenty of other people think the job sounds great too and apply for the job. A few days later, the employer is staring at a pile of several hundred resumes. Several hundred? you ask. Isn't that an inflated number? Not really. A job offer often attracts between 100 and 1000 resumes these days, so you are facing a great deal of competition.
Back to the fantasy and the prospective employer staring at the huge stack of resumes: This person isn't any more excited about going through this pile of dry, boring documents than you would be. But they have to do it, so they dig in. After a few minutes, they are getting sleepy. They are not really focusing any more. Then, they run across your resume. As soon as they start reading it, they perk up. The more they read, the more interested, awake and turned on they become.
Most resumes in the pile have only gotten a quick glance. But yours gets read, from beginning to end. Then, it gets put on top of the tiny pile of resumes that make the first cut. These are the people who will be asked in to interview. In this mini resume writing guide, what we hope to do is to give you the basic tools to take this out of the realm of fantasy and into your everyday life.» » top
THE NUMBER ONE PURPOSE OF A RESUME
The resume is a tool with one specific purpose: to win an interview. If it does what the fantasy resume did, it works. If it doesn't, it isn't an effective resume. A resume is an advertisement, nothing more, nothing less.
A great resume doesn't just tell them what you have done but makes the same assertion that all good ads do: If you buy this product, you will get these specific, direct benefits. It presents you in the best light. It convinces the employer that you have what it takes to be successful in this new position or career.
It is so pleasing to the eye that the reader is enticed to pick it up and read it. It "whets the appetite," stimulates interest in meeting you and learning more about you. It inspires the prospective employer to pick up the phone and ask you to come in for an interview.» top
OTHER POSSIBLE REASONS TO HAVE A RESUME
To pass the employer's screening process (requisite educational level, number years' experience, etc.), to give basic facts which might favorably influence the employer (companies worked for, political affiliations, racial minority, etc.). To provide contact information: an up-to-date address and a telephone number (a telephone number which will always be answered during business hours).
To establish you as a professional person with high standards and excellent writing skills, based on the fact that the resume is so well done (clear, well-organized, well-written, well-designed, of the highest professional grades of printing and paper). For persons in the art, advertising, marketing, or writing professions, the resume can serve as a sample of their skills.
To have something to give to potential employers, your job-hunting contacts and professional references, to provide background information, to give out in "informational interviews" with the request for a critique (a concrete creative way to cultivate the support of this new person), to send a contact as an excuse for follow-up contact, and to keep in your briefcase to give to people you meet casually - as another form of "business card."
To use as a covering piece or addendum to another form of job application, as part of a grant or contract proposal, as an accompaniment to graduate school or other application.
To put in an employer's personnel files.
To help you clarify your direction, qualifications, and strengths, boost your confidence, or to start the process of commiting to a job or career change. » top
WHAT IT ISN'T
It is a mistake to think of your resume as a history of your past, as a personal statement or as some sort of self expression. Sure, most of the content of any resume is focused on your job history. But write from the intention to create interest, to persuade the employer to call you. If you write with that goal, your final product will be very different than if you write to inform or catalog your job history.
Most people write a resume because everyone knows that you have to have one to get a job. They write their resume grudgingly, to fulfill this obligation. Writing the resume is only slightly above filling out income tax forms in the hierarchy of worldly delights. If you realize that a great resume can be your ticket to getting exactly the job you want, you may be able to muster some genuine enthusiasm for creating a real masterpiece, rather than the feeble products most people turn out.» top
WHAT IF I'M NOT SURE OF MY JOB TARGET?
If you are hunting for a job but are not sure you are on a career path that is perfect for you, you are probably going to wind up doing something that doesn't fit you very well, that you are not going to find fulfilling, and that you will most likely leave within five years. Doesn't sound like much of a life to me. How about you? Are you willing to keep putting up with pinning your fate on the random turnings of the wheel?» top
DO U WANT LAB JOB ?
Your resume is powerful tool to allow employers to get an idea of your experiences and skills. In the clinical laboratory one critical aspect is listing the equipment and procedures performed in each area. This allows employers to see the breadth and depth of your clinical training. Your clinical rotations count as work experience. Employers know that recent graduates will have other non-laboratory jobs listed. The fact that you have not been employed in the last 2 years or that you switched jobs often will not be held against you. They may review your history prior to school to see the types of jobs performed and the length of time at each. Having reviewed many resumes myself, I look at how long they were at a position, what tasks they performed and why did they leave. This gives me an idea of how likely a person may stay at my facility. It costs a lot of money to train a medical laboratory technician, one supervisor stated that the cost is about $10,000 if they stay 6 months. A comment from an Advance article titled The High Cost of Hiring states: "New hire costs typically run from 10 to 40 percent of the employee's first year salary. The numbers also do not measure the reduced productivity while the new employee gets fully up to speed.". With this type of expense they wish to be assured that you will stay at least a year so they can recoup the money spent on training.
I encourage you to read job descriptions and model your resume based on the needs of the potential employer. Go to ADVANCE for Healthcare Careers Job Search to research job descriptions. Recruiter Meets Résumé is an article by a recruiter lists some very specific "does" and "don'ts". Your goal is to create a basic resume which can then be altered for the specific company you are applying to.
Research interview questions that may be asked of you. Most interviewers will ask for a strength, a weakness, and for a problem you encountered and how you resolved it. Prepare your answers now. Be sure to comment on your adaptability and flexibility as the clinical laboratory is ALWAYS in a state of change, whether it be organizational or technical, and you will be expected to "roll with the flow". Iniative, problem solving and being a team player are important characteristics for a laboratory professional. The articles "Answering Questions" , "An Interview Dialogue" and "Disastrous Moments" will be extremely helpful to you.
An article from Advance for Medical Laboratory Professionals (I strongly encourage you to subscribe to this FREE publication) states: "Jones recommends that students become involved in laboratory associations, including regulatory organizations. "Understanding regulatory agencies and their mission/intent is vital. It really gives the new professionals the theory behind why things are done or performed in a certain way," she affirmed.". If you have not joined ASCP yet I strongly encourage you to do so. Familiarize yourself with the College of American Pathologists (CAP), Clinical Laboratory Improvement Act (CLIA), COLA, and the Joint Commission on the Accreditation of Hospital Organizations. As an entry level MLT you will not need extensive knowledge but you will be expected to have some knowledge of these organizations and their impact on the laboratory.
I encourage you to read job descriptions and model your resume based on the needs of the potential employer. Go to ADVANCE for Healthcare Careers Job Search to research job descriptions. Recruiter Meets Résumé is an article by a recruiter lists some very specific "does" and "don'ts". Your goal is to create a basic resume which can then be altered for the specific company you are applying to.
Research interview questions that may be asked of you. Most interviewers will ask for a strength, a weakness, and for a problem you encountered and how you resolved it. Prepare your answers now. Be sure to comment on your adaptability and flexibility as the clinical laboratory is ALWAYS in a state of change, whether it be organizational or technical, and you will be expected to "roll with the flow". Iniative, problem solving and being a team player are important characteristics for a laboratory professional. The articles "Answering Questions" , "An Interview Dialogue" and "Disastrous Moments" will be extremely helpful to you.
An article from Advance for Medical Laboratory Professionals (I strongly encourage you to subscribe to this FREE publication) states: "Jones recommends that students become involved in laboratory associations, including regulatory organizations. "Understanding regulatory agencies and their mission/intent is vital. It really gives the new professionals the theory behind why things are done or performed in a certain way," she affirmed.". If you have not joined ASCP yet I strongly encourage you to do so. Familiarize yourself with the College of American Pathologists (CAP), Clinical Laboratory Improvement Act (CLIA), COLA, and the Joint Commission on the Accreditation of Hospital Organizations. As an entry level MLT you will not need extensive knowledge but you will be expected to have some knowledge of these organizations and their impact on the laboratory.
PROTIEN AND OTHER PARAMETERS
Other enzymes and proteins
Test
Low
High
Unit
Comments
Creatine kinase (CK) - male
24[6]
195
U/L
Creatine kinase (CK) - female
24[7]
170
U/L
* Aspartate transaminase (AST)
8
35
U/L
Also called serum glutamic oxatoacetic transaminase (SGOT)
* Lactate dehydrogenase (LDH)
85
285
U/L
Amylase
n/a
120[8]
U/L
C-reactive protein (CRP)
n/a
5[9]
mg/L
D-dimer
n/a
500
ng/mL
Test
Low
High
Unit
Comments
Creatine kinase (CK) - male
24[6]
195
U/L
Creatine kinase (CK) - female
24[7]
170
U/L
* Aspartate transaminase (AST)
8
35
U/L
Also called serum glutamic oxatoacetic transaminase (SGOT)
* Lactate dehydrogenase (LDH)
85
285
U/L
Amylase
n/a
120[8]
U/L
C-reactive protein (CRP)
n/a
5[9]
mg/L
D-dimer
n/a
500
ng/mL
LIVER FUNCTION TESTS
Liver function
Further information: Liver function tests
Test
Low
High
Unit
Comments
* Total Protein
60
80
g/L
* Albumin
35[5]
50
g/L
* Total Bilirubin
2
14
μmol/L
* Direct Bilirubin
0
4
μmol/L
* Alanine transaminase (ALT)
8
40
U/L
Also called serum glutamic pyruvic transaminase (SGPT)
* Alkaline phosphatase (ALP)
40
130
U/L
Higher in children and pregnant women.
* Gamma glutamyl transferase
n/a
50
U/L
Further information: Liver function tests
Test
Low
High
Unit
Comments
* Total Protein
60
80
g/L
* Albumin
35[5]
50
g/L
* Total Bilirubin
2
14
μmol/L
* Direct Bilirubin
0
4
μmol/L
* Alanine transaminase (ALT)
8
40
U/L
Also called serum glutamic pyruvic transaminase (SGPT)
* Alkaline phosphatase (ALP)
40
130
U/L
Higher in children and pregnant women.
* Gamma glutamyl transferase
n/a
50
U/L
BIOCHEMISTRY NORMAL RANGES
Clinical biochemistry
Items marked with a ** are part of "CHEM-7"[1] and CHEM-20
Items marked with a * are part of "CHEM-20"[2], but not CHEM-7
[edit] Electrolytes and Metabolites
Electrolytes and Metabolites:
Test [3]
Patient type
Low [3]
High[3]
Unit
Comments
** Sodium (Na)
135
145
mmol/L
** Potassium (K)
3.5
5.1
mmol/L
Chloride (Cl)
98
107
mmol/L
Osmolality
275
295
mOsm/kg
Urea
2.5
6.4
mmol/L
** BUN - blood urea nitrogen
7
18
mg/dL
** Creatinine
male
62
115
μmol/L
May be complemented with creatinine clearance
0.7
1.3
mg/dL
female
53
97
μmol/L
0.6
1.1
mg/dL
** Glucose (fasting)
3.9
5.8
mmol/L
See also glycosylated hemoglobin
70
105
mg/dL
Serum iron[4]
male
65
176
µg/dL
female
50
170
newborns
100
250
children
50
120
TIBC
240
450
Transferrin saturation
20
50
%
Items marked with a ** are part of "CHEM-7"[1] and CHEM-20
Items marked with a * are part of "CHEM-20"[2], but not CHEM-7
[edit] Electrolytes and Metabolites
Electrolytes and Metabolites:
Test [3]
Patient type
Low [3]
High[3]
Unit
Comments
** Sodium (Na)
135
145
mmol/L
** Potassium (K)
3.5
5.1
mmol/L
Chloride (Cl)
98
107
mmol/L
Osmolality
275
295
mOsm/kg
Urea
2.5
6.4
mmol/L
** BUN - blood urea nitrogen
7
18
mg/dL
** Creatinine
male
62
115
μmol/L
May be complemented with creatinine clearance
0.7
1.3
mg/dL
female
53
97
μmol/L
0.6
1.1
mg/dL
** Glucose (fasting)
3.9
5.8
mmol/L
See also glycosylated hemoglobin
70
105
mg/dL
Serum iron[4]
male
65
176
µg/dL
female
50
170
newborns
100
250
children
50
120
TIBC
240
450
Transferrin saturation
20
50
%
NORMAL RANGES OF THYROID HORMONE
Thyroid Function TestsNormal Laboratory Values
Test
Abbreviation
Typical Ranges
Serum thyroxine
T4
4.6-12 ug/dl
Free thyroxine fraction
FT4F
0.03-0.005%
Free Thyroxine
FT4
0.7-1.9 ng/dl
Thyroid hormone binding ratio
THBR
0.9-1.1
Free Thyroxine index
FT4I
4-11
Serum Triiodothyronine
T3
80-180 ng/dl
Free Triiodothyronine l
FT3
230-619 pg/d
Free T3 Index
FT3I
80-180
Radioactive iodine uptake
RAIU
10-30%
Serum thyrotropin
TSH
0.5-6 uU/ml
Thyroxine-binding globulin
TBG
12-20 ug/dl T4 +1.8 ugm
TRH stimulation test Peak
TSH
9-30 uIU/ml at 20-30 min
Serum thyroglobulin l
Tg
0-30 ng/m
Thyroid microsomal antibody titer
TMAb
Varies with method
Thyroglobulin antibody titer
TgAb
Varies with method
Test
Abbreviation
Typical Ranges
Serum thyroxine
T4
4.6-12 ug/dl
Free thyroxine fraction
FT4F
0.03-0.005%
Free Thyroxine
FT4
0.7-1.9 ng/dl
Thyroid hormone binding ratio
THBR
0.9-1.1
Free Thyroxine index
FT4I
4-11
Serum Triiodothyronine
T3
80-180 ng/dl
Free Triiodothyronine l
FT3
230-619 pg/d
Free T3 Index
FT3I
80-180
Radioactive iodine uptake
RAIU
10-30%
Serum thyrotropin
TSH
0.5-6 uU/ml
Thyroxine-binding globulin
TBG
12-20 ug/dl T4 +1.8 ugm
TRH stimulation test Peak
TSH
9-30 uIU/ml at 20-30 min
Serum thyroglobulin l
Tg
0-30 ng/m
Thyroid microsomal antibody titer
TMAb
Varies with method
Thyroglobulin antibody titer
TgAb
Varies with method
THYROIDFUNCTION TESTS
THYROID FUNCTION TESTS ARE
T3,T4AND TSH.
THYROID GLAND IAs we have seen from our, the thyroid gland produces T4 and T3. But this production is not possible without stimulation from the pituitary gland (TSH) which in turn is also regulated by the hypothalamus's TSH Releasing Hormone. Now, with radioimmunoassay techniques it is possible to measure circulating hormones in the blood very accurately. Knowledge of this thyroid physiology is important in knowing what thyroid test or tests are needed to diagnose different diseases. No one single laboratory test is 100% accurate in diagnosing all types of thyroid disease; however, a combination of two or more tests can usually detect even the slightest abnormality of thyroid function.For example, a low T4 level could mean a diseased thyroid gland ~ OR ~ a non-functioning pituitary gland which is not stimulating the thyroid to produce T4. Since the pituitary gland would normally release TSH if the T4 is low, a high TSH level would confirm that the thyroid gland (not the pituitary gland) is responsible for the hypothyroidism.If the T4 level is low and TSH is not elevated, the pituitary gland is more likely to be the cause for the hypothyroidism. Of course, this would drastically effect the treatment since the pituitary gland also regulates the body's other glands (adrenals, ovaries, and testicles) as well as controlling growth in children and normal kidney function. Pituitary gland failure means that the other glands may also be failing and other treatment than just thyroid may be necessary. The most common cause for the pituitary gland failure is a tumor of the pituitary and this might also require surgery to remove.S BUTTER FLY SHAPED ENDOCRINE GLAND
The following are commonly used thyroid tests
Measurement of Serum Thyroid Hormones: T4 by RIA. T4 by RIA (radioimmunoassay) is the most used thyroid test of all. It is frequently referred to as a T7 which means that a resin T3 uptake (RT3u) has been done to correct for certain medications such as birth control pills, other hormones, seizure medication, cardiac drugs, or even aspirin that may alter the routine T4 test. The T4 reflects the amount of thyroxine in the blood. If the patient does not take any type of thyroid medication, this test is usually a good measure of thyroid function.Measurement of Serum Thyroid Hormones: T3 by RIA. As stated on our thyroid hormone production page, thyroxine (T4) represents 80% of the thyroid hormone produced by the normal gland and generally represents the overall function of the gland. The other 20% is triiodothyronine measured as T3 by RIA. Sometimes the diseased thyroid gland will start producing very high levels of T3 but still produce normal levels of T4. Therefore measurement of both hormones provides an even more accurate evaluation of thyroid function.Thyroid Binding Globulin. Most of the thyroid hormones in the blood are attached to a protein called thyroid binding globulin (TBG). If there is an excess or deficiency of this protein it alters the T4 or T3 measurement but does not affect the action of the hormone. If a patient appears to have normal thyroid function, but an unexplained high or low T4, or T3, it may be due to an increase or decrease of TBG. Direct measurement of TBG can be done and will explain the abnormal value. Excess TBG or low levels of TBG are found in some families as an hereditary trait. It causes no problem except falsely elevating or lowering the T4 level. These people are frequently misdiagnosed as being hyperthyroid or hypothyroid, but they have no thyroid problem and need no treatment. Measurement of Pituitary Production of TSH. Pituitary production of TSH is measured by a method referred to as IRMA (immunoradiometric assay). Normally, low levels (less than 5 units) of TSH are sufficient to keep the normal thyroid gland functioning properly. When the thyroid gland becomes inefficient such as in early hypothyroidism, the TSH becomes elevated even though the T4 and T3 may still be within the "normal" range. This rise in TSH represents the pituitary gland's response to a drop in circulating thyroid hormone; it is usually the first indication of thyroid gland failure. Since TSH is normally low when the thyroid gland is functioning properly, the failure of TSH to rise when circulating thyroid hormones are low is an indication of impaired pituitary function. The new "sensitive" TSH test will show very low levels of TSH when the thyroid is overactive (as a normal response of the pituitary to try to decrease thyroid stimulation). Interpretations of the TSH level depends upon the level of thyroid hormone; therefore, the TSH is usually used in combination with other thyroid tests such as the T4 RIA and T3 RIA.TRH Test. In normal people TSH secretion from the pituitary can be increased by giving a shot containing TSH Releasing Hormone (TRH...the hormone released by the hypothalamus which tells the pituitary to produce TSH). A baseline TSH of 5 or less usually goes up to 10-20 after giving an injection of TRH. Patients with too much thyroid hormone (thyroxine or triiodothyronine) will not show a rise in TSH when given TRH. This "TRH test" is presently the most sensitive test in detecting early hyperthyroidism. Patients who show too much response to TRH (TSH rises greater than 40) may be hypothyroid. This test is also used in cancer patients who are taking thyroid replacement to see if they are on sufficient medication. It is sometimes used to measure if the pituitary gland is functioning. The new "sensitive" TSH test (above) has eliminated the necessity of performing a TRH test in most clinical situations. Iodine Uptake Scan. A means of measuring thyroid function is to measure how much iodine is taken up by the thyroid gland (RAI uptake). Remember, cells of the thyroid normally absorb iodine from our blood stream (obtained from foods we eat) and use it to make thyroid hormone (described on our thyroid function page). Hypothyroid patients usually take up too little iodine and hyperthyroid patients take up too much iodine. The test is performed by giving a dose of radioactive iodine on an empty stomach. The iodine is concentrated in the thyroid gland or excreted in the urine over the next few hours. The amount of iodine that goes into the thyroid gland can be measured by a "Thyroid Uptake". Of course, patients who are taking thyroid medication will not take up as much iodine in their thyroid gland because their own thyroid gland is turned off and is not functioning. At other times the gland will concentrate iodine normally but will be unable to convert the iodine into thyroid hormone; therefore, interpretation of the iodine uptake is usually done in conjunction with blood tests.Thyroid Scan. Taking a "picture" of how well the thyroid gland is functioning requires giving a radioisotope to the patient and letting the thyroid gland concentrate the isotope (just like the iodine uptake scan above). Therefore, it is usually done at the same time that the iodine uptake test is performed. Although other isotopes, such as technetium, will be concentrated by the thyroid gland; these isotopes will not measure iodine uptake which is what we really want to know because the production of thyroid hormone is dependent upon absorbing iodine. It has also been found that thyroid nodules that concentrate iodine are rarely cancerous; this is not true if the scan is done with technetium. Therefore, all scans are now done with radioactive iodine. Both of the scans above show normal sized thyroid glands, but the one on the left has a "HOT" nodule in the lower aspect of the right lobe, while the scan on the right has a "COLD" nodule in the lower aspect of the left lobe (outlined in red and yellow). Pregnant women should not have thyroid scans performed because the iodine can cause development troubles within the baby's thyroid gland.
Two types of thyroid scans are available. A camera scan is performed most commonly which uses a gamma camera operating in a fixed position viewing the entire thyroid gland at once. This type of scan takes only five to ten minutes. In the 1990's, a new scanner called a Computerized Rectilinear Thyroid (CRT) scanner was introduced. The CRT scanner utilizes computer technology to improve the clarity of thyroid scans and enhance thyroid nodules. It measures both thyroid function and thyroid size. A life-sized 1:1 color scan of the thyroid is obtained giving the size in square centimeters and the weight in grams. The precise size and activity of nodules in relation to the rest of the gland is also measured. CTS of the normal thyroid gland In addition to making thyroid diagnosis more accurate, the CRT scanner improves the results of thyroid biopsy. The accurate sizing of the thyroid gland aids in the follow-up of nodules to see if they are growing or getting smaller in size. Knowing the weight of the thyroid gland allows more accurate radioactive treatment in patients who have Graves' disease.
Thyroid Scans are used for the following reasons:
Identifying nodules and determining if they are "hot" or "cold".Measuring the size of the goiter prior to treatment. Follow-up of thyroid cancer patients after surgery. Locating thyroid tissue outside the neck, i.e. base of the tongue or in the chest.Thyroid Ultrasound. Thyroid ultrasound refers to the use of high frequency sound waves to obtain an image of the thyroid gland and identify nodules. It tells if a nodule is "solid" or a fluid-filled cyst, but it will not tell if a nodule is benign or malignant. Ultrasound allows accurate measurement of a nodule's size and can determine if a nodule is getting smaller or is growing larger during treatment. Ultrasound aids in performing thyroid needle biopsy by improving accuracy if the nodule cannot be felt easily on examination. Several more pages are dedicated to the use of ultrasound in evaluating thyroid nodules.Thyroid Antibodies. The body normally produces antibodies to foreign substances such as bacteria; however, some people are found to have antibodies against their own thyroid tissue. A condition known as Hashimoto's Thyroiditis is associated with a high level of these thyroid antibodies in the blood. Whether the antibodies cause the disease or whether the disease causes the antibodies is not known; however, the finding of a high level of thyroid antibodies is strong evidence of this disease. Occasionally, low levels of thyroid antibodies are found with other types of thyroid disease. When Hashimoto's thyroiditis presents as a thyroid nodule rather than a diffuse goiter, the thyroid antibodies may not be present.Thyroid Needle Biopsy. This has become the most reliable test to differentiate the "cold" nodule that is cancer from the "cold" nodule that is benign ("hot" nodules are rarely cancerous). It provides information that no other thyroid test will provide. While not perfect, it will provide definitive information in 75% of the nodules biopsied. A very extensive discussion of Thyroid Needle Biopsy is found on another page.
T3,T4AND TSH.
THYROID GLAND IAs we have seen from our, the thyroid gland produces T4 and T3. But this production is not possible without stimulation from the pituitary gland (TSH) which in turn is also regulated by the hypothalamus's TSH Releasing Hormone. Now, with radioimmunoassay techniques it is possible to measure circulating hormones in the blood very accurately. Knowledge of this thyroid physiology is important in knowing what thyroid test or tests are needed to diagnose different diseases. No one single laboratory test is 100% accurate in diagnosing all types of thyroid disease; however, a combination of two or more tests can usually detect even the slightest abnormality of thyroid function.For example, a low T4 level could mean a diseased thyroid gland ~ OR ~ a non-functioning pituitary gland which is not stimulating the thyroid to produce T4. Since the pituitary gland would normally release TSH if the T4 is low, a high TSH level would confirm that the thyroid gland (not the pituitary gland) is responsible for the hypothyroidism.If the T4 level is low and TSH is not elevated, the pituitary gland is more likely to be the cause for the hypothyroidism. Of course, this would drastically effect the treatment since the pituitary gland also regulates the body's other glands (adrenals, ovaries, and testicles) as well as controlling growth in children and normal kidney function. Pituitary gland failure means that the other glands may also be failing and other treatment than just thyroid may be necessary. The most common cause for the pituitary gland failure is a tumor of the pituitary and this might also require surgery to remove.S BUTTER FLY SHAPED ENDOCRINE GLAND
The following are commonly used thyroid tests
Measurement of Serum Thyroid Hormones: T4 by RIA. T4 by RIA (radioimmunoassay) is the most used thyroid test of all. It is frequently referred to as a T7 which means that a resin T3 uptake (RT3u) has been done to correct for certain medications such as birth control pills, other hormones, seizure medication, cardiac drugs, or even aspirin that may alter the routine T4 test. The T4 reflects the amount of thyroxine in the blood. If the patient does not take any type of thyroid medication, this test is usually a good measure of thyroid function.Measurement of Serum Thyroid Hormones: T3 by RIA. As stated on our thyroid hormone production page, thyroxine (T4) represents 80% of the thyroid hormone produced by the normal gland and generally represents the overall function of the gland. The other 20% is triiodothyronine measured as T3 by RIA. Sometimes the diseased thyroid gland will start producing very high levels of T3 but still produce normal levels of T4. Therefore measurement of both hormones provides an even more accurate evaluation of thyroid function.Thyroid Binding Globulin. Most of the thyroid hormones in the blood are attached to a protein called thyroid binding globulin (TBG). If there is an excess or deficiency of this protein it alters the T4 or T3 measurement but does not affect the action of the hormone. If a patient appears to have normal thyroid function, but an unexplained high or low T4, or T3, it may be due to an increase or decrease of TBG. Direct measurement of TBG can be done and will explain the abnormal value. Excess TBG or low levels of TBG are found in some families as an hereditary trait. It causes no problem except falsely elevating or lowering the T4 level. These people are frequently misdiagnosed as being hyperthyroid or hypothyroid, but they have no thyroid problem and need no treatment. Measurement of Pituitary Production of TSH. Pituitary production of TSH is measured by a method referred to as IRMA (immunoradiometric assay). Normally, low levels (less than 5 units) of TSH are sufficient to keep the normal thyroid gland functioning properly. When the thyroid gland becomes inefficient such as in early hypothyroidism, the TSH becomes elevated even though the T4 and T3 may still be within the "normal" range. This rise in TSH represents the pituitary gland's response to a drop in circulating thyroid hormone; it is usually the first indication of thyroid gland failure. Since TSH is normally low when the thyroid gland is functioning properly, the failure of TSH to rise when circulating thyroid hormones are low is an indication of impaired pituitary function. The new "sensitive" TSH test will show very low levels of TSH when the thyroid is overactive (as a normal response of the pituitary to try to decrease thyroid stimulation). Interpretations of the TSH level depends upon the level of thyroid hormone; therefore, the TSH is usually used in combination with other thyroid tests such as the T4 RIA and T3 RIA.TRH Test. In normal people TSH secretion from the pituitary can be increased by giving a shot containing TSH Releasing Hormone (TRH...the hormone released by the hypothalamus which tells the pituitary to produce TSH). A baseline TSH of 5 or less usually goes up to 10-20 after giving an injection of TRH. Patients with too much thyroid hormone (thyroxine or triiodothyronine) will not show a rise in TSH when given TRH. This "TRH test" is presently the most sensitive test in detecting early hyperthyroidism. Patients who show too much response to TRH (TSH rises greater than 40) may be hypothyroid. This test is also used in cancer patients who are taking thyroid replacement to see if they are on sufficient medication. It is sometimes used to measure if the pituitary gland is functioning. The new "sensitive" TSH test (above) has eliminated the necessity of performing a TRH test in most clinical situations. Iodine Uptake Scan. A means of measuring thyroid function is to measure how much iodine is taken up by the thyroid gland (RAI uptake). Remember, cells of the thyroid normally absorb iodine from our blood stream (obtained from foods we eat) and use it to make thyroid hormone (described on our thyroid function page). Hypothyroid patients usually take up too little iodine and hyperthyroid patients take up too much iodine. The test is performed by giving a dose of radioactive iodine on an empty stomach. The iodine is concentrated in the thyroid gland or excreted in the urine over the next few hours. The amount of iodine that goes into the thyroid gland can be measured by a "Thyroid Uptake". Of course, patients who are taking thyroid medication will not take up as much iodine in their thyroid gland because their own thyroid gland is turned off and is not functioning. At other times the gland will concentrate iodine normally but will be unable to convert the iodine into thyroid hormone; therefore, interpretation of the iodine uptake is usually done in conjunction with blood tests.Thyroid Scan. Taking a "picture" of how well the thyroid gland is functioning requires giving a radioisotope to the patient and letting the thyroid gland concentrate the isotope (just like the iodine uptake scan above). Therefore, it is usually done at the same time that the iodine uptake test is performed. Although other isotopes, such as technetium, will be concentrated by the thyroid gland; these isotopes will not measure iodine uptake which is what we really want to know because the production of thyroid hormone is dependent upon absorbing iodine. It has also been found that thyroid nodules that concentrate iodine are rarely cancerous; this is not true if the scan is done with technetium. Therefore, all scans are now done with radioactive iodine. Both of the scans above show normal sized thyroid glands, but the one on the left has a "HOT" nodule in the lower aspect of the right lobe, while the scan on the right has a "COLD" nodule in the lower aspect of the left lobe (outlined in red and yellow). Pregnant women should not have thyroid scans performed because the iodine can cause development troubles within the baby's thyroid gland.
Two types of thyroid scans are available. A camera scan is performed most commonly which uses a gamma camera operating in a fixed position viewing the entire thyroid gland at once. This type of scan takes only five to ten minutes. In the 1990's, a new scanner called a Computerized Rectilinear Thyroid (CRT) scanner was introduced. The CRT scanner utilizes computer technology to improve the clarity of thyroid scans and enhance thyroid nodules. It measures both thyroid function and thyroid size. A life-sized 1:1 color scan of the thyroid is obtained giving the size in square centimeters and the weight in grams. The precise size and activity of nodules in relation to the rest of the gland is also measured. CTS of the normal thyroid gland In addition to making thyroid diagnosis more accurate, the CRT scanner improves the results of thyroid biopsy. The accurate sizing of the thyroid gland aids in the follow-up of nodules to see if they are growing or getting smaller in size. Knowing the weight of the thyroid gland allows more accurate radioactive treatment in patients who have Graves' disease.
Thyroid Scans are used for the following reasons:
Identifying nodules and determining if they are "hot" or "cold".Measuring the size of the goiter prior to treatment. Follow-up of thyroid cancer patients after surgery. Locating thyroid tissue outside the neck, i.e. base of the tongue or in the chest.Thyroid Ultrasound. Thyroid ultrasound refers to the use of high frequency sound waves to obtain an image of the thyroid gland and identify nodules. It tells if a nodule is "solid" or a fluid-filled cyst, but it will not tell if a nodule is benign or malignant. Ultrasound allows accurate measurement of a nodule's size and can determine if a nodule is getting smaller or is growing larger during treatment. Ultrasound aids in performing thyroid needle biopsy by improving accuracy if the nodule cannot be felt easily on examination. Several more pages are dedicated to the use of ultrasound in evaluating thyroid nodules.Thyroid Antibodies. The body normally produces antibodies to foreign substances such as bacteria; however, some people are found to have antibodies against their own thyroid tissue. A condition known as Hashimoto's Thyroiditis is associated with a high level of these thyroid antibodies in the blood. Whether the antibodies cause the disease or whether the disease causes the antibodies is not known; however, the finding of a high level of thyroid antibodies is strong evidence of this disease. Occasionally, low levels of thyroid antibodies are found with other types of thyroid disease. When Hashimoto's thyroiditis presents as a thyroid nodule rather than a diffuse goiter, the thyroid antibodies may not be present.Thyroid Needle Biopsy. This has become the most reliable test to differentiate the "cold" nodule that is cancer from the "cold" nodule that is benign ("hot" nodules are rarely cancerous). It provides information that no other thyroid test will provide. While not perfect, it will provide definitive information in 75% of the nodules biopsied. A very extensive discussion of Thyroid Needle Biopsy is found on another page.
HOSPITALS
1. MOULANA HOSPITAL PERINTHALMANNA. KERALA. INDIA
2. AL-SHIFA HOSPITAL PERINTHAL MANNA.
3. E.M.S. HOSPITAL PERINTHAL MANNA.
4. DISTRICT GOVENMENT HOSPITAL MANJERY.
5. KORAMBAYIL HOSPITAL MANJERI.
K.P.M ORCHID, HOSPITAL MALAPPURAM.
RELIEF HOSPITAL KONDOTTY.
M.K.H. HOSPITAL CHEMMAD.
JANATHA DIAGNOSTICS CHEMMAD
AL-MAS KOTTAKKEL.
AL-SALAMA VENGARA
2. AL-SHIFA HOSPITAL PERINTHAL MANNA.
3. E.M.S. HOSPITAL PERINTHAL MANNA.
4. DISTRICT GOVENMENT HOSPITAL MANJERY.
5. KORAMBAYIL HOSPITAL MANJERI.
K.P.M ORCHID, HOSPITAL MALAPPURAM.
RELIEF HOSPITAL KONDOTTY.
M.K.H. HOSPITAL CHEMMAD.
JANATHA DIAGNOSTICS CHEMMAD
AL-MAS KOTTAKKEL.
AL-SALAMA VENGARA
Friday, April 11, 2008
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