Rajendra Dev Bhatt | Kathmandu University (original) (raw)

Papers by Rajendra Dev Bhatt

Annals of Clinical Chemistry and Laboratory Medicine, 2015

BACKGROUND: A characteristic pattern, termed dyslipidemia, consists of deranged of any single com... more BACKGROUND: A characteristic pattern, termed dyslipidemia, consists of deranged of any single components of lipid profile test. This pattern is most frequently seen in diabetes and may be a preventable risk factor for subsequent cardiovascular disease. This study determined the influence of type 2 diabetes mellitus (T2DM) on lipid profile of diabetic patients reporting in a tertiary hospital in Bhubaneswar, India. METHODS: 50 confirmed T2DM patients and 50 non-diabetic control subjects were selected for the study. Fasting and 2 hours post prandial blood samples were collected from both study and control patients. Fasting blood sample was analyzed for lipid profile test and serum glucose, and post prandial sample was analyzed for serum glucose only. RESULTS: Sixty two (62%) of diabetic patients were males whilst thirty eight (38%) were females in this study. The mean plasma glucose levels, Total cholesterol and Triacylglycerol were significantly raised in the diabetics as compared to...

Journal of Lumbini Medical College, Feb 21, 2018

Introduction: Vitamin D, a steroid vitamin, has attracted noticeable interest of clinicians and r... more Introduction: Vitamin D, a steroid vitamin, has attracted noticeable interest of clinicians and researchers for decades because of its diverse array of biological functions. Various studies have shown that the level of vitamin D is low in significant proportion of healthy individuals. However, indoor workers especially health care professionals are not focused, particularly in Nepal. We aimed to measure level of vitamin D in apparently healthy health care professionals. Methods: A descriptive cross-sectional study was carried out in apparently healthy health care professionals working at Kathmandu University Hospital in Dhulikhel, Nepal. Structured questionnaire including socio-demographics, dietary habits, and anthropometric measurements was filled in by the participants. Total serum 25-hydroxy vitamin D was measured by Chemiluminescence Immunoassay (CLIA) technique. Results were analyzed with t-test, Chisquare test, and Pearson correlation test. Results: Data from 64 female and 47 male were analyzed, mean 25-hydroxy vitamin D level was 8.81 ng/dl (SD = 4). Almost all (98.2%, n = 109) participants had vitamin D lower than normal where 72.7% (n = 92) were deficient, 24.5% (n = 17) were insufficient, and only 2.7% (n = 2) were having adequate level. Non-specific body pain was the only factor among all we studied that was significantly associated with vitamin D levels (p = 0.002). Conclusion: Hypovitaminosis of 25-hydroxy vitamin D was found to be very common (98.2%) in apparently healthy health care subjects of Dhulikhel Hospital. This may necessitate further research to redefine the biological reference value for our population.

Background Cardiovascular diseases (CVDs) are the leading cause of deaths and disability in Nepal... more Background Cardiovascular diseases (CVDs) are the leading cause of deaths and disability in Nepal. Health systems can improve CVD health outcomes even in resource-limited settings by directing efforts to meet critical system gaps. This study aimed to identify Nepal’s health systems gaps to prevent and manage CVDs. Methods We formed a task force composed of the government and non-government representatives and assessed health system performance across six building blocks: governance, service delivery, human resources, medical products, information system, and financing in terms of equity, access, coverage, efficiency, quality, safety and sustainability. We reviewed 125 national health policies, plans, strategies, guidelines, reports and websites and conducted 52 key informant interviews. We grouped notes from desk review and transcripts’ codes into equity, access, coverage, efficiency, quality, safety and sustainability of the health system. Results National health insurance covers l...

EJIFCC, 2019

Background The turnaround time (TAT) as defined by most of the laboratories is the time interval ... more Background The turnaround time (TAT) as defined by most of the laboratories is the time interval between the specimens received in the laboratory to the time of reports dispatched with verification. Nearly 80% of hospital-attached clinical laboratories receive complaints about delayed TAT. Reporting in time is a crucial indicator of quality services along with accurate, precise and reliable reports, thus each clinical laboratory should identify affecting factors to eliminate them for the enhancement of quality services. Methodology Dhulikhel Hospital-Kathmandu University Hospital is a tertiary care hospital, where this observational descriptive study was conducted in 2017. Requested tests received on database in the Department of Clinical Biochemistry Laboratory along with test requisition form (TRF) were carefully screened for any possible error. When analysis of individual patient’s tests was completed, results of individual parameters were entered in the database manually. TAT wa...

Birat Journal of Health Sciences

Introduction: Non-alcoholic fatty liver disease (NAFLD) is one of the most prominent causes of ch... more Introduction: Non-alcoholic fatty liver disease (NAFLD) is one of the most prominent causes of chronic liver disease. It is known that dyslipidemia in NAFLD patients may have more severe atherogenic potential with high triglyceride and low density lipoprotein (LDL) as well as less high density lipoprotein (HDL) level. Objective: To determine the atherogenic dyslipidemia and associated factors among patients with NAFLD, Visiting Tertiary Care Center Methodology: Prospective cross-sectional study was conducted at Dhulikhel Hospital-Kathmandu University Hospital (DH-KUH) from January, 2016 to December, 2016. All the patients (n= 973) diagnosed to have fatty liver during this study period were initially enrolled in this study. Patients were further asked to fill up the questioner. Out of total 973 cases, 169 patients were identified as NAFLD. Fasting blood sample and anthropometric measurements (BMI, WHR) were taken. After adjusting exclusion criteria, refusal to participate and dropout...

Annals of Clinical Chemistry and Laboratory Medicine

Beta thalassemia trait is a heterogeneous autosomal recessive form of beta thalassemia. Individua... more Beta thalassemia trait is a heterogeneous autosomal recessive form of beta thalassemia. Individual with beta thalassemia are clinically asymptomatic. Here we have described a case that has been incidentally diagnosed as beta thalassemia trait. A 31 year old male form Newar Community came to hospital for routine health checkup was send for hematological investigation. On examination, his red cell morphology was found to be microcytic hypochromic and his hemoglobin concentration was mildly decrease. His other parameters was evaluated and requested for analysis of iron profile and hemoglobin electrophoresis. Iron profile test was normal. Hemoglobin electrophoresis showed prominent band in HbA2 region. Presence of HbA2 band was confirmed by hemoglobin variant HPLC analysis. A diagnosis of heterozygous beta thalassemia trait was made. Prevalence of beta thalassemia gene in Tharu population was reported but its presence in other communities is still unknown therefore, it is recommended to study the prevalence of beta thalassemia gene in Newar ethnicity as well.

Journal of Hypertension

Objectives: Diabetes mellitus is the main threat for atherosclerosis and inflammation in the bloo... more Objectives: Diabetes mellitus is the main threat for atherosclerosis and inflammation in the blood vessels plays detrimental effect in the process of atherosclerosis. Regular monitoring and evaluation of inflammatory markers is essential particularly in diabetic patients. However measurements of inflammatory markers are big financial burden especially in poor patients and laboratories of rural area of developing country. Methods: Descriptive cross-sectional study was conducted in the Department of Clinical Biochemistry Laboratory of Dhulikhel Hospital. All the known cases of diabetes with or without hypertension were included along with age and sex matched healthy subjects. Pre-structured questionnaire for sociodemographics status, anthropometric measurements and overnight fasting blood sample was collected for lipid profile and glucose tests. High sensitive C-reactive protein and HbA1c was measured by Nephelometery and High Performance Liquid Chromatography respectively and calculated cardiac risk ratio compared with inflammatory marker of atherosclerosis, hs-CRP. Results: 182 inclusion criteria matched diabetic patients were recruited, out of which 101 male and 81 were female with a mean age of 55.6 years. Out of all these patients 90.6% have some sorts of dyslipidemia. Calculated Cardiac risk ratio was found between 6–8 in17.0% patients while 1.9% subjects had calculated cardiac risks was more than eight. Participants having calculated cardiac risk ratio above six have average hs-CRP level was 6.92 mg/L which is double than reference range. Conclusion: Total cholesterol to HDL cholesterol ratio is very simple and significant to predict atherosclerosis in diabetic patients and it is more prominent in diabetes with hypertension.

Journal of Hypertension, 2016

Objective: Workers in shoes making factories were exposed to diverse range of chemicals which are... more Objective: Workers in shoes making factories were exposed to diverse range of chemicals which are used in various manufacturing steps such as leather tanning, dyeing and finishing. Hazardous chemical substances mainly used as adhesives contain benzene, xylene, ethyl benzene and toluene, which are mainly exposed through inhalation and skin absorption. Prevalence of hypertension is well documented in most of the population and professionals but footwear factory workers have attracted less attention particularly in Nepal. This study aims to assess the hypertension and cardio vascular risk factors among footwear factory workers. Design and Method: A descriptive cross sectional study was conducted from August 2015 to February 2016 in randomly selected 209 aged 18–48 years subjects from five major shoe factories of Kathmandu valley. All subjects were interviewed with pre-structured questionnaire for family history, life style and dietary habit. Blood pressure was measured using standard calibrated tools. Fasting blood sample was collected for lipid profile [Total cholesterol (TC), High density Lipoprotein cholesterol (HDLc), Low density lipoprotein (LDLc), Triacylglycerol (TAG)], fasting blood glucose, and HbA1c. A recently introduced markers of plasma atherogenicity “Non HDL cholesterol [TC minus HDLc (NHc)], Risk ratio [TC/HDLc-(RR)] and Atherogenic index of plasma [log (TG/HDLc)-(AIP)”] was calculated from Lipid parameters to assess CVD risk. Results: The prevalence of hypertension was 33.49%, with smoking habit and alcohol consumption of 37% and 59% respectively. The average duration of work (exposure to the chemicals) was 4.2 ± 2.34 years. Age and exposure with chemicals directly correlated with the TC and NHc. AIP and Risk ratio projected that long term smoking and exposure to the chemicals are potential risk factors for hypertension and CVD. Conclusions: The result of this study clearly indicates that hypertension and risk factors of CVD are unnoticed challenge along with respiratory disease and skin disease in shoe factory workers of Kathmandu valley.

Journal of Hypertension, 2016

Objective: High blood pressure and Cigarette smoking are the major precipitating factors for the ... more Objective: High blood pressure and Cigarette smoking are the major precipitating factors for the cardiovascular events. The exact toxic components of cigarette smoke and the mechanisms involved in cigarette smoking related cardiovascular dysfunction are largely unknown. Various studies suggest that the coexistence of hypertension and smoking increases inflammation, thrombosis, oxidation of low-density lipoprotein cholesterol, oxidative stress and depletion of antioxidant. As oxidative stress is a potential mechanism for initiating cardiovascular dysfunction, this study was designed to compare the effect of smoking in biochemical parameters, non-enzymatic antioxidant status, lipid peroxidation product and lipid profile in Hypertensive smokers as compared to age-matched hypertensive non-smokers. Design and Method: This cross sectional study was conducted among 205 hypertensive subjects from September 2015 to February 2016. Hypertensive smokers (n = 100) of age 36.2 ± 9.94 years and age-matched hypertensive controls (35.2 ± 4.73 years, n = 105) were interviewed with structured questionnaire. Serum vitamin E, vitamin C, albumin, bilirubin, uric acid, were measured by standard methods. Lipid profile [Total Cholesterol(TC), HDL cholesterol(HDLc), LDL cholesterol (LDLc) and Triacylglycerol(TAG) were measured and recently introduced predictive markers of plasma atherogenicity-“Risk ratio [TC/HDLc(RR)], Non HDL cholesterol[TC minus HDLc(NHC)] and Atherogenic index of plasma [log TAG/HDLc(AIP) were calculated]”. Serum malondialdehyde(MDA) level was estimated as a measure of lipid peroxidation. Results: After adjusting the effect of age, dietary habit, alcohol consumption, blood glucose and duration of hypertension-Vitamin C, Vitamin E, and albumin were found to be decreased significantly and MDA level was increased significantly among hypertensive smokers as compared to hypertensive nonsmokers with p ⩽ 0.005. Vitamin C and vitamin E showed inverse correlation with MDA, whereas MDA showed direct and significant positive correlation with TC, LDLc, RR, NHC and AIP. Conclusions: These findings suggest that smoking induces oxidative stress, depleted antioxidants activities and subsequent alteration in circulating lipids in hypertension. Thus hypertensive smokers are more likely to develop severe forms of hypertension and Cardiovascular disease.

Annals of Clinical Chemistry and Laboratory Medicine, 2015

International journal of physiology, …, 2010

The present study investigated the effects of antioxidant vitamins along with atorvastatin and at... more The present study investigated the effects of antioxidant vitamins along with atorvastatin and atorvastatinniacin combination on diet-induced hypercholesterolemia in rats. High cholesterol diet produced a significant increase in the serum total cholesterol, LDL-C, VLDL-C, TG, atherogenic index and decrease in HDL-C and HDL/LDL ratio. The lipid peroxidation and oxidative stress were significantly high in the hyperlipidemic control group. Atorvastatin improved atherogenic index but not the HDL/LDL ratio whereas atorvastatin-niacin combination improved both atherogenic index and HDL/LDL ratio. However, both atorvastatin and atorvastatin-niacin did not affect antioxidant status significantly. Co-administration of vitamin-E and vitamin-C along with atorvastatin and atorvastatin-niacin have improved serum lipid profile, prevented lipid peroxidation and improved antioxidant status. Addition of β-carotene along with lipid lowering drugs did not show additional benefits on serum lipid profile, lipid peroxidation and antioxidant status. Atorvastatin, atorvastatin-niacin combination when added with anti-oxidant vitamins, increased reduced glutathione level but did not affect MDA level, SOD and catalase activity in the liver tissue. Administration of both vitamin-E and vitamin-C along with atorvastatin-niacin therapy produced a significant improvement in the lipid profile as well as antioxidant status. Addition of β-carotene along with atorvastatin-niacin-vitamin-E-vitamin-C combination improved lipid profile but improvement was not as marked as observed with atorvastatin-niacin-vitamin-E-vitamin-C combination. The same beneficial effects of atorvastatin-niacin combination on lipid profile were not observed when it was combined with anti-oxidant vitamins especially β-carotene. The pro-oxidant role of β-carotene may be responsible for this effect

Annals of Clinical Chemistry and Laboratory Medicine, 2015

Beta thalassemia trait is a heterogeneous autosomal recessive form of beta thalassemia. Individua... more Beta thalassemia trait is a heterogeneous autosomal recessive form of beta thalassemia. Individual with beta thalassemia are clinically asymptomatic. Here we have described a case that has been incidentally diagnosed as beta thalassemia trait. A 31 year old male form Newar Community came to hospital for routine health checkup was send for hematological investigation. On examination , his red cell morphology was found to be microcytic hypochromic and his hemoglobin concentration was mildly decrease. His other parameters was evaluated and requested for analysis of iron profile and hemoglobin electrophoresis. Iron profile test was normal. Hemoglobin electrophoresis showed prominent band in HbA2 region. Presence of HbA2 band was confirmed by hemoglobin variant HPLC analysis. A diagnosis of heterozygous beta thalassemia trait was made. Prevalence of beta thalassemia gene in Tharu population was reported but its presence in other communities is still unknown therefore, it is recommended to study the prevalence of beta thalassemia gene in Newar ethnicity as well.

BACKGROUND Participation in External Quality Assessment (EQA) program with practice of Internal Q... more BACKGROUND Participation in External Quality Assessment (EQA) program with practice of Internal Quality Control (IQC) is the excellent indicator of good laboratory practice (GLP) to assure quality services. EQA/proficiency testing is an essential component of Quality Assurance to assess the analytical performance compared within same methods of other laboratories. It is also important to detect equipments failure, identifying reagent problems, reviewing staff training as well as to initiate and evaluate corrective action timely.

BACKGROUND Participation in External Quality Assessment (EQA) program with practice of Internal Q... more BACKGROUND Participation in External Quality Assessment (EQA) program with practice of Internal Quality Control (IQC) is the excellent indicator of good laboratory practice (GLP) to assure quality services. EQA/proficiency testing is an essential component of Quality Assurance to assess the analytical performance compared within same methods of other laboratories. It is also important to detect equipments failure, identifying reagent problems, reviewing staff training as well as to initiate and evaluate corrective action timely.

Introduction: Vitamin D, a steroid vitamin, has attracted noticeable interest of clinicians and r... more Introduction: Vitamin D, a steroid vitamin, has attracted noticeable interest of clinicians and researchers for decades because of its diverse array of biological functions. Various studies have shown that the level of vitamin D is low in significant proportion of healthy individuals. However, indoor workers especially health care professionals are not focused, particularly in Nepal. We aimed to measure level of vitamin D in apparently healthy health care professionals. Methods: A descriptive cross-sectional study was carried out in apparently healthy health care professionals working at Kathmandu University Hospital in Dhulikhel, Nepal. Structured questionnaire including socio-demographics, dietary habits, and anthropometric measurements was filled in by the participants. Total serum 25-hydroxy vitamin D was measured by Chemiluminescence Immunoassay (CLIA) technique. Results were analyzed with t-test, Chi-square test, and Pearson correlation test. Results: Data from 64 female and 47 male were analyzed, mean 25-hydroxy vitamin D level was 8.81 ng/dl (SD = 4). Almost all (98.2%, n = 109) participants had vitamin D lower than normal where 72.7% (n = 92) were deficient, 24.5% (n = 17) were insufficient, and only 2.7% (n = 2) were having adequate level. Non-specific body pain was the only factor among all we studied that was significantly associated with vitamin D levels (p = 0.002). Conclusion: Hypovitaminosis of 25-hydroxy vitamin D was found to be very common (98.2%) in apparently healthy health care subjects of Dhulikhel Hospital. This may necessitate further research to redefine the biological reference value for our population.

BACKGROUND: A characteristic pattern, termed dyslipidemia, consists of deranged of any single com... more BACKGROUND: A characteristic pattern, termed
dyslipidemia, consists of deranged of any single
components of lipid profile test. This pattern is most
frequently seen in diabetes and may be a preventable
risk factor for subsequent cardiovascular disease. This
study determined the influence of type 2 diabetes
mellitus (T2DM) on lipid profile of diabetic patients
reporting in a tertiary hospital in Bhubaneswar, India.
METHODS: 50 confirmed T2DM patients and 50
non-diabetic control subjects were selected for the
study. Fasting and 2 hours post prandial blood
samples were collected from both study and control
patients. Fasting blood sample was analyzed for lipid
profile test and serum glucose, and post prandial
sample was analyzed for serum glucose only.
RESULTS: Sixty two (62%) of diabetic patients were
males whilst thirty eight (38%) were females in this
study. The mean plasma glucose levels, Total
cholesterol and Triacylglycerol were significantly
raised in the diabetics as compared to those in the
control subjects. This is substantiated by the fact that
the entire lipid fractions are disturbed in diabetics as
compared to healthy controls.
CONCLUSION: Thus dyslipidemia was quite
common in diabetes and Hypertriglyceridemia was the
most common one.

Annals of Clinical Chemistry and Laboratory Medicine, 2015

BACKGROUND: A characteristic pattern, termed dyslipidemia, consists of deranged of any single com... more BACKGROUND: A characteristic pattern, termed dyslipidemia, consists of deranged of any single components of lipid profile test. This pattern is most frequently seen in diabetes and may be a preventable risk factor for subsequent cardiovascular disease. This study determined the influence of type 2 diabetes mellitus (T2DM) on lipid profile of diabetic patients reporting in a tertiary hospital in Bhubaneswar, India. METHODS: 50 confirmed T2DM patients and 50 non-diabetic control subjects were selected for the study. Fasting and 2 hours post prandial blood samples were collected from both study and control patients. Fasting blood sample was analyzed for lipid profile test and serum glucose, and post prandial sample was analyzed for serum glucose only. RESULTS: Sixty two (62%) of diabetic patients were males whilst thirty eight (38%) were females in this study. The mean plasma glucose levels, Total cholesterol and Triacylglycerol were significantly raised in the diabetics as compared to...

Journal of Lumbini Medical College, Feb 21, 2018

Introduction: Vitamin D, a steroid vitamin, has attracted noticeable interest of clinicians and r... more Introduction: Vitamin D, a steroid vitamin, has attracted noticeable interest of clinicians and researchers for decades because of its diverse array of biological functions. Various studies have shown that the level of vitamin D is low in significant proportion of healthy individuals. However, indoor workers especially health care professionals are not focused, particularly in Nepal. We aimed to measure level of vitamin D in apparently healthy health care professionals. Methods: A descriptive cross-sectional study was carried out in apparently healthy health care professionals working at Kathmandu University Hospital in Dhulikhel, Nepal. Structured questionnaire including socio-demographics, dietary habits, and anthropometric measurements was filled in by the participants. Total serum 25-hydroxy vitamin D was measured by Chemiluminescence Immunoassay (CLIA) technique. Results were analyzed with t-test, Chisquare test, and Pearson correlation test. Results: Data from 64 female and 47 male were analyzed, mean 25-hydroxy vitamin D level was 8.81 ng/dl (SD = 4). Almost all (98.2%, n = 109) participants had vitamin D lower than normal where 72.7% (n = 92) were deficient, 24.5% (n = 17) were insufficient, and only 2.7% (n = 2) were having adequate level. Non-specific body pain was the only factor among all we studied that was significantly associated with vitamin D levels (p = 0.002). Conclusion: Hypovitaminosis of 25-hydroxy vitamin D was found to be very common (98.2%) in apparently healthy health care subjects of Dhulikhel Hospital. This may necessitate further research to redefine the biological reference value for our population.

Background Cardiovascular diseases (CVDs) are the leading cause of deaths and disability in Nepal... more Background Cardiovascular diseases (CVDs) are the leading cause of deaths and disability in Nepal. Health systems can improve CVD health outcomes even in resource-limited settings by directing efforts to meet critical system gaps. This study aimed to identify Nepal’s health systems gaps to prevent and manage CVDs. Methods We formed a task force composed of the government and non-government representatives and assessed health system performance across six building blocks: governance, service delivery, human resources, medical products, information system, and financing in terms of equity, access, coverage, efficiency, quality, safety and sustainability. We reviewed 125 national health policies, plans, strategies, guidelines, reports and websites and conducted 52 key informant interviews. We grouped notes from desk review and transcripts’ codes into equity, access, coverage, efficiency, quality, safety and sustainability of the health system. Results National health insurance covers l...

EJIFCC, 2019

Background The turnaround time (TAT) as defined by most of the laboratories is the time interval ... more Background The turnaround time (TAT) as defined by most of the laboratories is the time interval between the specimens received in the laboratory to the time of reports dispatched with verification. Nearly 80% of hospital-attached clinical laboratories receive complaints about delayed TAT. Reporting in time is a crucial indicator of quality services along with accurate, precise and reliable reports, thus each clinical laboratory should identify affecting factors to eliminate them for the enhancement of quality services. Methodology Dhulikhel Hospital-Kathmandu University Hospital is a tertiary care hospital, where this observational descriptive study was conducted in 2017. Requested tests received on database in the Department of Clinical Biochemistry Laboratory along with test requisition form (TRF) were carefully screened for any possible error. When analysis of individual patient’s tests was completed, results of individual parameters were entered in the database manually. TAT wa...

Birat Journal of Health Sciences

Introduction: Non-alcoholic fatty liver disease (NAFLD) is one of the most prominent causes of ch... more Introduction: Non-alcoholic fatty liver disease (NAFLD) is one of the most prominent causes of chronic liver disease. It is known that dyslipidemia in NAFLD patients may have more severe atherogenic potential with high triglyceride and low density lipoprotein (LDL) as well as less high density lipoprotein (HDL) level. Objective: To determine the atherogenic dyslipidemia and associated factors among patients with NAFLD, Visiting Tertiary Care Center Methodology: Prospective cross-sectional study was conducted at Dhulikhel Hospital-Kathmandu University Hospital (DH-KUH) from January, 2016 to December, 2016. All the patients (n= 973) diagnosed to have fatty liver during this study period were initially enrolled in this study. Patients were further asked to fill up the questioner. Out of total 973 cases, 169 patients were identified as NAFLD. Fasting blood sample and anthropometric measurements (BMI, WHR) were taken. After adjusting exclusion criteria, refusal to participate and dropout...

Annals of Clinical Chemistry and Laboratory Medicine

Beta thalassemia trait is a heterogeneous autosomal recessive form of beta thalassemia. Individua... more Beta thalassemia trait is a heterogeneous autosomal recessive form of beta thalassemia. Individual with beta thalassemia are clinically asymptomatic. Here we have described a case that has been incidentally diagnosed as beta thalassemia trait. A 31 year old male form Newar Community came to hospital for routine health checkup was send for hematological investigation. On examination, his red cell morphology was found to be microcytic hypochromic and his hemoglobin concentration was mildly decrease. His other parameters was evaluated and requested for analysis of iron profile and hemoglobin electrophoresis. Iron profile test was normal. Hemoglobin electrophoresis showed prominent band in HbA2 region. Presence of HbA2 band was confirmed by hemoglobin variant HPLC analysis. A diagnosis of heterozygous beta thalassemia trait was made. Prevalence of beta thalassemia gene in Tharu population was reported but its presence in other communities is still unknown therefore, it is recommended to study the prevalence of beta thalassemia gene in Newar ethnicity as well.

Journal of Hypertension

Objectives: Diabetes mellitus is the main threat for atherosclerosis and inflammation in the bloo... more Objectives: Diabetes mellitus is the main threat for atherosclerosis and inflammation in the blood vessels plays detrimental effect in the process of atherosclerosis. Regular monitoring and evaluation of inflammatory markers is essential particularly in diabetic patients. However measurements of inflammatory markers are big financial burden especially in poor patients and laboratories of rural area of developing country. Methods: Descriptive cross-sectional study was conducted in the Department of Clinical Biochemistry Laboratory of Dhulikhel Hospital. All the known cases of diabetes with or without hypertension were included along with age and sex matched healthy subjects. Pre-structured questionnaire for sociodemographics status, anthropometric measurements and overnight fasting blood sample was collected for lipid profile and glucose tests. High sensitive C-reactive protein and HbA1c was measured by Nephelometery and High Performance Liquid Chromatography respectively and calculated cardiac risk ratio compared with inflammatory marker of atherosclerosis, hs-CRP. Results: 182 inclusion criteria matched diabetic patients were recruited, out of which 101 male and 81 were female with a mean age of 55.6 years. Out of all these patients 90.6% have some sorts of dyslipidemia. Calculated Cardiac risk ratio was found between 6–8 in17.0% patients while 1.9% subjects had calculated cardiac risks was more than eight. Participants having calculated cardiac risk ratio above six have average hs-CRP level was 6.92 mg/L which is double than reference range. Conclusion: Total cholesterol to HDL cholesterol ratio is very simple and significant to predict atherosclerosis in diabetic patients and it is more prominent in diabetes with hypertension.

Journal of Hypertension, 2016

Objective: Workers in shoes making factories were exposed to diverse range of chemicals which are... more Objective: Workers in shoes making factories were exposed to diverse range of chemicals which are used in various manufacturing steps such as leather tanning, dyeing and finishing. Hazardous chemical substances mainly used as adhesives contain benzene, xylene, ethyl benzene and toluene, which are mainly exposed through inhalation and skin absorption. Prevalence of hypertension is well documented in most of the population and professionals but footwear factory workers have attracted less attention particularly in Nepal. This study aims to assess the hypertension and cardio vascular risk factors among footwear factory workers. Design and Method: A descriptive cross sectional study was conducted from August 2015 to February 2016 in randomly selected 209 aged 18–48 years subjects from five major shoe factories of Kathmandu valley. All subjects were interviewed with pre-structured questionnaire for family history, life style and dietary habit. Blood pressure was measured using standard calibrated tools. Fasting blood sample was collected for lipid profile [Total cholesterol (TC), High density Lipoprotein cholesterol (HDLc), Low density lipoprotein (LDLc), Triacylglycerol (TAG)], fasting blood glucose, and HbA1c. A recently introduced markers of plasma atherogenicity “Non HDL cholesterol [TC minus HDLc (NHc)], Risk ratio [TC/HDLc-(RR)] and Atherogenic index of plasma [log (TG/HDLc)-(AIP)”] was calculated from Lipid parameters to assess CVD risk. Results: The prevalence of hypertension was 33.49%, with smoking habit and alcohol consumption of 37% and 59% respectively. The average duration of work (exposure to the chemicals) was 4.2 ± 2.34 years. Age and exposure with chemicals directly correlated with the TC and NHc. AIP and Risk ratio projected that long term smoking and exposure to the chemicals are potential risk factors for hypertension and CVD. Conclusions: The result of this study clearly indicates that hypertension and risk factors of CVD are unnoticed challenge along with respiratory disease and skin disease in shoe factory workers of Kathmandu valley.

Journal of Hypertension, 2016

Objective: High blood pressure and Cigarette smoking are the major precipitating factors for the ... more Objective: High blood pressure and Cigarette smoking are the major precipitating factors for the cardiovascular events. The exact toxic components of cigarette smoke and the mechanisms involved in cigarette smoking related cardiovascular dysfunction are largely unknown. Various studies suggest that the coexistence of hypertension and smoking increases inflammation, thrombosis, oxidation of low-density lipoprotein cholesterol, oxidative stress and depletion of antioxidant. As oxidative stress is a potential mechanism for initiating cardiovascular dysfunction, this study was designed to compare the effect of smoking in biochemical parameters, non-enzymatic antioxidant status, lipid peroxidation product and lipid profile in Hypertensive smokers as compared to age-matched hypertensive non-smokers. Design and Method: This cross sectional study was conducted among 205 hypertensive subjects from September 2015 to February 2016. Hypertensive smokers (n = 100) of age 36.2 ± 9.94 years and age-matched hypertensive controls (35.2 ± 4.73 years, n = 105) were interviewed with structured questionnaire. Serum vitamin E, vitamin C, albumin, bilirubin, uric acid, were measured by standard methods. Lipid profile [Total Cholesterol(TC), HDL cholesterol(HDLc), LDL cholesterol (LDLc) and Triacylglycerol(TAG) were measured and recently introduced predictive markers of plasma atherogenicity-“Risk ratio [TC/HDLc(RR)], Non HDL cholesterol[TC minus HDLc(NHC)] and Atherogenic index of plasma [log TAG/HDLc(AIP) were calculated]”. Serum malondialdehyde(MDA) level was estimated as a measure of lipid peroxidation. Results: After adjusting the effect of age, dietary habit, alcohol consumption, blood glucose and duration of hypertension-Vitamin C, Vitamin E, and albumin were found to be decreased significantly and MDA level was increased significantly among hypertensive smokers as compared to hypertensive nonsmokers with p ⩽ 0.005. Vitamin C and vitamin E showed inverse correlation with MDA, whereas MDA showed direct and significant positive correlation with TC, LDLc, RR, NHC and AIP. Conclusions: These findings suggest that smoking induces oxidative stress, depleted antioxidants activities and subsequent alteration in circulating lipids in hypertension. Thus hypertensive smokers are more likely to develop severe forms of hypertension and Cardiovascular disease.

Annals of Clinical Chemistry and Laboratory Medicine, 2015

International journal of physiology, …, 2010

The present study investigated the effects of antioxidant vitamins along with atorvastatin and at... more The present study investigated the effects of antioxidant vitamins along with atorvastatin and atorvastatinniacin combination on diet-induced hypercholesterolemia in rats. High cholesterol diet produced a significant increase in the serum total cholesterol, LDL-C, VLDL-C, TG, atherogenic index and decrease in HDL-C and HDL/LDL ratio. The lipid peroxidation and oxidative stress were significantly high in the hyperlipidemic control group. Atorvastatin improved atherogenic index but not the HDL/LDL ratio whereas atorvastatin-niacin combination improved both atherogenic index and HDL/LDL ratio. However, both atorvastatin and atorvastatin-niacin did not affect antioxidant status significantly. Co-administration of vitamin-E and vitamin-C along with atorvastatin and atorvastatin-niacin have improved serum lipid profile, prevented lipid peroxidation and improved antioxidant status. Addition of β-carotene along with lipid lowering drugs did not show additional benefits on serum lipid profile, lipid peroxidation and antioxidant status. Atorvastatin, atorvastatin-niacin combination when added with anti-oxidant vitamins, increased reduced glutathione level but did not affect MDA level, SOD and catalase activity in the liver tissue. Administration of both vitamin-E and vitamin-C along with atorvastatin-niacin therapy produced a significant improvement in the lipid profile as well as antioxidant status. Addition of β-carotene along with atorvastatin-niacin-vitamin-E-vitamin-C combination improved lipid profile but improvement was not as marked as observed with atorvastatin-niacin-vitamin-E-vitamin-C combination. The same beneficial effects of atorvastatin-niacin combination on lipid profile were not observed when it was combined with anti-oxidant vitamins especially β-carotene. The pro-oxidant role of β-carotene may be responsible for this effect

Annals of Clinical Chemistry and Laboratory Medicine, 2015

Beta thalassemia trait is a heterogeneous autosomal recessive form of beta thalassemia. Individua... more Beta thalassemia trait is a heterogeneous autosomal recessive form of beta thalassemia. Individual with beta thalassemia are clinically asymptomatic. Here we have described a case that has been incidentally diagnosed as beta thalassemia trait. A 31 year old male form Newar Community came to hospital for routine health checkup was send for hematological investigation. On examination , his red cell morphology was found to be microcytic hypochromic and his hemoglobin concentration was mildly decrease. His other parameters was evaluated and requested for analysis of iron profile and hemoglobin electrophoresis. Iron profile test was normal. Hemoglobin electrophoresis showed prominent band in HbA2 region. Presence of HbA2 band was confirmed by hemoglobin variant HPLC analysis. A diagnosis of heterozygous beta thalassemia trait was made. Prevalence of beta thalassemia gene in Tharu population was reported but its presence in other communities is still unknown therefore, it is recommended to study the prevalence of beta thalassemia gene in Newar ethnicity as well.

BACKGROUND Participation in External Quality Assessment (EQA) program with practice of Internal Q... more BACKGROUND Participation in External Quality Assessment (EQA) program with practice of Internal Quality Control (IQC) is the excellent indicator of good laboratory practice (GLP) to assure quality services. EQA/proficiency testing is an essential component of Quality Assurance to assess the analytical performance compared within same methods of other laboratories. It is also important to detect equipments failure, identifying reagent problems, reviewing staff training as well as to initiate and evaluate corrective action timely.

BACKGROUND Participation in External Quality Assessment (EQA) program with practice of Internal Q... more BACKGROUND Participation in External Quality Assessment (EQA) program with practice of Internal Quality Control (IQC) is the excellent indicator of good laboratory practice (GLP) to assure quality services. EQA/proficiency testing is an essential component of Quality Assurance to assess the analytical performance compared within same methods of other laboratories. It is also important to detect equipments failure, identifying reagent problems, reviewing staff training as well as to initiate and evaluate corrective action timely.

Introduction: Vitamin D, a steroid vitamin, has attracted noticeable interest of clinicians and r... more Introduction: Vitamin D, a steroid vitamin, has attracted noticeable interest of clinicians and researchers for decades because of its diverse array of biological functions. Various studies have shown that the level of vitamin D is low in significant proportion of healthy individuals. However, indoor workers especially health care professionals are not focused, particularly in Nepal. We aimed to measure level of vitamin D in apparently healthy health care professionals. Methods: A descriptive cross-sectional study was carried out in apparently healthy health care professionals working at Kathmandu University Hospital in Dhulikhel, Nepal. Structured questionnaire including socio-demographics, dietary habits, and anthropometric measurements was filled in by the participants. Total serum 25-hydroxy vitamin D was measured by Chemiluminescence Immunoassay (CLIA) technique. Results were analyzed with t-test, Chi-square test, and Pearson correlation test. Results: Data from 64 female and 47 male were analyzed, mean 25-hydroxy vitamin D level was 8.81 ng/dl (SD = 4). Almost all (98.2%, n = 109) participants had vitamin D lower than normal where 72.7% (n = 92) were deficient, 24.5% (n = 17) were insufficient, and only 2.7% (n = 2) were having adequate level. Non-specific body pain was the only factor among all we studied that was significantly associated with vitamin D levels (p = 0.002). Conclusion: Hypovitaminosis of 25-hydroxy vitamin D was found to be very common (98.2%) in apparently healthy health care subjects of Dhulikhel Hospital. This may necessitate further research to redefine the biological reference value for our population.

BACKGROUND: A characteristic pattern, termed dyslipidemia, consists of deranged of any single com... more BACKGROUND: A characteristic pattern, termed
dyslipidemia, consists of deranged of any single
components of lipid profile test. This pattern is most
frequently seen in diabetes and may be a preventable
risk factor for subsequent cardiovascular disease. This
study determined the influence of type 2 diabetes
mellitus (T2DM) on lipid profile of diabetic patients
reporting in a tertiary hospital in Bhubaneswar, India.
METHODS: 50 confirmed T2DM patients and 50
non-diabetic control subjects were selected for the
study. Fasting and 2 hours post prandial blood
samples were collected from both study and control
patients. Fasting blood sample was analyzed for lipid
profile test and serum glucose, and post prandial
sample was analyzed for serum glucose only.
RESULTS: Sixty two (62%) of diabetic patients were
males whilst thirty eight (38%) were females in this
study. The mean plasma glucose levels, Total
cholesterol and Triacylglycerol were significantly
raised in the diabetics as compared to those in the
control subjects. This is substantiated by the fact that
the entire lipid fractions are disturbed in diabetics as
compared to healthy controls.
CONCLUSION: Thus dyslipidemia was quite
common in diabetes and Hypertriglyceridemia was the
most common one.