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  • 1
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    Non-Thyroidal Illness Syndrome: A Pattern of Thyroid Dysfunction Seen in Intensive Care Unit Patients of a Tertiary Care Centre
    Nepal Journals Online (JOL) ; 2022
    In:  Med Phoenix Vol. 7, No. 1 ( 2022-08-19), p. 51-56
    Details
    In: Med Phoenix, Nepal Journals Online (JOL), Vol. 7, No. 1 ( 2022-08-19), p. 51-56
    Abstract: Introduction: The response to the endocrine mechanism including thyroid gland hormones to critical illness is a complex phenomenon.1 There is a marked and distinct changes in the levels of thyroid hormones in critical illness.2 The magnitude of the decrease in circulating tri-iodothyronine (fT3) levels (also known as non-thyroidal illness) during the first 24 hour after the onset of acute illness reflects the severity of illness and correlates with mortality. The study aims to evaluate the thyroid function test (TFT) of critically ill patients. The results of the study will be helpful in determining the thyroid picture of the critically ill patients in our setting and definitely help in assessing the outcome of the patient admitted in ICU or ward. Materials and Methods: This is a hospital based cross sectional study. A total of 150 cases with the critical illness assessed as per Acute Physiology and Chronic Health Evaluation II (APACHE II) score were enrolled in the study from 12th December 2021 to 15th June, 2022. Informed written consent and ethical approval were taken. Results: The majority of the cases (52%) were of geriatric age group with the mean age of 57 years. Majority of the study participants (42%) in APACHE II were from 20–24 across all participants, and both sexes. Fifty‑one percent of the patients had reduced fT3 levels. There was an increase in percentage of patients with decreased fT3 levels with increasing APACHE II score, compared to normal fT3 levels at similar APACHE II score and the distribution was found to be statistically significant (p = 0.0233). Of the 68 patients expired, 52 of them had low fT3 levels whereas only 16 cases expired were with the normal fT3 level, making it a strong predictor of severity and outcome. Conclusion: Decrease in the levels of fT3, a condition of non-thyroidal illness, is a crucial prognostic indicator in critically ill patients which in coordination APACHE Score II can be helpful in clinical settings to predict the severity and outcome of such patients.
    Type of Medium: Online Resource
    ISSN: 2631-1992 , 2392-425X
    URL: Article
    DOI: 10.3126/medphoenix.v7i1.47404
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2022
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  • 2
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    Study of Hemoglobin and Calcium Phosphorus Product in Patients with Chronic Kidney Disease
    Nepal Journals Online (JOL) ; 2023
    In:  Med Phoenix Vol. 8, No. 1 ( 2023-07-30), p. 74-78
    Details
    In: Med Phoenix, Nepal Journals Online (JOL), Vol. 8, No. 1 ( 2023-07-30), p. 74-78
    Abstract: Introduction: Kidneys play a vital role in the metabolism of minerals such as calcium and phosphorous. Moreover, kidney is involved in the production of erythropoietin hormone.The bone marrow suppression may occur in Chronic Kidney Disease (CKD) patients. Reduced hemoglobin and increased calcium phosphorous product concentration is also common in CKD patients.The current study is aimed to find out the impact of CKD in calcium phosphorous product and hemoglobin level in Nepalese population. Materials And Methods: One hundred consecutive diagnosed cases of CKDpatients were enrolled retrospectively for the study. Calcium, phosphorous, urea, creatinine and other biochemical parameters were measured in fully automated biochemistry analyzer and hemoglobin was measured using hematology analyzer (Beckman Coulter DxH500 Automated Hematology analyzer). Results: The current study revealed the hemoglobin and calcium phosphorous product in CKD patients.The Calcium Phosphorous Product (CaP) of 69 subjects were having less than 〈 40mg2/dL2 and remaining 31 were having ≥ 40mg2/dL2. The negative correlation of calcium phosphorous product was seen with calcium (r= -0.478, p-value = 0.000) and sodium (r=-0.309, p-value=0.002) whereas positive correlation of calcium phosphorous product was seen with urea (r= 0.559, p-value=0.000) andCreatinine (r=0.353, p-value = 0.000). The creatinine was negatively correlated with the hemoglobin concentration (r= -0.320, p-value = 0.001). Conclusion: Calcium phosphate product can be fluctuated in chronic kidney disease patients along with the decrement of hemoglobin concentration. The serum calcium phosphorous product measurement can assist to rule out the severity of chronic kidney disease.
    Type of Medium: Online Resource
    ISSN: 2631-1992 , 2392-425X
    URL: Article
    DOI: 10.3126/medphoenix.v8i1.56928
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2023
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  • 3
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    Hematological Profiles in Hemoglobinopathy Patients in South Western Nepal
    Nepal Journals Online (JOL) ; 2020
    In:  Journal of Universal College of Medical Sciences Vol. 8, No. 1 ( 2020-07-02), p. 27-32
    Details
    In: Journal of Universal College of Medical Sciences, Nepal Journals Online (JOL), Vol. 8, No. 1 ( 2020-07-02), p. 27-32
    Abstract: INTRODUCTION: Homozygous inheritance of the hemoglobin results in sickle cell anemia (SCA), heterozygous inheritance results in sickle cell trait (SCT). Sickle cell anemia and β-thalasemia (β-TT) have been a major health threat for the tharu living in the South-Western Terai of  Nepal. This study is carried out to apply and optimise the phenotypic method and haematological profile to characterise the SCT, SCA and β-TT from suspected tharu community dwellers. MATERIAL AND METHODS: We enrolled 100 suspected cases of hemoglobinopathies of 12-14 years children and ≥15 years adults tharu community dwellers from Dang, Kapilvastu, Nepalgunj, Rupandehi and Nawalparasi of South-Western Nepal from May 2018 to November 2018. Five mililitre of blood was collected in EDTA vial and transported to the laboratory maintaining cold chain. The hematological profile was recorded after investigations. The hemolysate from blood samples were subjected to phenotypic testing by adopting cellulose acetate electrophoresis at pH 8.6. RESULTS: Our result showed the commonest hemoglobinopathy was SCT (38%) followed by β-TT (21%) and SCA (5%). Males were more affected with SCA (60%) while that of females were most affected with β-TT (57.1%). Only 44.7% females were affected with SCT while 42.9% males were affected with β-TT. The significant difference in mean was observed in Hb level (p=0.0001), RBC (p=0.004), MCHC (p=0.015) and RDW (p=0.028) whereas the non-significant difference in mean was observed for glucose 6 phosphate dehydrogenase (G6PD) level (p=0.063) in hemoglobinopathy patients. CONCLUSION: Most cases develop severe type of anemia as shown by change in hematological parameters. This information could advocate for timely counselling before constellation of associated condition appeared in hemoglobinopathy patients.
    Type of Medium: Online Resource
    ISSN: 2350-8582 , 2091-2846
    URL: Article
    DOI: 10.3126/jucms.v8i1.29813
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2020
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  • 4
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    Association of Thyroid Profile and Prolactin Level in patient with Secondary Amenorrhea
    Penerbit Universiti Sains Malaysia ; 2016
    In:  Malaysian Journal of Medical Sciences Vol. 23, No. 5 ( 2016), p. 51-56
    Details
    In: Malaysian Journal of Medical Sciences, Penerbit Universiti Sains Malaysia, Vol. 23, No. 5 ( 2016), p. 51-56
    Type of Medium: Online Resource
    ISSN: 1394-195X , 2180-4303
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.21315/mjms2016.23.5
    DOI: 10.21315/mjms
    DOI: 10.21315/mjms2016.23.5.7
    Language: Unknown
    Publisher: Penerbit Universiti Sains Malaysia
    Publication Date: 2016
    detail.hit.zdb_id: 2197205-9
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  • 5
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    Thyroid Peroxidase Autoantibody in Subclinical and Overt Hypothyroidism: A Hospital Based Retrospective Study
    Nepal Journals Online (JOL) ; 2023
    In:  Med Phoenix Vol. 7, No. 2 ( 2023-01-06), p. 34-38
    Details
    In: Med Phoenix, Nepal Journals Online (JOL), Vol. 7, No. 2 ( 2023-01-06), p. 34-38
    Abstract: Introduction:Thyroid peroxidase (TPO) is a key enzyme of thyroid hormone biosynthesis as it catalyzes the iodination and the coupling steps. Subclinical hypothyroidism is the condition of increased Thyroid Stimulating Hormone (TSH) and normal levels of serum free thyroxine (ft4) and free triiodothyronine (ft3) levels. Subclinical hypothyroidism can be progressed to overt hypothyroidism in which ft3 and ft4 levels are decreased along with an increment of TSH levels. Materials and methods: This was the hospital-based retrospective study conducted on the patients who had undergone thyroid function test measurements along with thyroid peroxidase autoantibody level in serum. The study duration was eight months (January 2022 to August 2022). All the data were entered in Microsoft Excel version 10 and analyzed in SPSS version 22 accordingly. Results: In the study among 424 patients, 73.8% were female and 26.2% were male. Firstly, our study revealed subclinical hypothyroidism was predominant (41.7%), followed by euthyroidism (34.7%) overt hypothyroidism (20.3%), and overt hyperthyroidism (3.3%). Secondly, there was no statistically significant difference in age (P value: 0.26) and gender (0.64) between subclinical and overt hypothyroidism. There was no statistically significant difference in serum anti-TPO antibodies level between subclinical (median 6.25) and overt hypothyroidism (median 6.12) (P value: 0.92) when median and interquartile ranges were compared. Correlation analysis revealed a significant positive correlation of TPO antibodies with TSH (0.27, 0.00) and no significant negative correlation with fT4 (-0.02, 0.46) and fT3 (-0.05, 0.37). Conclusion: The current study revealed the elevation of thyroid peroxidase autoantibodies in both subclinical and overt hypothyroid patients though subclinical hypothyroidism was predominant.
    Type of Medium: Online Resource
    ISSN: 2631-1992 , 2392-425X
    URL: Article
    DOI: 10.3126/medphoenix.v7i2.49408
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2023
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  • 6
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    Prevalence of Metabolic Syndrome in Patients with Subclinical and Overt Hypothyroidism Visiting Tertiary Care Centre of Western Nepal
    Nepal Journals Online (JOL) ; 2020
    In:  Journal of Universal College of Medical Sciences Vol. 8, No. 1 ( 2020-07-02), p. 33-37
    Details
    In: Journal of Universal College of Medical Sciences, Nepal Journals Online (JOL), Vol. 8, No. 1 ( 2020-07-02), p. 33-37
    Abstract: INTRODUCTION: Hypothyroidism is a syndrome resulting from thyroid hormone deficiency. Metabolic syndrome (MetS) is a cluster of metabolic abnormalities is associated with increased risk for atherosclerotic cardiovascular disease (CVS) and type 2 diabetes mellitus. Thyroid hormones are major regulatory hormones that control the rate of metabolic function; thus, alteration in the levels of these hormones may be associated with MetS. The objective of our study was to find out the prevalence of MetS in subclinical and overt hypothyroidism. MATERIAL AND METHODS: A hospital-based cross sectional study was conducted at Universal College of Medical Sciences Teaching Hospital (UCMS-TH) Bhairahawa from March to September 2019. A total of 222 hypothyroid patients were enrolled in this study. MetS was diagnosed by National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III; 2005) revision criteria. The anthropometric indices were recorded. fT3, fT4  and TSH were measured by chemiluminescence immunoassay (CLIA) method and other biochemical parameters were estimated by colorimetric method. Data were analyzed by using SPSS 16.0. RESULTS: Patients were aged between 10 and 60 years, with a mean age of 38.89 years. The prevalence of MetS was 44.1% of which 80.6% were females. Furthermore, the prevalence of MetS was found to be 43.7% in subclinical hypothyroidism and 46.6% in overt hypothyroidism. CONCLUSION: The prevalence of MetS is high in both overt and subclinical hypothyroidism. Screening for MetS in patients with hypothyroidism can reduce the risk for CVD, as well as the mortality rate and mortality associated with it.
    Type of Medium: Online Resource
    ISSN: 2350-8582 , 2091-2846
    URL: Article
    DOI: 10.3126/jucms.v8i1.29822
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2020
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  • 7
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    Estimation of Serum Vitamin D2, Growth Hormone, Alkaline Phosphatase and Calcium Phosphate Product in Patients with End Stage Renal Disease
    Nepal Journals Online (JOL) ; 2021
    In:  Journal of Universal College of Medical Sciences Vol. 9, No. 01 ( 2021-06-22), p. 61-65
    Details
    In: Journal of Universal College of Medical Sciences, Nepal Journals Online (JOL), Vol. 9, No. 01 ( 2021-06-22), p. 61-65
    Abstract: INTRODUCTION The chronic kidney disease (CKD) patient's calcium phosphate product, alkaline phosphatase (ALP), vitamin-D2  and human growth hormone (hGH) are altered under haemodialysis. This study aimed to evaluate these biochemical variables in conjunction with haemoglobin and blood pressure to find out their association in End Stage Renal Disease (ESRD) patients. MATERIAL AND METHODS This cross-sectional study comprised of 104 patients with ESRD undergoing haemodialysis. The estimated glomerular filtration rate (eGFR) was calculated by Cockcroft-Gault (CG) equation and calcium, phosphorus, ALP were measured by fully automated analyzer whereas vitamin-D2  and hGH were measured by sandwich and competitive enzyme linked immune sorbent assay (ELISA) techniques. RESULTS The mean age of patients was 53.12 ±16.37 years comprising 68% male. The hypovitaminosis D was 57.7% deficiency and 23.1% insufficiency states whereas hGH insufficiency was 22.1%. The calcium phosphate product was found to be increased in only 39.9% cases. The increased ALP level was observed in 64.4% cases. There was statistically significant association between hGH and Hb status (p=0.03). The significant difference in mean sodium and Ca×P of ESRD cases was observed with hypertension status (p=0.03 and p=0.01) respectively. Moreover, the significant difference in mean eGFR and hGH was observed with haemoglobin status (p=0.0001and p=0.01) respectively. CONCLUSION Increased level of ALP and hypovitaminosis-D was very common in ESRD patients undergoing dialysis with less prevalence of hGH insufficiency and calcium phosphate product increment. The anaemia and hypertension status can be pre-existing condition with ESRD which are cumbersome to control if not monitor in these patients.
    Type of Medium: Online Resource
    ISSN: 2350-8582 , 2091-2846
    URL: Article
    DOI: 10.3126/jucms.v9i01.37979
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2021
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  • 8
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    Status of Serum Vitamin B12 in Type 2 Diabetes Mellitus Patients under Metformin Therapy
    Nepal Journals Online (JOL) ; 2022
    In:  Nepal Journal of Health Sciences Vol. 2, No. 2 ( 2022-12-31), p. 9-14
    Details
    In: Nepal Journal of Health Sciences, Nepal Journals Online (JOL), Vol. 2, No. 2 ( 2022-12-31), p. 9-14
    Abstract: Introduction: Type 2 diabetes mellitus, a prevalent global health problem, is a major cause of morbidity and mortality. Metformin, the most widely used hypoglycemic agent can lead to a deficiency of vitamin B12. Very less information is available regarding the relationship between metformin therapy and vitamin B12 deficiency in the Nepalese population. Objectives: The study aims to evaluate the level of vitamin B12 in cases of diabetes mellitus under metformin therapy and to access the relationship of serum vitamin B12 level with the duration of metformin therapy. Methods: A hospital-based cross-sectional study with 300 diagnosed diabetes mellitus cases under metformin therapy were enrolled in the study after the consent was taken. The prior ethical clearance was taken and the duration of the study was from December 2021 to June 2022. Results: The study showed 78% (n=234) of the total diabetic cases under metformin therapy had lower vitamin B12. In 50-60 years, age group, 91% of them were vitamin B12 deficient. Vitamin B12 deficient cases were more with the increase in duration and dose of metformin therapy. All the diabetics who were under medication for 16-20 years had lower vitamin levels. About 94% (n=200) of the diabetics taking more than 1000 mg/day were vitamin B12 deficient whereas only 39% (n=34) of diabetics taking less than 1000mg/day were found to be deficient. Conclusions: Vitamin B12 is deficient in diabetics under long-term and higher doses of metformin therapy. Diabetic patients who are undergoing metformin treatment should monitor their vitamin B12 status as they are more prone to vitamin B12 deficiency.
    Type of Medium: Online Resource
    ISSN: 2795-1812 , 2795-1618
    URL: Article
    DOI: 10.3126/njhs.v2i2.56784
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2022
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  • 9
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    Association of Lipid Profile with fasting and Post Prandial Glucose Level in type 2 Diabetic Patients
    Nepal Journals Online (JOL) ; 2015
    In:  Journal of Universal College of Medical Sciences Vol. 3, No. 1 ( 2015-09-03), p. 2-5
    Details
    In: Journal of Universal College of Medical Sciences, Nepal Journals Online (JOL), Vol. 3, No. 1 ( 2015-09-03), p. 2-5
    Abstract: INTRODUCTION: The cardiovascular disease (CVD) is associated with diabetes mellitus and dyslipidemia plays important role in CVD. This paper explores the frequency and pattern of dyslipidemia in type 2 diabetes mellitus patients and that compared with healthy control. The correlation of glucose level with lipid profile including Non-HDL/HDL and TG/HDL has been projected in this study.MATERIAL AND METHODS: This case-control study includes 263 type 2 diabetes mellitus and compared with 55 healthy controls. The diagnosis of Diabetes mellitus was made according to the World Health Organization (WHO) criteria and the criteria for dyslipidemia was obtained by National Cholesterol Education Program Expert Panel/American Treatment Protocol III (NCEP/ATP III).RESULTS: Most common dyslipidemia was found in increase TG (49.42%) followed by decreased HDL (48.66%), increased LDL (40.30%) and increased TC (33.84%) respectively. The proportion is much higher in male than female. The statistically significant differences between control and case for glucose and lipid profile were observed in FBS (p 〈 0.001), PPBS (p 〈 0.001), HDL (p 〈 0.01), Non-HDL/HDL (p 〈 0.002) and TG/HDL (p 〈 0.039). TG, TC and LDL were statistically non- significant between control and case. The Pearson's correlation coefficient shows significant correlation of FBS and PPBS with TG (p 〈 0.01), Non-HDL/HDL (p 〈 0.01) and TG/HDL (p 〈 0.01) respectively.CONCLUSION: Our study has suggested the dyslipidemia is associated with DM with increased TG, low HDL, high cholesterol and LDL. The increased Non-HDL/HDL and TG/HDL could be better indicator than single lipid abnormality which needs to be verified prospectively by including large population and controlsJournal of Universal College of Medical Sciences Vol. 3, No. 1, 2015: 2-5
    Type of Medium: Online Resource
    ISSN: 2350-8582 , 2091-2846
    URL: Article
    DOI: 10.3126/jucms.v3i1.13247
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2015
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  • 10
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    Serum Vitamin D and B12 Levels in Alcoholic Male Patients: A Cross-sectional Study
    Nepal Journals Online (JOL) ; 2021
    In:  Journal of Universal College of Medical Sciences Vol. 9, No. 01 ( 2021-06-22), p. 47-51
    Details
    In: Journal of Universal College of Medical Sciences, Nepal Journals Online (JOL), Vol. 9, No. 01 ( 2021-06-22), p. 47-51
    Abstract: INTRODUCTION Alcohol dependence is a global problem and is rapidly increasing in developing countries. We aimed to analyze the serum levels of vitamin B12 and vitamin D in chronic alcoholic patients and their association with parameters of liver function. MATERIAL AND METHODS A cross-sectional study was carried out in Universal College of Medical Sciences, Bhairahawa, Nepal from March 2020 to September 2020 on patients visiting the Psychiatric Out Patient Department (OPD) for the treatment of alcohol dependence. The patients were categorized as excessive and moderate drinkers. Serum vitamin B12, vitamin D, and hepatic function parameters were measured. RESULTS The median serum vitamin B12 and vitamin D levels were 467.8 pg/ml and 24.9 ng/ml respectively. Excessive drinkers had significantly higher B12   levels than moderate drinkers. Vitamin B12   levels correlated positively with liver function parameters, as well as alcohol amount and duration of consumption. Vitamin D levels were insufficient in 57 (71.25%) of the overall participants. CONCLUSION Serum levels of vitamin B12 are not affected in patients with alcohol dependence. Alcohol consumption, however, reduces serum concentrations of vitamin D. Vitamin B12  concentration is positively associated with liver enzymes and other parameters of liver function.  
    Type of Medium: Online Resource
    ISSN: 2350-8582 , 2091-2846
    URL: Article
    DOI: 10.3126/jucms.v9i01.37976
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2021
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