Knowledge of Internal Quality Control for Laboratory Tests among Laboratory Personnel Working in Department of Biochemistry in a Tertiary Care Center: A Descriptive Cross-sectional Study.

Introduction: Clinical laboratory holds a central position in patient care, thus, ensuring accurate laboratory test results is a necessity. Internal quality control ensures day-to-day laboratory consistency. However, unless practised, laboratory quality systems cannot be achieved. This depends on the efforts and commitment of laboratory personnel for its implementation. Hence, the aim of this study was to find out the knowledge of internal quality control for laboratory tests among laboratory personnel working in the Department of Biochemistry in a tertiary care centre. Methods: This was a descriptive cross-sectional study conducted from 1 July 2022 to 30 August 2022 after receiving ethical approval from Institutional Review Committee (Reference number: 2341/022). Semi-structured questionnaire was used to assess knowledge on internal quality control. Three non-respondents were excluded. The operational definition of the knowledge domain was set before finalizing the questionnaire. The convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 20 laboratory personnel, 5 (25%) (6.02-43.98, 95% Confidence Interval) had adequate knowledge of internal quality control. The mean knowledge score was 12±2.44. Conclusions: The prevalence of adequate knowledge of internal quality control for laboratory tests among laboratory personnel working in the Department of Biochemistry was similar to the other study done in a similar setting. Keywords: biochemistry; knowledge; laboratory personnel; quality control.

Worksite intervention study to prevent diabetes in Nepal: a randomised trial protocol.

INTRODUCTION: In Nepal, approximately 31% of adult industrial employees have diabetes. While the prevention of type 2 diabetes through behavioural intervention has been disseminated, worksite could be an effective platform for the translation of this knowledge into action as employed adults spend most of their workday waking hours at workplaces. METHODS AND ANALYSIS: We will conduct a randomised controlled trial to assess the effectiveness of a behavioural and a canteen intervention on diabetes risk reduction among those who are prediabetic at two worksites in eastern Nepal. We will recruit 162 adult full-time factory workers with haemoglobin A1c (HbA1c) of 5.7%-6.4% at baseline or fasting blood sugar of 100-125 mg/dL. The 8-14 months' control period will be followed by the behavioural intervention where half of the participants will be randomised to receive the behavioural intervention and half will act as a control and will not receive any intervention. Then, all participants will receive the canteen intervention. The analysis will be intent-to-treat, comparing the difference in the change in HbA1c% between the behavioural intervention group and the control group using a two-sample t-test. The within-participant changes in HbA1c after 6 or more months on the canteen intervention among those not randomised to the behavioural intervention in the previous period will be assessed using the paired t-test. ETHICS AND DISSEMINATION: Ethical approval was obtained from the Institutional Review Board at Yale School of Public Health, New Havens, USA and the Nepal Health Research Council. TRIAL REGISTRATION NUMBER: NCT04161937.

Gender Differences in the Prevalence of Depression among the Working Population of Nepal.

OBJECTIVE: To estimate the prevalence of depression in the working population; to examine if any gender disparity prevails; and to determine the sociodemographic mediators of depression. METHODS: Data from previous research was retrieved for this study. Only paid workers were selected (n=160). Sociodemographic variables including prevalence of moderate depression were compared between the genders using Chi square test. Significant variables were subject to logistic regression. Validated Nepali version of the Beck Depression Inventory scale (BDI-Ia) was used to determine depressive symptoms with a cutoff score of ≥20 considered as moderate depression. RESULT: The overall prevalence of moderate depression was 15%, with higher prevalence among working women compared to men [χ 2 (df) = 6.7(1), P=0.01], those practicing religions other than Hinduism [χ 2 (df) = 5.5(1), P=0.01], those educated up to primary school compared to other education criteria [χ 2 (df) = 9.4(4), P=0.03], those having vitamin D deficiency compared to others [χ 2 (df) = 8.5(3), P=0.03], and sedentary lifestyle compared to active lifestyle [χ 2 (df) = 6.7(1), P=0.009]. The OR (95% CI) for moderate depression was significantly higher in women than in men [3.2 (1.1-9.6), P= 0.03] and sedentary lifestyle [2.9(1.1-8.2), P= 0.04] even after adjusting for confounding variables. CONCLUSION: Working women have increased odds of depression compared to men. Among various characteristics, sedentary lifestyle was the most important causative factor for depression among women.

Serum procalcitonin in bacterial & non-bacterial meningitis in children.

BACKGROUND: Bacterial meningitis is a paediatric emergency with high mortality and morbidity requiring prompt diagnosis and treatment. Clinically, it is often difficult to differentiate between bacterial and non-bacterial meningitis. Several studies have demonstrated the raised values of serum procalcitonin (PCT) in bacterial infections including meningitis but without definite cut-off guidelines. Hence, this study was done to evaluate serum PCT as a marker to differentiate bacterial and non-bacterial meningitis in children and assess its efficacy. METHODS: It was a cross-sectional study done over a period of 5 months (Aug 2016-Dec 2016) in the department of Paediatrics, B P Koirala Institute of Health Sciences (BPKIHS). Fifty children aged 3 months to 15 years with suspected meningitis were enrolled and investigated with relevant investigations like complete blood counts, and cerebrospinal fluid (CSF) analysis along with serum PCT. Patients were classified into bacterial (22) and non-bacterial meningitis (28) according to clinical & CSF findings and data analysed using SPSS software. RESULTS: Serum PCT levels were significantly higher in bacterial meningitis group (median = 2.04 (1.2-3.18) ng/ml) compared with non-bacterial meningitis (median = 0.35 (0.18-0.35) ng/ml); p < 0.001. The sensitivity and specificity of serum PCT in diagnosis of bacterial meningitis at cut-off level of 0.5 ng/ml were 95.45% and 84.61% respectively. Procalcitonin showed maximum area under receiver operating characteristics (ROC) curve 0.991 (0.974-1.00) (p < 0.001) compared to total leukocyte count and CSF cytochemistry. CONCLUSION: Serum PCT has high sensitivity and specificity for early diagnosis of bacterial meningitis in children. Hence it can be a useful adjunct in differentiating bacterial and non-bacterial meningitis for prompt and better management of the children.

Thyroid Dysfunction and Associated Risk Factors among Nepalese Diabetes Mellitus Patients.

Objectives. To assess thyroid function and associated risk factors in Nepalese diabetes mellitus patients. Methods. A cross-sectional study was carried out among 419 diabetes mellitus patients at B. P. Koirala Institute of Health Sciences, Dharan, Nepal. Information on demographic and anthropometric variables and risk factors for thyroid dysfunction was collected. Blood samples were analysed to measure thyroid hormones, blood sugar, and lipid profile. Results. Prevalence rate of thyroid dysfunction was 36.03%, with subclinical hypothyroidism (26.5%) as the most common thyroid dysfunction. Thyroid dysfunction was much common in females (42.85%) compared to males (30.04%) (p = 0.008) and in type 1 diabetes (50%) compared to type 2 diabetes mellitus (35.41%) (p = 0.218). Diabetic patients with thyroid dysfunction had higher total cholesterol, HDL cholesterol, and LDL cholesterol in comparison to patients without thyroid dysfunction. Significant risk factors for thyroid dysfunction, specifically hypothyroidism (overt and subclinical), were smoking (relative risk of 2.56 with 95% CI (1.99-3.29, p < 0.001)), family history of thyroid disease (relative risk of 2.57 with 95% CI (2.0-3.31, p < 0.001)), and female gender (relative risk of 1.44 with 95% CI (1.09-1.91, p = 0.01)). Conclusions. Thyroid dysfunction is common among Nepalese diabetic patients. Smoking, family history of thyroid disease, and female gender are significantly associated with thyroid dysfunction.