Iron Profile and Status of Anemia with the Associated Factors in Chronic Kidney Disease Patients.

BACKGROUND: One of the main complications of chronic kidney disease is anemia. Disorders of iron homeostasis seen in such patients make the management of anemia more challenging and risky. To obtain the desired result, erythropoietin and iron dose must be carefully regulated. The aim of the study is to find out the prevalence of anemia and level iron indices in patients of chronic kidney disease at a tertiary care hospital. METHODS: A cross-sectional descriptive study was conducted on chronic kidney disease patients at a tertiary care center. Demographic data like age, sex, height and weight were collected with the help of using Performa. The hematological and biochemical study variables were assayed by blood sample of the patients in the clinical laboratory services. Data were analyzed by statistical package for the social sciences Version 20.0 Results: Out of 171 patients with chronic kidney disease, 162 (94.7%) were anemic, with the highest percentage 54 (31.5%) having hypertension. The median value with inter-quartile range of hemoglobin, serum iron, serum ferritin, TIBC and transferring saturation were 8.9 gm/dl (6.7-10.0), 115.0 (µg/dl) (60.0-140.0), 599.0 ng/ml (142.6-973.0), 279.0 µg/dl (250.0-342.0) and 41.0 % (22.0-53.0) respectively. Serum creatinine and eGFR were significantly correlated with hemoglobin and iron indices. CONCLUSIONS: The current study showed that anemia was more prevalent in patients of chronic kidney disease in our setting as compared to similar studies. Hypertension was the most common disease among them. The median value of parameters of iron profile except ferritin among them was within the reference limit.

Dyslipidemia and Thyroid Dysfunction Associated with Psoriasis.

BACKGROUND: Psoriasis is a T-cell mediated inflammatory skin disorder which causes considerable psychosocial disability resulting in major impact on patient's quality of life. The dominant response of Th1 cells and the high expression of related inflammatory factors appears in both psoriasis and thyroid dysfunction. Psoriasis can lead to increased risk of incidence of cardiovascular events for which dyslipidemia is an important risk factor. This study aims to evaluate thyroid function and lipid profile and its association in patients with psoriasis. METHODS: This was a prospective case-control study conducted at the Department of Biochemistry, Nobel Medical College Teaching Hospital from November 2021 to October 2022. Seventy six clinically diagnosed psoriatic patients were taken as case and eighty non-psoriatic patients coming for other skin lesions were included in the study as control. Thyroid function test (serum free T3, T4, TSH) and lipid profile (total cholesterol, low density lipoprotein, high density lipoprotein and triglyceride) were done. RESULTS: Hypothyroidism was most common thyroid abnormalities in our study population which was 13.15% (n=10). The lipid profile parameters were significantly higher in the psoriatic patients than in the controls (p<0.001). The odds of psoriatic patient having thyroid dysfunction was 2.8 times higher compared to other non-psoriatic patients and the odds of psoriatic patient having dyslipidemia was 8.7 times higher compared to other non-psoriatic patients. CONCLUSIONS: It is thus useful to assess thyroid function test and lipid profile in patients with psoriasis considering their role in etiopathogenesis and co-morbidity of psoriasis.

Raised D-dimer Level among COVID-19 Patients in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

Introduction: Serum D-dimer is a protein fragment generated during the final phase of clot formation. Increased serum D-dimer levels indicate the hemostatic change in patients, likely related to the prothrombotic switch. As the world is battling with the damaging effect of coronavirus disease, it is very important to find out the early and effective predictors of prognosis to improve the management of COVID-19 patients. Thus, our study aims to find out the prevalence of increased D-dimer levels in coronavirus disease patients. Methods: A descriptive cross-sectional study was conducted on a total of 235 patients admitted in the COVID ward and COVID Intensive Care Units at a tertiary care hospital from July 2020 to August 2021 after getting ethical approval (Reference number: 401/2020) from the Institutional Review Committee. A convenience sampling method was used for sample collection. The highest recorded values for D-dimer during the hospital stay were taken for data collection. The data were entered in Microsoft Excel 2013 and analyzed using Statistical Package for the Social Sciences version 16.0. Point estimate at 95% Confidence Interval was calculated along with frequency, proportion, mean and standard deviation. Results: Among 235 patients, elevated D- dimer level was in 175 (74.46%) (68.88-80.04 at 95% Confidence Interval). Majority of the patients were males 136 (77.71%) whereas 39 (22.28%) of the patients were females. Conclusions: The prevalence of raised D-dimer levels was quite higher in our studies compared to other studies done in different parts of the world. Thus, serum D-dimer level may serve as an early marker in improving the management of patients with coronavirus disease. Keywords: corona virus disease; d-dimer; disease severity.

Thyroid Dysfunction in Patient with Abnormal Uterine Bleeding in a Tertiary Hospital of Eastern Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: Thyroid hormone is known to affect reproductive biology. Abnormal uterine bleeding is one of the common presentations in gynaecology outpatient departments and thyroid dysfunction is known to affect its progression. This study aims to find the prevalence of thyroid dysfunction in diagnosed cases of abnormal uterine bleeding in patients in a tertiary hospital of eastern Nepal. METHODS: A descriptive cross-sectional study was conducted in patients diagnosed with abnormal uterine bleeding in a tertiary care hospital of eastern Nepal from April 2019-March 2020 after taking ethical clearance from the Institutional Review Committee. On basis of inclusion and exclusion criteria, 95 cases of abnormal uterine bleeding were included in the study. A blood sample was taken and a thyroid function test was done by chemiluminescence assay on an automated analyzer. Convenient sampling method was used for sample collection. Statistical analysis was done using Statistical Package for the Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Out of the total cases of abnormal uterine bleeding, 15 (15.79%) (8.46-23.12 at 95% Confidence Interval) had thyroid dysfunction. Among total cases, 80 (84.21%) were euthyroid. The mean age of the patients was 33±8 years. Among thyroid dysfunction, 9 (60.0%) were hypothyroid, 4 (26.66 %) were subclinical hypothyroid, and 2 (13.33 %) were hyperthyroid. CONCLUSIONS: Thyroid dysfunction was common among patients with abnormal uterine bleeding, with hypothyroidism being the most common type.

Burden of Alcoholic Liver Disease in a Tertiary Care Center: A Descriptive Cross-sectional Study.

INTRODUCTION: Alcoholic liver disease is a serious health problem related to an unhealthy lifestyle. The three most widely recognized forms of alcoholic liver disease are alcoholic fatty liver, acute alcoholic hepatitis, and alcoholic cirrhosis. The main aim of our study is to find out the prevalence of alcoholic liver disease in tertiary care center. METHODS: A descriptive cross-sectional study was conducted among inpatient cases admitted in the medicine department of tertiary care center from 1st June 2018 to 31st May 2019. Ethical approval was taken for the study. Convenience sampling method was used. All the biochemical parameters were expressed as mean±standard deviation for each group and point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Prevalence of alcoholic liver disease is 50 (50%) at a 95% Confidence Interval (40.2%-59.8%) and non-alcoholic fatty liver disease is also the same. The mean age of alcoholic liver disease was 59±12 years where as the mean age for non-alcoholic fatty liver disease was 46±18 years. Out of fifty patients of alcoholic liver disease, majority 48 (96%) of the cases were males which suggests that the prevalence of alcoholic liver disease is very common in males. Similarly, for non-alcoholic fatty liver disease, prevalence was 34 (68%) showing higher prevalence than that of females. CONCLUSIONS: Prevalence of alcoholic liver disease is low compared to previous studies done in the similar settings. Monitoring these biochemical parameters in alcoholic liver disease at early stage could guide in planning the protocol for the initial treatment.