Hypothyroidism among Patients Visiting the Department of Biochemistry in Central Laboratory of a Tertiary Care Center: A Descriptive Cross-Sectional Study.

Introduction: The global burden of thyroid disorders, especially hypothyroidism, is high and increasing. Prevalence studies of such disorders are limited in Nepal. The aim of this study was to find out the prevalence of hypothyroidism among patients visiting the Department of Biochemistry in the central laboratory of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients visiting the Department of Biochemistry in the central laboratory from 1 August 2020 to 31 July 2021 after taking ethical approval from the Institutional Review Committee (Reference number: UCMS/IRC/054/20). Patients of all age groups and gender were considered. Hypothyroid patients were identified based on the thyroid function parameters. They were further categorized as sub-clinical and overt hypothyroid. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 3,010 patients, the prevalence of hypothyroidism was seen in 770 (25.58%) (24.02-27.14, 95% Confidence Interval). Out of total hypothyroid patients, 555 (72.08%) were females. Overt hypothyroidism 519 (67.40%) was the most prevalent hypothyroid disorder, followed by subclinical hypothyroidism 251 (32.60%). Conclusions: The prevalence of hypothyroidism among patients visiting the Department of Biochemistry in the central laboratory of a tertiary care centre was higher than in other studies done in similar settings. Keywords: hypothyroidism; Nepal; thyroid-stimulating hormone.

Hypovitaminosis D among Blood Samples of Patients Presenting to the Department of Biochemistry of a Tertiary Care Center.

Introduction: Hypovitaminosis D is a global public health problem affecting approximately one billion people, with a particularly high prevalence in South Asia. Several hospital-based studies from Nepal show a high prevalence of hypovitaminosis D. However, large-scale community-based studies are lacking. The aim of the study was to find out the prevalence of hypovitaminosis D among blood samples of patients presenting to the Department of Biochemistry of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among blood samples of patients presenting to the Department of Biochemistry of a tertiary care centre from 3 November 2022 to 30 April 2023 after obtaining ethical approval from the Institutional Review Committee (Reference number: 136/22). Patients of all age groups and genders who were sent for the evaluation of Vitamin D at the laboratory were included. A convenience sampling technique was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of 376 patients, hypovitaminosis was seen in 274 (72.87%) (68.38-77.36, 95% Confidence Interval). Vitamin D insufficiency was present in 252 (91.97%) and vitamin D deficiency was present in 22 (8.03%) participants. Conclusions: The prevalence of hypovitaminosis D was found to be higher than other studies done in similar settings. Keywords: prevalence; vitamin D; vitamin D deficiency.

Microalbuminuria in Patients with Hypertension Visiting Tertiary Care Centre, Western Nepal.

BACKGROUND: Renal complications of hypertension are associated with high morbidity and mortality. Prediction of such complications at the earliest is of utmost importance. We aimed to assess the prevalence of microalbuminuria in hypertensive patients. METHODS: A total of 130 clinically diagnosed hypertensive patients were enrolled in the study. Biochemical parameters that included serum creatinine, urinary albumin, and urinary creatinine were measured using standard methods. Albumin Creatinine ratio and estimated glomerular filtration rate were calculated. Albumin Creatinine ratio values between 30-300 mg/g were considered as microalbuminuria. Statistical analysis was performed on 120 samples after excluding frank proteinuria. RESULTS: The prevalence of microalbuminuria in hypertensive patients was 19.16%. Mean ranks of systolic blood pressure, pulse pressure, and serum creatinine levels were significantly higher in hypertensive patients with microalbuminuria. Mean estimated glomerular filtration rate was significantly low in hypertensive patients with microalbuminuria. Older age and increased duration as well as severity of hypertension were not associated with a higher prevalence of microalbuminuria. CONCLUSIONS: The prevalence of microalbuminuria was high in hypertensive patients. Serum creatinine and estimated glomerular filtration rate were significantly altered in patients with microalbuminuria. Early screening of microalbuminuria in such patients might help prevent renal complications.

Accuracy of Glucose Meter among Adults in a Semi-urban Area in Kathmandu, Nepal.

INTRODUCTION: Glucose meters are gaining popularity in monitoring of blood glucose at household levels and in health care set-ups due to their portability, affordability and convenience of use over the laboratory based reference methods. Still they are not free of limitations. Operator's technique, extreme temperatures, humidity, patients' medication, hematocrit values can affect the reliability of glucose meter results. Hence, the accuracy of glucose meter has been the topic of concern since years. Therefore, present study aims to evaluate the analytical and clinical accuracy of glucose meter using International Organization for Standardization 15197 guideline. METHODS: A community based descriptive cross-sectional study was conducted in Kapan, Kathmandu, Nepal in April 2018. Glucose levels were measured using glucose meter and reference laboratory method simultaneously among 203 adults ≥20 years, after an overnight fasting and two hours of ingestion of 75 grams glucose. Modified Bland-Altman plots were created by incorporating ISO 15197 guidelines to check the analytical accuracy and Park error grid was used to evaluate the clinical accuracy of the device. RESULTS: Modified Bland-Altman plots showed>95% of the test results were beyond the acceptable analytical criteria of ISO 15197:2003 and 2013. Park Error Grid-Analysis showed 99% of the data within zones A and B of the consensus error grid. CONCLUSIONS: Glucose meter readings were within clinically acceptable parameters despite discrepancies on analytical merit. Possible sources of interferences must be avoided during the measurement to minimize the disparities and the values should be interpreted with caution.

Depression, malnutrition, and health-related quality of life among Nepali older patients.

BACKGROUND: Little is known about the health, nutrition, and quality of life of the aging population in Nepal. Consequently, we aimed to assess the nutritional status, depression and health-related quality of life (HRQOL) of Nepali older patients and evaluate the associated factors. Furthermore, a secondary aim was to investigate the proposed mediation-moderation models between depression, nutrition, and HRQOL. METHODS: A cross-sectional survey was conducted from January-April of 2017 among 289 Nepali older patients in an outpatient clinic at Nepal Medical College in Kathmandu. Nutritional status, depression and HRQOL were assessed using a mini nutritional assessment, geriatric depression scales, and the European quality of life tool, respectively. Linear regression models were used to find the factors associated with nutritional status, depression, and HRQOL. The potential mediating and moderating role of nutritional status on the relationship between depression and HRQOL was explored; likewise, for depression on the relationship between nutritional status and HRQOL. RESULTS: The prevalence of malnutrition and depression was 10% and 57.4% respectively; depression-malnutrition comorbidity was 7%. After adjusting for age and gender, nutritional score (ß = 2.87; BCa 95%CI = 2.12, 3.62) was positively associated and depression score (ß = - 1.23; BCa 95%CI = - 1.72, - 0.72) was negatively associated with HRQOL. After controlling for covariates, nutritional status mediated 41% of the total effect of depression on HRQOL, while depression mediated 6.0% of the total effect of the nutrition on HRQOL. CONCLUSIONS: A sizeable proportion of older patients had malnutrition and depression. Given that nutritional status had a significant direct (independently) and indirect (as a mediator) effect on HRQOL, we believe that nutritional screening and optimal nutrition among the older patients can make a significant contribution to the health and well-being of Nepali older patients. Nonetheless, these findings should be replicated in prospective studies before generalization.