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Background: Dengue virus infection is a major source of morbidity and mortality in the majority of tropical and subtropical nations. In Nepal, the first case of dengue was reported in 2004, followed by numerous outbreaks exerting a critical impact on public health. This study aims to describe the clinical and laboratory characteristics of dengue patients visiting a tertiary care hospital to see the trend of presentation. Method: Hospital based cross‐sectional study was conducted among diagnosed cases of dengue from April 2023 to September 2023. A total of 692 patients undergoing testing by commercially available dengue rapid diagnostic tests were recruited and categorized dengue positive (if NS1 and/or IgM positive) and dengue negative (NS1, IgM, and IgG all negative or only IgG positive). The dengue‐positive cases were further subdivided into three groups (only NS1 positive, only IgM positive, both NS1 and IgM positive). Additionally, biochemical and hematological analyses were performed, and results were compared between positive and negative cases by using Mann–Whitney U test while subgroups of dengue‐positive cases were compared using Kruskal–Wallis H test. Results: Most common symptoms were fever (94.5%) followed by headache (79.8%) and myalgia (74.7%). Among 346 dengue‐positive subjects, 53.2% (n = 184) were NS1‐only positive, 21.7% (n = 75) were IgM‐only positive, and 25.1% (n = 87) were both NS1+IgM positive. Thrombocytopenia (n = 179, 51.7%), leucopenia (n = 99, 28.6%), increased SGPT (n = 182, 52.6%), increased SGOT (n = 188, 54.3%) were seen among dengue positive patients. Leukopenia was more severe in patients with only NS1 positive cases (p = 0.008) whereas thrombocytopenia (p ≤ 0.001) was more severe in patients with both IgM and NS1 positive cases. Conclusion: Our study depicted there is a marked alteration in biochemical and hematological parameters specifically thrombocytopenia, leukopenia, increased transaminase levels, and high prothrombin time seen in dengue positive cases. [ABSTRACT FROM AUTHOR]

Context: Meditation and related relaxation techniques are good means of alleviating stress and maintaining good health. Osho dynamic meditation decreases several psychopathological variables such as anxious‐depressive syndrome, aggressive behaviors, and depression which is practiced in Nepal and all over the world. Various studies have shown alteration in different hormone levels due to meditation by strengthening adaptive mechanisms. Aim: The aim of this study was to evaluate the effect of Osho meditation on serum hormonal levels in pre‐ and postmeditation participants. Methods: A pre–post study was conducted among 70 healthy volunteers (42 male and 28 female) where various types of Osho dynamic meditation techniques were incorporated together to understand their combined effects on serum hormone levels in participants attending the 7 days meditation camp. Serum hormones such as cortisol, estrogen, progesterone, free triiodothyronine (fT3), free thyroxine (fT4), thyroid‐stimulating hormone (TSH), testosterone, and growth hormone were measured by chemiluminescence immunoassay. Results: Out of 70 participants, 68 participants (97%) had subjective opinion of Osho dynamic meditation being effective in alleviating stress, depression, and anger. Also, there was a significant decline in body weight and body mass index in both male and female populations after a strict vegetarian diet and meditation. Likewise, a significant rise in the level of estrogen (p < 0.001), progesterone (p < 0.001), growth hormone (p < 0.001), testosterone (p = 0.002), and fT3 (p = 0.049) in postmeditation male participants indicates the importance of Osho dynamic meditation on elevating sex hormones such as estrogen, progesterone, testosterone as well as fT3, and growth hormones among Osho meditation practicing participants. Conclusion: Our findings suggest significant changes in the hormonal levels and improvement in stress and depression in participants undergoing Osho meditation. [ABSTRACT FROM AUTHOR]

Introduction: Samples received in the laboratory are often rejected because of visible hemolysis. Every laboratory has protocols on whether to accept or reject hemolyzed samples based on tests ordered. The objective of the study was to observe and analyze the variations seen in association with hemolyzed samples in liver function test parameters and electrolytes measurement. Methods: This cross-sectional observational study was carried out in 88 laboratory samples in the Clinical Biochemistry Laboratory. Hemolysis was induced by mechanical mixing. This study compared reported values of bilirubin, protein, albumin, aminotransferases (ALT and AST), alkaline phosphatase (ALP), gamma glutamyl transpeptidase (GGT), sodium and potassium between hemolyzed and non-hemolyzed samples. Results: Mean values of total bilirubin (TB) and direct bilirubin (TB), ALT, ALP, GGT and sodium (Na) were found to be significantly decreased post hemolysis (p<=0.001) with mean variances (s2) at 0.30 (TB), 0.38 (DB), 0.56 (ALT), 0.18 (ALP), 0.01 (GGT) and 0.001 (Na). In contrast, mean values of AST (s2= -0.9, p<0.001) and potassium (s2 = -0.3, p<0.001) were found to be significantly elevated post hemolysis. Total protein and albumin were also found to be elevated in hemolyzed samples but the average variance was not statistically significant. Degree of hemolysis had highly varying effects in some parameters like AST and total protein, but less varying and more consistent effects on other measured parameters. Conclusion: Free hemoglobin estimation should be considered before rejecting a clinical sample because of hemolysis. Mathematical equations cannot be expected to reproduce corrected values of the analytes in question because of the large variances, so these tests need to be repeated on non-hemolyzed samples for the analytes that are affected. [ABSTRACT FROM AUTHOR]

INTRODUCTION The chronic kidney disease (CKD) patient's calcium phosphate product, alkaline phosphatase (ALP), vitamin-D and 2 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-D and hGH were measured by sandwich and competitive enzyme linked 2 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) is a chronic disease characterized by insulin deficiency or peripheral resistance resulting in hyperglycemia. Poor glycemic control leads to diabetic complications. Hyperuricemia has been reported with increased risk of renal insufficiency. The aim of this study was to evaluate the relationship between serum uric acid concentration, degree of urinary albumin excretion (UAE) and glycated hemoglobin (HbA) in Type 2 DM (T2DM) patients. Materials and Methods: Serum uric acid concentrations, urine microalbumin, and HbA1c were measured in fifty T2DM patients. We then evaluated relationship between uric acid concentrations, degree of UAE and glycemic control as well as other confounding variables. Results: Serum uric acid concentration correlated positively with UAE (r = 0.323, P < 0.05), age (r = 0.337, P < 0.05), age at onset (r = 0.341, P < 0.05), and duration of DM (r = 0.312, P < 0.05). Multiple regression analysis demonstrated that serum uric acid concentration (β = 0.293, P < 0.0001), duration of DM (β = 0.261, P < 0.0001), HbA1c (β = 0.173, P < 0.005), and systolic blood pressure (β = 0.268, P < 0.005) were independent determinants of UAE. Conclusions: Serum uric acid concentration is associated with microalbuminuria and HbA1c in T2DM patients. [ABSTRACT FROM AUTHOR]

Background: Oxidative stress and malnutrition are shown to have pathogenic effect in Chronic Obstructive Pulmonary Disease (COPD). Aim: This study was done to assess the burden of oxidative stress in COPD and to determine its relation to their nutritional status. Materials and Methods: In this cross-sectional study, 100 COPD cases from emergency and medical ward and meeting inclusion criteria, along with age, sex and occupation (mainly farmers, housewives and drivers) matched 100 controls without COPD and meeting inclusion criteria were enrolled. Oxidative stress was assessed by measuring lipid peroxidation product, Malondialdehyde (MDA) and antioxidants, like Vitamin C, E and Red Blood Cell Catalase (RBCC). Mini Nutritional Assessment (MNA) tool and Body Mass Index (BMI) were used to assess nutritional status. Statistical Analysis: Chi-square test was applied for categorical variable. Student t-test was applied for comparison of means. Analysis of Variance (ANOVA) was applied for comparison between groups followed by Bonferroni post hoc analysis. Pearson correlation method was used for quantitative variables. Statistical significance was defined as p< 0.05 (two tailed). Results: COPD cases had significantly high MDA level with low level of Vitamin E and catalase as compared to controls (p < 0.001). Most of the COPD cases were underweight (BMI ⩽ 18.5 Kg/m2) and malnourished (MNA score less than 7). Bonferroni post-hoc analysis, showed significantly high burden of oxidative stress in underweight and malnourished cases as compared to normal weight (p < 0.05) among COPD cases. Highly significant correlation was seen between BMI and plasma MDA level (r = -0.27, p = 0.008) in COPD cases. Conclusion: This study shows impaired oxidant/antioxidant balance along with malnutrition and underweight in COPD, which signals for considering antioxidant therapy along with nutritional management. [ABSTRACT FROM AUTHOR]

Background: Amenorrhea is the absence of menstrual periods. It has multiple social consequences as it may leads to infertility. This case control study was conducted for determining the association of thyroid hormones with hyperprolactinemia in patient with amenorrhea. Methods: We investigated 50 women with diagnosed cases of secondary amenorrhoea, who attended UCMS hospital, for hormonal evaluations. Fifty two healthy women were taken as the controls. The thyroid dysfunction and serum prolactin level were reviewed in cases and in the controls. Results: Mean serum prolactin level was found to be significantly higher in the cases as compared to the controls. Mean serum fT3 and fT4 level in the hyperprolactinemic cases (mean = 2.67, SD = 1.04 pg/ml) and (mean = 1.38, SD = 0.51 ng/dl respectively) were slightly lower as compared to normoprolactinemic cases (mean = 3.21, SD = 1.86 pg/ml) and (mean = 1.73, SD = 1.37 ng/dl) respectively. Mean TSH of normoprolactinemic and hyperprolactinemic cases were comparable (P = 0.049). There was positive correlation between prolactin, BMI and TSH whereas negative correlation of prolactin was seen with fT3, fT4 and age. In hyperprolactainemic cases, prolactin was found to be negatively correlated with TSH (r = -0.155, P = 0.491) whereas prolactin was positively correlated with TSH (r = 0.296, P = 0.126) in normoprolactainemic cases. Conclusions: Thus, hyperprolactinemia with thyroid dysfunction may be contributory hormonal factor in patient with amenorrhoea and as such, estimation of prolactin, fT3, fT4 and TSH should be included for diagnostic evaluation of amenorrhea. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovary syndrome is a common hormonal disorder that affects women of reproductive age which is characterized by hyperandrogenism, polycystic ovarian morphology, ovarian dysfunction, and hyperinsulinemia. Increased prevalence of cardiovascular disease and higher cardiovascular morbidity is seen in women with polycystic ovary syndrome. This study aimed to estimate the prevalence of high serum homocysteine levels among women with polycystic ovarian syndrome visiting an infertility clinic of a tertiary care centre., Methods: This was a descriptive cross-sectional study conducted among women with polycystic ovarian syndrome visiting an infertility clinic at the Department of Obstetrics and Gynaecology of a tertiary care centre from 1 June 2023 to 1 September 2023. The study was conducted after obtaining ethical approval from the Institutional Review Committee. Biochemical analysis of gonadal hormones, serum homocysteine and lipid profile was done. A convenience sampling method was used. The point estimate was calculated at a 95% confidence interval., Results: Among 76 women, the prevalence of high serum homocysteine level was found in 54 (71.05%) (60.86-81.25, 95% Confidence Interval). The mean age of patients was 27.46±6.18 years., Conclusions: The prevalence of high homocysteine levels among women with polycystic ovarian syndrome is higher than other studies done in similar settings., Keywords: body mass index; homocysteine; polycystic ovary syndrome; prevalence.

Introduction: Polycystic ovarian syndrome is the most common endocrine-metabolic disorder, affecting women of reproductive age groups, which shares various symptoms with thyroid dysfunctions. Despite it predisposition of aforesaid cohorts to autoimmunity, these etiologies have not adequately been studied in them. This study aimed to find out the prevalence of positive thyroid peroxidase antibodies among women with polycystic ovarian syndrome visiting an infertility clinic at a tertiary care centre., Methods: This was a cross-sectional study conducted at a tertiary care centre among patients visiting the infertility clinic at the Department of Obstetrics and Gynaecology from 21 September 2022 to 21 February 2023. Biochemical analysis of thyroid hormones, gonadal hormones, anti-mullerian hormone and thyroid peroxidase antibody were done in Abbott ARCHITECT ci4100 and SNIBE Maglumi 800 autoanalyzer. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval., Results: Among 70 participants, thyroid peroxidase antibody was positive in 16 (22.86%) (13.02-32.69, 95% Confidence Interval). The mean age of the patients was 28.25±5.26 years. In the individuals with thyroid-stimulating hormone below 2.5 mIU/l, 5 (31.25%) had positive thyroid peroxidase antibody titre., Conclusions: The prevalence of positive thyroid peroxidase antibodies among women with polycystic ovarian syndrome is similar to other studies done in similar settings. Regular monitoring of thyroid peroxidase antibodies is recommended in these women to guide conception in order to evade inevitable adverse pregnancy outcomes., Keywords: anti-thyroid autoantibodies; autoimmunity; infertility; prevalence; polycystic ovary syndrome.

Background and Objectives: Human Epidermal Growth Factor Receptor 2 (HER2/neu) is one of the most extensively studied proto-oncogens in breast cancer patients.  Accurate and timely assessment of the HER2/neu over expression is pivotal for the identification of breast cancer patients that could benefit from HER2-targeted therapy.  The present study was undertaken to investigate the diagnostic utility of serum HER2/neu testing by chemiluminescent immunoassay (CLIA) in breast cancer patients and compare it with the immunohistochemistry (IHC) method of HER2/neu expression., Methods: Serum sample and tissue/paraffin block was collected from 52 patients with breast cancer before start of any anticancer regimen or hormonal therapy.  The tissue specimens were processed in Histopathology lab. Sections were immunostained with anti -estrogen receptor (ER) , anti -progesteron receptor (PR) and anti HER2/neu receptor  mouse monoclonal antibodies.) Serum HER2/neu was estimated using the chemiluminiscent immunoassay using 15ng/ml as the cut off., Results: Out of 52 patients with breast cancer, serum HER2/neu was found elevated in 25(48.1%) patients and remaining 27(51.9%) showed normal serum HER2/neu concentrations. On IHC HER2/neu score was 3+ in 9(17.3%), 2+ in 10(19.2%), 1+ in 1(1.9%); while 32(61.5%) showed no HER2/neu expression.  31(59.6%) patients were ER positive and 28(53.8%) were PR positive. There was a significant correlation (P<0.001) of serum HER2 concentration with tissue expression of HER2/neu and Histological tumor grade. Serum HER2/neu levels showed a negative correlation with ER status (P=0.047) but no correlation with PR status., Conclusion: The result showed that the elevated serum HER2/neu was correlated with the IHC expression of HER2/neu in tissue and the histological grade of the tumor.  Findings suggest that post initial tissue diagnosis (IHC HER2/neu), serum HER2 assay may supplement subsequent tissue tests to monitor disease status and response to therapy.