Browsing by Author "Bhattarai, Aseem"
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Publication High Sensitive C-Reactive Protein and Lipid Profile Alteration In Subclinical Hypothyroidism for Cardiovascular Risk Assessment(Nepal Health Research Council, 2024) Rajkarnikar, Smrity; Sharma, Vijay Kumar; Baidya, Sujata; Kadel, Pratibha; Tuladhar, Eans Tara; Niraula, Apeksha; Bhattarai, Aseem; Raut, Mithileshwer; Dubey, Raju Kumar; Parajuli, NareshBackground: The purpose of this study was to investigate the association of subclinical hypothyroidism with High sensitive C-reactive protein & lipid profile which can predispose to development of Cardiovascular disease. Methods: This hospital-based comparative cross-sectional study was conducted for a period of six months. A total of 71 patients with subclinical hypothyroidism & 37 healthy control subjects were enrolled for the study. Thyroid hormones, lipid profile, hs- CRP were measured and lipid variables were used to calculate lipid indices. Student t-test were used to compare means & Spearman’s correlation was done to determine the association between variables. ROC curve analysis was used to determine the diagnostic value of tests. Results: Out of 71 cases & 37 control, majority had female preponderance (71.8% in case & 83.8% in control). The mean values between case & control groups for hs-CRP, AIP, LCI and non-HDL cholesterol were statistically significant. There was positive correlation between TSH and hs-CRP (r=0.492, p <0.001), AIP and TSH (r=0.430, p<0.001), LCI and TSH (r=0.269, p =0.005), TSH and non-HDL cholesterol (r=0.308, p=0.001) & AI and LDL (r= 0.712, p<0.001) with weak correlation with statistical significance as per Spearman’s correlation. Area under ROC curve for hs-CRP indicated it as a positive biomarker for CVD assessment. Conclusions: Our findings shows that SCH patients are more at risk of CVD & hs-CRP contributes as a significant marker, thus requiring timely intervention. Lipid indices and AIP must be determined even in patients with a normal lipid profile to improve atherogenic risk. Keywords: Cardiovascular risk; dyslipidemia; hs-CRP; subclinical hypothyroidism.Publication High Serum Homocysteine among Women with Polycystic Ovarian Syndrome Visiting an Infertility Clinic of a Tertiary Care Centre(Nepal Medical Association, 2024) Sharma, Vijay Kumar; Kandel, Pratibha; Baidya, Sujata; Rajkarnikar, Smrity; Niraula, Apeksha; Tuladhar, Eans Tara; Bhattarai, Aseem; Raut, Mithileshwer; Dubey, Raju Kumar; Koirala, PoonamAbstract 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.Publication Mean Serum Creatine Kinase among Organophosphate Poisoning Cases in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Twayana, Saru; Sharma, Vijay Kumar; Raut, Mithileshwor; Bhattarai, Aseem; Yadav, Binod Kumar; Bajracharya, Sangha Ratna; Tuladhar, Eans TaraAbstract Introduction: Major cases of poisoning are associated with organophosphates. Cholinergic effects and an intermediate phase seen with organophosphate poisoning may implicate myopathy. Creatine kinase is a marker of muscle tissue damage. This study aimed to find out the mean serum creatine kinase among organophosphate poisoning cases in a tertiary care centre. Methods: A descriptive cross-sectional study was carried out among organophosphate poisoning cases in a tertiary care hospital from 13 October 2017 to 30 March 2018. Ethical approval was taken from the Institutional Review Committee [Reference number: 117(6-11-E) 2/074/075]. Blood samples were assayed for serum acetylcholinesterase in the pharmacology laboratory and for serum creatine kinase and lactate dehydrogenase in the biochemistry laboratory. Low serum acetylcholinesterase was taken as the basis for the establishment of organophosphate poisoning. A convenience sampling technique was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 103 organophosphate poisoning cases, the mean serum creatine kinase was 931.35±446.60 IU/l (845.10-1017.60, 95% Confidence Interval). Conclusions: The mean serum creatine kinase level among organophosphate poisoning cases was higher than in other studies done in similar settings.Publication Positive Thyroid Peroxidase Antibody among Women with Polycystic Ovarian Syndrome Visiting an Infertility Clinic at a Tertiary Care Centre(Nepal Medical Association, 2023) Sharma, Vijay Kumar; Baidya, Sujata; Kandel, Pratibha; Rajkarnikar, Smrity; Niraula, Apeksha; Dubey, Raju Kumar; Raut, Mithileshwer; Bhattarai, Aseem; Tuladhar, Eans Tara; Koirala, PoonamAbstract 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.Publication Whole-Blood Tacrolimus Trough Concentration in Renal Transplant Recipients at a Tertiary Care Center in Central Nepal: A Cross-sectional Study(Institute of Medicine, Tribhuvan University, 2024) Sharma, Vijay; Niraula, Apeksha; Tuladhar, Eans Tara; Dubey, Raju Kumar; Bhattarai, Aseem; Raut, Mithileshwer; Kadel, Anuradha; Kharal, Nikita; Sapkota, Srijana; Pokhrel, PrakashAbstract: Introduction Tacrolimus, a widely used immunosuppressant for renal transplantation, requires careful monitoring due to its narrow therapeutic index and high pharmacokinetic variability. Hence, this study aimed to evaluate the whole blood tacrolimus trough levels in post-renal transplant patients at TUTH. Methods A total of 257 patients who had undergone kidney transplantation were included in this descriptive cross-sectional study Whole-blood tacrolimus concentration was measured using the ARCHITECT i1000SR analyzer (Abbott Diagnostics, North Chicago, USA) by CMIA. Ethical approval was taken from the Institutional Review Committee of TUTH [Ref. No.: 448(6-11) E2081/082]. Results Among the 257 renal transplant recipients, 197(76.65%) were male and 60(23.35%) were female, with a mean age of 38.06±10.74 years. The mean tacrolimus trough level was 7.58±3.92 ng/mL, with a median of 6.8(IQR: 5.4- 9.1) ng/ml. Females had a slightly higher median tacrolimus concentration [7.2(IQR: 5.7- 9.1)] compared to males [6.8(IQR: 5.7- 9.1)]. Of the determinations, 175(68.09%) were within the therapeutic range (5-15 ng/mL), 68(26.46%) were below it, and 14(5.45%) had elevated tacrolimus levels. Conclusions The median tacrolimus trough level in this study was 6.8 ng/mL (IQR: 5.4–9.1), slightly higher but within the therapeutic range compared to similar studies done in similar settings. Monitoring of tacrolimus trough concentrations is of utmost importance in the management of kidney transplant recipients.