Browsing by Author "Raut, Mithileshwor"
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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 Six-Sigma Methodology for Quality Monitoring in a Teaching Hospital Biochemistry Laboratory in Nepal(Institute of Medcine, 2021) Mishra, Akash; Pokhrel, Rakesh; Budhathoki, Uttam; Yadav, Binod K; Sharma, Vijay K; Tuladhar, Eans T; Bhattarai, Aseem; Raut, MithileshworABSTRACT Introduction: Six-sigma is emerging method of choice for performance testing of clinical laboratory. This study was designed to evaluate the performance of 12 routine biochemical analytes on sigma-scale and calculate the quality goal index (QGI). Methods: A cross-sectional study was conducted at Tribhuvan University Teaching Hospital (TUTH), Biochemistry Laboratory for 3 months. BT1500 and BT3500 automated biochemistry analyzers were used. Internal quality control (IQC) performed routinely for 12 clinical analytes for both control levels were recorded from both analyzers and used for calculation of coefficient of variation (CV%). Bias was estimated based on the average difference obtained for each analyte from the target values provided. Values for total allowable errors (TEa) were taken from Clinical Laboratories Improvement Act guidelines. Variables used for calculation of sigma values and QGI were CV%, percentage bias and TEa. Results: Both levels of control for alanine-aminotransferase (ALT) in BT1500 and only control level L2 for aspartate-aminotransferase (AST) in both analyzers showed the sigma value greater than six. Sigma-values between three and six were found for uric acid for both levels of control in both analyzers. Less than three sigma values were obtained for parameters urea, creatinine, albumin, triglyceride, total-cholesterol, alkaline phosphatase (ALP) and magnesium for both levels of control in both analyzers indicating the need towards improvement in these methods. Conclusion:The quality of test for urea, creatinine, albumin, triglyceride, total-cholesterol, ALP and magnesium were unacceptable. Hence, appropriate actions should be taken towards measurement method in these parameters to improve accuray and report quality. Keywords: Bias, IQC, quality goal index, six-sigma, total allowable error