Browsing by Author "Sharma, Vijay Kumar"
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Publication Association Between Vitamin D Levels and Vitamin D Receptor (VDR) Gene Polymorphisms in Nepalese Population(Nepal Health Research Council, 2025) Baidya, Sujata; Kandel, Pratibha; Rajkarnikar, Smrity; Sah, Anil Kumar; Niraula, Apeksha; Tuladhar, Eans Tara; Shakya, Yagya Laxmi; Bam, Niraj; Sharma, Vijay Kumar; Yadav, Binod KumarAbstract: Background: Vitamin D deficiency is a global public health concern. Small variations in the proteins involved in vitamin D metabolism affect levels and physiological roles of vitamin D. However, there is a paucity of data regarding such factors in our population. This study was designed to assess the distribution of polymorphisms of vitamin D Receptor (VDR) gene (rs2238136 and rs731236) in vitamin-D deficient Nepalese population. Methods: A total of 400 apparently healthy individuals visiting our center were enrolled. Five ml of blood was collected in gel vial and EDTA vial. The 25(OH)D levels were estimated in ABBOTT Architect autoanalyzer. After extracting genomic DNA, the VDR gene polymorphism (rs2238136 and rs731236) was analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The amplified products, 135 bp and 716 bp were digested using restriction enzymes Bpu10IA and TaqI for rs2238136 and rs731236, respectively, electrophoresed on 2% agarose gel and visualized under UV illuminator. Statistical analysis was done using SPSS version 21.0. Results: The distribution of both rs2238136 and rs731236 followed Hardy-Weinberg equilibrium. There were 24 AA, 238 GG, and 138 AG genotypes found in rs2238136, whereas 226 TT, 34 CC, and 140 TC genotypes were found in rs731236. In contrast to rs731236, vitamin D levels varied among genotypes of rs2238136. Conclusions: In our population, there was a higher prevalence of GG genotype (rs2238136) and TT genotype (rs731236). Increased prevalence of vitamin D deficiency in our region may be due to these genetic variations.Publication Effects of Hemolysis on Serum Markers of Liver Function(Institute of Medicine, 2024) Bhattarai, Aseem; Thapa, Ranjana; Dubey, Raju Kumar; Raut, Mithileshwer; Niraula, Apeksha; Sharma, Vijay Kumar; Tuladhar, Eans TaraABSTRACT 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 (σ2) 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 (σ2= -0.9, p<0.001) and potassium (σ2 = -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. Keywords: Hemolysis; interference; routine chemistry analysisPublication 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 Study of Thyroid Function and Lipid Profile in Depression Patients(Nepal Health Research Council, 2025) Suwal, Sagun; Baidya, Sujata; Chhusyabaga, Mandira; Karanjit, Rabita; Makaju, Sunita; Pant, Sagun Ballav; Sharma, Vijay KumarAbstract: Background: Depression is a common mental disorder, associated with a global increase in disabilities and suicidality. Different factors are responsible for depression in which thyroid dysfunction and dyslipidemia are the biological causes. This study aimed to find the association and alteration of thyroid function tests and lipid profiles among patients with depressive disorders. Methods: A case-control study was performed on patients being managed for depressive disorder visiting the Psychiatry Department of Tribhuvan University Teaching Hospital, Kathmandu, Nepal. The blood samples were collected from 40 newly diagnosed cases of depressive disorder not under any drugs and 80 from healthy individuals. Thyroid hormones and lipid profile parameters were analyzed in Johnson and Johnson, ECI Vitros 3600, US, Ortho Clinical Diagnostics, and BT-1500. Data were collected and statistical analysis was done using SPSS version 22. Results: Among the 40 patients with depressive disorders, 27.5% had thyroid dysfunction with sub-clinical hypothyroidism, overt hypothyroidism, and hyperthyroidism among 12.5%, 12.5%, and 2.5% respectively. Similarly, dyslipidemia was observed in 37.5% of participants. About 52.5% of patients managed for depressive patients were found to have anxiety as well. Despite an alteration of thyroid hormones, there was no significant correlation between thyroid hormones and lipid parameters in patients being managed for depressive disorder. Conclusions: This study concludes that thyroid dysfunction and dyslipidemia are seen among depressive patients with unclear reasons. For proper diagnosis and treatment of depression, it is better to carry out thyroid function tests and lipid profiles.