Browsing by Author "Sherchand, O"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Publication Blood Lead Levels of Primary School children in Kathmandu Municipality, Nepal(Institute of Medicine, 2014) Sherchand, O; Mehta, K.D; Poudel, P; Deo, B; Baral, NAbstract Introduction: Lead is a toxic metal which has contaminated our environment and created health problems around the globe. Children are vulnerable to lead as the intake per unit body weight is higher and even low levels can cause neurological damage. Nepal lacks data on sources of lead exposure and its health impacts; hence screening of blood lead is mandatory. Objectives: To determine blood lead levels, its associated risk factors and impact on health in primary school children in Kathmandu municipality, Nepal. Methods: A total of 218 school children between 6-16 years age from Kathmandu were included in the study undertaken from November 2012 to June 2013. Consents were taken from guardians and students. Questionnaire was used to acquire data followed by blood sampling. Lead was measured using atomic absorption Spectrophotometer, hemoglobin and serum calcium was measured using commercial kits. Intelligent Quotient was assessed using serum form board. Data was analyzed using SPSS version 20. Results: Overall, 63% (137) had detectable blood lead level (BLL) and 54% (117) had BLL ≥ 5 ug/dl. 55% were male and 45% female. The median BLL (IQR) was 8(0-34) and 4(0-18)b in males and females respectively. The mean hemoglobin and serum calcium was 13.7±2.4 and 8.1±1.8 respectively. On risk factors evaluation, the odds of having elevated blood lead level (EBLL) was significantly higher in children living in homes with chipping walls (p value 0.001). Children belonging to families with lower socioeconomic status (p value 0.001) and residing near traffic congested areas (p value 0.007). The median IQ was 73.5(66–91). EBLL showed significant negative correlation with IQ (p value 0.001). EBLL was identified as significant risk factor lowering IQ by 2.35 points per 10 ug/dl rise in blood. Conclusion: Children living in homes with chipping walls, having lower socioeconomic status and residing near traffic congested areas had significantly higher lead level. EBLL showed significant negative correlation with IQ. Keywords: blood lead level, elevated blood level, intelligent quotient, leadPublication Enteropathogenic microorganisms in children(Institute of Medicine, 2008) Tandulkar, S; Sherchand, O; Singh, A; Sherchand, JBAbstract Introduction: Diarrhoeal disease is a leading cause of mortality and morbidity in the developing world. It is one of the most important causes of death in childhood and is still a considerable public health problem in developing countries especially among less than five years old. Materials and Methods: Stool samples from children attending both ORT centre and OPD of Kanti Children’s Hospital below 10 years of age were collected and simultaneously data on predisposing factors associated with gastroenteritis along with acute diarrhoea were collected according to the questionnaire designated. The collected stool samples were brought immediately to the laboratory. Upon arrival the stool samples were processed according to the standard laboratory methods. Result: The distribution of enteropathogens showed that rotavirus was found highest constituting 27% of the total cases. Among parasites, protozoan (12.2%) dominated over helminthes (3.0%). Among the protozoa, Entamoeba. histolytica (7.0%) was major causative agent of dysentery followed by Giardia lambia (3.8%), Cyclospora cayetanensis (1.2%), and Entamoeba coli (0.3%). Among the helminthes, Ascaris lumbricoices was the major pathogen constituting 1.3% followed by Trichuris trichiura (0.8%), Hookworm (0.5%) and Hymenolepis nana (0.3%) of the total cases. Similarly, among bacteria Shigella spp. was highest of the total cases. Shigella dysenteriae in 2.0% (12 out of total 607); followed by Shigella flexneri in 1.0% and Shigella boydii in 0.3%. In case of Vibrio cholera it constitutes about 2.0% and Salmonella spp. in 1.3% of total cases. The study shows that the prevalence of Salmonella Paratyphi A in 0.3% (2 out of 607) followed by Salmonella Paratyphi B in 0.3% and Salmonella Typhi in 0.6%. Conclusion: It can be concluded that lots of enteropathogens were involved in children diarrhoea. Among them rotavirus were predominant followed by parasites and bacteria. Children under 2 years were more affected age groups. Keywords: Diarrhoea, Enteropathogens, Rotavirus, Bacteria and ParasitesPublication Laboratory parameters of β thalassemia minor patients visiting BPKIHS as diagnosed by Agarose Gel Electrophoresis(Institute of Medicine, 2013) Sherchand, O; KC, R; Lamsal, M; Baral, NAbstract Introduction: Thalassemia is one of the most common genetic disorders worldwide. The current study aims at various laboratory parameters including agarose gel electrophoresis (AGE) pattern of patients consistent with clinical symptoms of β thalassemia minor. Methods: A total of 78 blood samples collected from patients visiting BPKIHS, Dharan to workup for anemia and red blood cell indices. From these 78 patients, 8 samples were suspected of β thalassemia minor and were included in the study. The patients were divided in two groups, adult above 15 years of age and children less than 15 years of age. These samples were further investigated using various laboratory indices including electrophoresis. Results: β-thalassemia minor was detected in 8 cases with various hematological parameters and electrophortic mobilities. The electrophoretic mobility pattern revealed that the patient had increased HbA2 and HbF band and decreased HbA1 band. Among hematological parameters, the mean hemoglobin was 8.1± 2.3gm% in >15 years age group and 3.9± 1.7 in <15 years age group, Peripheral smear revealed microcytic, hypochromic, anisopoikilocytic, target cells and solubility test for sickle cell was negative for all samples. The median unconjugated bilirubin level was 1.95 (IQR: 1.6-2.1) in <15 yrs and 2.25 (IQR: 1.7-7.7) in >15 yrs, the median reticulocyte count was 1.65 (IQR: 0.55-2.3) in <15 yrs and 1.8 (IQR: 1-5) in >15 yrs, Reticulocyte production Index was less than two, median HbF was 7.5 (IQR: 4.2-25) in <15 yrs and 8 (IQR: 1.7-18) >15 yrs , median PCV was 23.4 (IQR: 19.5-25.9) in <15 yrs and 14.6 (IQR: 12.2-16.8) in > 15 yrs. The study also revealed that the β-thalassemia was predominant among Tharus (50%) compare to other ethnicity. Conclusion: Patients of β thalassemia minor showed decrease in hemoglobin, increased unconjugated bilirubin, abnormal peripheral smear, and abnormal hemoglobin pattern on electrophoretogram. Keywords: Beta thalassemia minor, agar gel electrophoresis, HbA2