Venereal syphilis is a sexually transmitted disease, involving pathological activities mediating tissue destruction by extensive tissue necrosis. As such, the goal amongst researchers has been set to the identification of effective laboratory biomarkers that can reflect the broad spectrum of disease and ultimately aid in timely diagnosis and effective treatment of syphilis. This research aimed to study the applications of hematological biomarkers associated with syphilitic patients visiting a tertiary care hospital.A retrospective cross-sectional study was conducted in the syphilitic patients attending KIST Medical College and Teaching Hospital, Lalitpur, Nepal. A total of 25 syphilitic patients and 41 non-syphilitic participants were included. The rapid plasma reagin test and Treponema pallidum hemagglutination assay were used for the screening and confirmation of syphilis respectively. The hematological investigation was performed using a hematology analyzer. Statistical Package for Social Science version 17.0 was used for data analysis. A P value <0.05 was considered significant.Syphilitic patients showed significantly elevated levels of lymphocytes (39.8±11.5) (p=0.025), monocyte (1.9±0.8) (p=0.002), mean corpuscular volume (MCV) (92.6±12.9) (p=0.005), and mean corpuscular hemoglobin (MCH) (31.9±4.6) (p=0.008) and lowered levels of red blood cell (RBC) (4.2±0.3) (p=0.005) and platelets (237.2±628.6) (p=0.048) as compared to the lymphocytes (32.9±11.9), monocyte (0.6±1.2), MCV (83.9±8.8), MCH (34.3±1.5), RBC (4.6±0.7), and platelets (280.9±113.3) of the non-syphilitic participants.The results showed that the elevated levels of lymphocyte, monocyte, MCV, and MCH and lowered levels of RBC and platelets are highly specific hematological biomarkers for the diagnosis of patients with syphilis.
Young paramilitary recruits, who undergo strenuous exercise during basic training, are often presented with stress fractures, which could be due to an inadequate vitamin D (25-hydroxyvitamin D) intake. This study aimed to find the prevalence of stress fracture among young paramilitary trainees visiting the orthopedic outpatient department of a paramilitary hospital.This was a descriptive cross-sectional study done among paramilitary trainees in a paramilitary Hospital of Nepal between April 2019 to April 2021. The study was approved by the Ethical Review Board (Reference number: 1003) of the Nepal Health Research Council. Convenience sampling was used. Anthropometric variables, serum 25-hydroxyvitamin D level, and bone mineral density of spine and hip were determined. Data analysis was performed using the Statistical Package for the Social Sciences software version 17.0. Point estimate at 95% Confidence Interval was calculated along with frequency, proportion for binary data and mean, standard deviation for continuous data.Among 417 young paramilitary trainees, 24 (5.76%) (3.52-7.99 at 95% Confidence Interval) were found to have a stress fracture. The stress fracture patients had a serum 25-hydroxyvitamin D level of 21.47ng/mL±6.98. Similarly, the bone mineral density value of the spine and hip among the patients was -1.34g/cm2±1.37 and 0.36g/cm2±1.24, respectively.The prevalence of stress fracture among young paramilitary trainee was high compared to previous studies. Additionally, average Vitamin D and the bone mineral density value of the spine and the total hip among stressed fractured patients were also low.
Background Multidrug-resistant tuberculosis (MDR-TB), characterized by isoniazid and rifampicin resistance, is caused by chromosomal mutations that restrict treatment options and complicate tuberculosis management. This study sought to investigate the prevalence of pre-extensively drug-resistant (pre-XDR) and extensively drug-resistant (XDR) tuberculosis, as well as mutation pattern, in Nepalese patients with MDR/rifampicin-resistant (RR)-TB strains. Methods A cross-sectional study was conducted on MDR/RR-TB patients at the German Nepal Tuberculosis Project from June 2017 to June 2018. The MTBDRsl line probe assay identified pre-XDR-TB and XDR-TB. Pre-XDR-TB included MDR/RR-TB with resistance to any fluoroquinolone (FLQ), while XDR-TB included MDR/RR-TB with resistance to any FLQ and at least one additional group A drug. Mutation status was determined by comparing bands on reaction zones [ gyrA and gyrB for FLQ resistance, rrs for SILD resistance, and eis for low-level kanamycin resistance, according to the GenoType MTBDRsl VER 2.0, Hain Lifescience GmbH, Nehren, Germany definition of pre-XDR and XDR] to the evaluation sheet. SPSS version 17.0 was used for data analysis. Results Out of a total of 171 patients with MDR/RR-TB, 160 had (93.57%) had MTBC, of whom 57 (35.63%) had pre-XDR-TB and 10 (6.25%) had XDR-TB. Among the pre-XDR-TB strains, 56 (98.25%) were FLQ resistant, while 1 (1.75%) was SLID resistant. The most frequent mutations were found at codons MUT3C (57.14%, 32/56) and MUT1 (23.21%, 13/56) of the gyrA gene. One patient had SLID resistant genotype at the MUT1 codon of the rrs gene (100%, 1/1). XDR-TB mutation bands were mostly detected on MUT1 (30%, 3/10) of the gyrA and rrs , MUT3C (30%, 3/10) of the gyrA , and MUT1 (30%, 3/10) of the rrs . Conclusions Pre-XDR-TB had a significantly higher likelihood than XDR-TB, with different specific mutation bands present in gyrA and rrs genes.
Intestinal parasitic infections (IPIs) are diseases of serious public health concern in low- and middle-income countries, including Nepal. Such infections can cause growth retardation and increased susceptibility to other parasitic infections. Hence, this study aims to assess the prevalence of IPIs among the patients attending a tertiary care hospital in central Nepal.Clinical and laboratory records of patients, whose stool samples were collected and transported to the Department of Clinical Microbiology, KIST Medical College and Teaching Hospital, during 2 years (January 2019 and December 2020) were examined for parasitological findings, by conventional microscopy using normal saline and iodine preparation.Out of 3,146 patients included in the study, 411 (13.1%) patients (median age[IQR]: 27[12-45]) were infected with the intestinal parasites. Patients of different age groups, such as 20-30 years (16.1%), 10-20 years (14.1%), and 30-40 years (13.3%) were mostly infected. Infection was more common in females (221/1572, 14.1%) than males (190/1574, 12.1%). There were 373 (90.8%) cases of IPIs due to Entamoeba histolytica, 34 (8.3%) cases due to Giardia lamblia, and 4 (0.9%) cases due to helminths. The prevalence of IPI in the first and second years was 14.5% (260/1794) and 11.2% (151/1352), respectively. IPIs were more common in summer (n=87, 12.8%) and spring(n=81, 10.8%).Present study showed a declined prevalence of helminth infection. However, a higher rate of protozoan infection indicated the water source contamination with fecal matters and therefore urgencies for awareness among the public about hygienic practices.
Objectives: Migration is one of the socioeconomic factors that contribute to the acquisition and dissemination of sexually transmitted disease/s (STDs), a long-recognized major global health issue. This study aimed to determine the seroprevalence of STDs among Nepalese overseas job seekers. Methods: Retrospective serological data of Nepalese overseas job seekers (n=14,980), who were tested for Hepatitis B (HB), Hepatitis C (HC) and Acquired Immune Deficiency Syndrome (AIDS) with an enzyme-linked immunosorbent assay, and syphilis with Treponema pallidum hemagglutination assay, were extracted (January and December 2021) from the electronic database of a diagnostic center and analyzed using SPSS version 17.0. Results: Syphilis seroprevalence was 0.59% among overseas job seekers, while HB, AIDS, and HC seroprevalences were 0.32%, 0.15%, and 0.11%, respectively. Unlike syphilis, which was predominated in the age group of 31-40 years, viral hepatitis and AIDS were prevalent in the age group of 21-30 years. Males had higher incidences of HB (n=48), HC (n=17), AIDS (n=23), and syphilis (n=86) compared with females. Co-prevalence of HIV-syphilis and HIV-HBV occurred in 0.020% (n=3) and 0.013% (n=2) of individuals, respectively, whereas both HIV-HCV and HBV-HCV co-prevalence was observed in 0.007% (n=1) of individuals. Conclusion: Syphilis is the most common STD among Nepalese overseas job seekers, with the highest co-occurrence with AIDS.
Immune and inflammatory responses developed by the patients with Coronavirus Disease 2019 (COVID-19) during rapid disease progression result in an altered level of biomarkers. Therefore, this study aimed to analyze levels of blood-based biomarkers that are significantly altered in patients with COVID-19.A cross-sectional study was conducted among COVID-19 diagnosed patients admitted to the tertiary care hospital. Several biomarkers-biochemical, hematological, inflammatory, cardiac, and coagulatory-were analyzed and subsequently tested for statistical significance at P<0.01 by using SPSS version 17.0.A total of 1,780 samples were analyzed from 1,232 COVID-19 patients (median age 45 years [IQR 33-57]; 788 [63.96%] male). The COVID-19 patients had significantly (99% Confidence Interval, P<0.01) elevated levels of glucose, urea, alanine transaminase (ALT), aspartate aminotransaminase (AST), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), ferritin, D-Dimer, and creatinine phosphokinase-MB (CPK-MB) compared to the control group. However, the levels of total protein, albumin, and platelets were significantly (P<0.01) lowered in COVID-19 patients compared to the control group. The elevated levels of glucose, urea, WBC, CRP, D-Dimer, and LDH were significantly (P<0.01) associated with in-hospital mortality in COVID-19 patients.Assessing and monitoring the elevated levels of glucose, urea, ALT, AST, ALP, WBC, CRP, PCT, IL-6, ferritin, LDH, D-Dimer, and CPK-MB and the lowered levels of total protein, albumin, and platelet could provide a basis for evaluation of improved prognosis and effective treatment in patients with COVID-19.
Introduction: Dengue, caused by the dengue virus, has a wide range of clinical features, including fever, body ache, lethargy, nausea, and vomiting. Blood-based biomarkers in patients with dengue virus infection reflect a variety of clinical spectrums, from bleeding manifestations to liver abnormalities, and can serve as an essential tool for clinicians. This study aimed to determine the prevalence of dengue among patients visiting the Outpatient Department in a secondary care centre. Methods: A descriptive cross-sectional study was conducted among patients visiting the Outpatient Department from 16 May 2022 to 15 November 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: 20790202). The socio-demographic details and biochemical and haematological findings of dengue virus-infected patients diagnosed with rapid diagnostic tests were collected. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Out of 706 individuals, the prevalence of dengue was 83 (11.76%) (9.38-14.14, 95% Confidence Interval). The median age of dengue virus-infected patients was 40 years, and the majority were males 54 (65.06%). Conclusions: The prevalence of dengue was found to be lower than in other studies done in similar settings.
The ability of Staphylococcus aureus to form biofilmsâ€"architectural complexes that cause chronic and recalcitrant infectionsâ€"along with its notorious variant, methicillin-resistant Staphylococcus aureus (MRSA), leads to multidrug-resistant (MDR) infections that are challenging to treat with antibiotics. This cross-sectional study investigated the prevalence of S. aureus infections in Kanti Children’s Hospital and characterized the antibiograms of MDR, MRSA, and biofilm-forming strains, along with their coexistence.
Vitamin D deficiency is a global health issue affecting billions of people. Its deficiency results in abnormal homeostasis of calcium and phosphorous levels in an individual and results in reduced bone mineral density, which further makes them more prone to develop osteogenic disorders, such as fractures. The aim of this study is to find out the prevalence of vitamin D deficiency among patients visiting the outpatient departments in a tertiary care centre.This was a descriptive cross-sectional study done among 582 patients visiting outpatient departments in a tertiary care centre between January 1, 2019 and July 31, 2020. The study was approved by the Institutional Review Committee (Reference number: 076/077/17) of a tertiary care centre. A convenience sampling method was used. Patients' demographic detail and serum vitamin D level were determined. Data were collected retrospectively from hospital records and analysis was performed using the Statistical Package for the Social Sciences software version 17.0. Point estimate at 95% Confidence Interval was calculated along with frequency, the proportion for binary data, and mean with standard deviation for continuous data.Among 582 patients enrolled in this study, 328 (56.35%) (52.32-60.38 at 95% Confidence Interval) patients were vitamin D deficient. Vitamin D deficiency was found in 238 (72.56%) females and 257 (78.35%) aged 16 to 59 years. Finally, there were 102 (31.09%) cases of vitamin D deficiency over the winter season.The prevalence of serum vitamin D deficiency in the current study was lower when compared to similar studies done in similar settings and similar to the prevalence from international literature.deficient; prevalence; vitamin D.
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