Background: Blood transfusions are lifesaving, but resource limitations and inadequate utilization patterns pose challenges in low- and middle-income countries. In Nepal, detailed analyses of blood use practices, are needed to inform resource allocation and policy decisions. The objective of this study was to study the overall and component-specific use, explore temporal trends in utilization of blood and blood products. Methods: We conducted an observational study analyzing data from Blood Bank of Tribhuvan University Teaching Hospital (TUTH), a tertiary hospital (January 1st - December 31st, 2019). Data included patient demographics, blood groups, blood products requested and transfused, and facility type. Data analysis was conducted with SPSS v20.Results: Patients from TUTH had substantially higher blood product requests, requesting 25,716 units compared to only 1855 units across other centers combined. Blood groups A positive (8089, 31.4%) and and O positive (7851, 30.6%) were the most requested blood groups. Whole blood (11358, 44.2%) and packed red blood cells (9565, 37.2%) were most frequently requested. We observed monthly fluctuations in demand with peak of 2742 requests in December with a trough in June (1947 units). Notably, only approximately 46% of blood products requested from patients admitted to TUTH were ultimately transfused. Conclusions: Whole blood and packed red blood cells were the most frequently requested blood products. Eventhough whole blood was the most frequently requested blood product, the most transfused one was packed red cells. Peak demand was observed in December. Our study provides valuable insights into blood utilization patterns, underscoring the need for specific strategies to improve blood transfusion management practices. Keywords: Blood banking; blood transfusion; blood utilization; LMICs. Nepal.
Introduction: Differential leukocyte is a frequently ordered laboratory test. It is the percentage distribution of types of leukocytes on a stained film. There are two methods to determine differential leukocyte count which are manual and automated. Manual method is considered the gold standard and is used to validate differential counts obtained by automated method. The comparative knowledge about the different methods to determine differential leukocyte count may guide us to use of proper method to determine the differential count more accurately and in a shorter time. The study aims to compare differential leukocyte count of normal blood samples by manual and automatic methods. Materials and methods: A cross-sectional, analytical study was conducted in laboratory of Kasturba Hospital, Manipal. A total of 347 blood samples of adults that did not show abnormalities in automatic analyzer were included in the study by purposive sampling method. Blood smears for manual count were prepared by Leishman’s stain. Results: A significant difference was observed between manual and automated leukocyte differential counts in 100 and 200 cells per specimen in neutrophils, lymphocytes, monocytes, eosinophils and basophils. Conclusions: The study concludes the need of improving accuracy and reliability of the automated methods. A reference range generated by further studies could help provide more accurate determination of differential leukocyte count.
Background: The Queens College Step Test is used to determine aerobic fitness. Peak Expiratory Flow Rate (PEFR) is the maximum rate of forceful exhalation following full inspiration. PEFR primarily reflects bronchial airflow and depends on the voluntary effort and muscular strength of the individual. Studies that correlate ventilatory capacity with body fat percentage are rare in published literature in Nepalese settings. Body fat percentage is regarded as a better indicator of obesity recently. Hence, this study aims to find an association between post-exercise change in PEFR and body adiposity in the context of Nepal.
Methods: A cross-sectional study was carried out from 20th July 2019 to 15th November in the laboratory of Clinical Physiology of Maharajgunj Medical Campus. Body fat percentage was measured by using OMRON BF 214. Pre-exercise PEFR of each subject was recorded by using Wright’s peak flow meter. Post-exercise PEFR was also recorded after three minutes of Queen’s College step test, which is the submaximal exercise test, and change in PEFR was calculated and correlated with body fat percentage.
Result: The study showed a negative correlation of change in PEFR with body fat percentage (r=-0.324; P<0.001). A significant difference (P = 0.002) was observed between different quartiles of body fat percentage. A highly significant difference (P = 0.003) was noted with the first and fourth quartiles.
Conclusion: Less ventilatory adjustment in response to exercise was noted in subjects with more body fat percentage compared to those with less body fat percentage.
Introduction Hand grip strength is used in evaluation of muscle strength and is also increasingly being used as an indicator for nutritional status. The maximum force applied voluntarily by the subject is called maximum handgrip strength, which is measured in kilograms. Muscular endurance is the ability of a muscle or muscle group to perform against a load for an extended period of time, measured in seconds. This study aims to correlate body mass index with handgrip strength and handgrip endurance in medical students.
MethodsThis is a cross sectional, observational study which included 74 undergraduate students of Maharajgunj Medical Campus by convenient sampling method. Body mass index was calculated by Quetelet’s formula. Camry digital hand dynamometer was used to measure handgrip strength in the dominant hand in kilograms. Participants were instructed to hold dynamometer with maintained pressure of 30% of maximum handgrip strength for as long as possible to determine the handgrip endurance. Statistical analyses were performed with SPSS Statistics software.
ResultsThe handgrip strength was more in males than females with a mean of 43.09±3.72 kg, while handgrip endurance was more in females with a mean of 123.60±50.65 sec. Positive correlation was seen between body mass index and handgrip strength (r=0.23 and p=0.045). Body mass index and handgrip endurance also showed positive correlation (r=0.34 and p=0.003).
ConclusionSignificant correlation of body mass index with handgrip strength and handgrip endurance was seen in medical students.
Background: Obesity is a major health problem worldwide in the developed as well as in developing countries like Nepal. It has been linked with different co-morbidities that are known to increase the incidence of cardiopulmonary problems. The study aims to find the association of obesity markers with peak expiratory flow rate in young healthy participants. Methods: A cross-sectional analytical study was performed in 114 students of Maharajgunj Medical Campus in between the age group of 18-25 years. Subject’s body mass index, waist circumference, waist hip ratio, body fat percentage and peak expiratory flow rate were assessed. Peak expiratory flow rate was correlated separately with obesity markers using Pearson’s correlation test. Results: The mean peak expiratory flow rates for male and female were 524.18±87.30 L/min and 355.78±77.89 L/min respectively. A negative correlation was found between peak expiratory flow rate and body mass index (r=-0.082, p=0.50), and also with waist circumference (r=-0.148, p=0.21), waist hip ratio (r=-0.095, p=0.42) and body fat percentage (r=-0.061, p=0.61) in males. In females, peak expiratory flow rate had a negative correlation with body mass index (r=-0.237, p=0.13) and body fat percentage (r=-0.227, p=0.15) whereas, it had a positive correlation with waist circumference (r=0.031, p=0.84) and waist hip ratio (r=0.023, p=0.89). Conclusion: All the obesity markers were negatively correlated with peak expiratory flow rate in males, whereas body mass index and body fat percentage were negatively correlated but waist circumference and waist hip ratio were positively correlated with peak expiratory flow rate in females. PEFR may not be affected by obesity both in males and females as all the correlations are weak.
Introduction: Height is used to calculating body mass index and body surface area which are used to interpret renal function tests and pulmonary function tests. The maximum vertical measurement of a person is the standing height. Arm span is the measurement between the tip of the middle finger of the right and left hands. The exact standing height of patients with abnormalities of disproportionate growth, spine deformities, skeletal dysplasia, limb deformities, amputated limb, pain, weakness or paralysis cannot be measured. In these conditions, an arm span may be used to determine the height of a person. Objective: This study aims to determine the association of height and arm span among the medical students of Maharajgunj, Medical Campus, Nepal. Methods: A cross-sectional analytical study was conducted among medical students in the Clinical Physiology Department of Maharajgunj Medical Campus from November 2020 to October 2021. Non-probability, the convenience sampling method was adopted and a total of 110 participants were enrolled in the study including 55 males and 55 females. Pearson’s correlation coefficient was used to find the association between height and arm span. A simple linear regression test was also used to formulate the equations of height and arm span and data analysis was done using SPSS version 25. Results: A significant positive correlation was observed between height and arm span where the total participants had r-value=0.765(p=0.00), males had r-value=0.557(p =0.00) and female had r-value=0.778(p=0.00). Conclusions: A strong positive correlation was observed between height and arm span among the participants.
Introduction: Hand grip strength is used in evaluation of muscle strength and is also increasingly being used as an indicator for nutritional status. The maximum force applied voluntarily by the subject is called maximum handgrip strength, which is measured in kilograms. Muscular endurance is the ability of a muscle or muscle group to perform against a load for an extended period of time, measured in seconds. This study aims to correlate body mass index with handgrip strength and handgrip endurance in medical students. Methods: This is a cross sectional, observational study which included 74 undergraduate students of Maharajgunj Medical Campus by convenient sampling method. Body mass index was calculated by Quetelet’s formula. Camry digital hand dynamometer was used to measure handgrip strength in the dominant hand in kilograms. Participants were instructed to hold dynamometer with maintained pressure of 30% of maximum handgrip strength for as long as possible to determine the handgrip endurance. Statistical analyses were performed with SPSS Statistics software. Results: The handgrip strength was more in males than females with a mean of 43.09±3.72 kg, while handgrip endurance was more in females with a mean of 123.60±50.65 sec. Positive correlation was seen between body mass index and handgrip strength (r=0.23 and p=0.045). Body mass index and handgrip endurance also showed positive correlation (r=0.34 and p=0.003). Conclusion: Significant correlation of body mass index with handgrip strength and handgrip endurance was seen in medical students.
Background: The seasonal changes are associated with changes in pulmonary functions including Peak Expiratory Flow Rate (PEFR). These changes are different among different population and location. This study thus aimed to evaluate the seasonal variations in PEFR among healthy young individuals in Kathmandu. Methods: A comaparative study was carried out among 60 undergraduate medical students of Maharajgunj Medical Campus in the department of Clinical Physiology. The students were selected by convenient sampling technique and after obtaining the informed consent, the PEFR was recorded with the help of Wright’s peak flow meter with proper training. The PEFR was recorded two times i.e. morning and daytime hours in winter season (January-February) 2023 and also in same daily hours of summer season (May-June) 2023 in the same participants. The data were analyzed using SPSS-16 version and the paired T test was used to compare the mean changes in PEFR in winter and in summer seasons. Results: The PEFR in summer morning (499.50±89.50 L/min) was recorded higher than in winter morning (487.50±86.09 L/min) among total participants and also in male participants (567.33±69.34; 550.83±69.58) which was statistically significant with P value <0.05. Similarly, the PEFR in summer daytime (505.08±88.85 L/min) was comparatively more than in winter daytime (491.27±92.07 L/min) which was statistically significant among all participants with P value <0.05. The PEFR in the winter and summer seasons of male participants and in the summer of total participants showed the existence of diurnal variation which was statistically significant. Conclusions: There is seasonal variation as well as diurnal variations of PEFR. So, the clinicians should be aware that the PEFR recorded in winter season and in the morning time might be less than that recorded in the summer and at the daytime respectively.
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