Introduction: Thyroid dysfunction is an important endocrine disorder worldwide among which hypothyroidism, is attributed to environmental deficiency of iodine. Congenital hypothyroidism is one of the most common preventable causes of intellectual disability worldwide. Hypothyroidism is easily treated and timely detection and treatment of the disorder could reduce the adverse fetal and maternal outcome. The aim of our study is to find the prevalence of thyroid illness in a tertiary health care center of Nepal. Methods: This was a descriptive, cross-sectional study carried out in the Department of Biochemistry of Shree Birendra Hospital, Chhauni, Kathmandu over a period of five months from March 2021 to July 2021. We selected 1000 patients with symptoms suggestive of thyroid disorders. Detailed history was obtained and free triiodothyronine (fT3), thyroxine (fT4) and thyroid stimulating hormone (TSH) estimation was done in Siemens CP Chemiluminescence Immunoassay analyzer. Data were entered in Microsoft Excel and managed in SPSS version 20.  Results: Most of our patients with hypothyroidism presented with puffiness of the face, hoarseness of voice, whereas weight loss and restlessness were predominant features in hyperthyroid patients. In our study, the prevalence of hypothyroidism and hyperthyroidism were 16.0% and 9.5% respectively. Conclusions: Hypothyroidism is common in the female population. We found that hypothyroidism and subclinical hypothyroidism were more prevalent in the reproductive age group.

Background Measurement of Glycosylated Hemoglobin (HbA1c) is an established procedure in evaluating long-term glycemic control in diabetic patients. It is an index of glycemic control which is not affected by diurnal glucose fluctuations. Methods A retrospective cross sectional study was performed in the Biochemistry department of Shree Birendra Hospital, Kathmandu, Nepal involving 100 known cases of type 2 diabetes mellitus. This study was designed to study the variation of HbA1c with hemoglobin levels. HbA1c was measured by Bio-Rad D10 (HPLC method) and Nycocard (Immunochromatography method). Linear regressive analysis with correlation coefficient was used to compare HbA1c with hemoglobin levels and a p-value < 0.05 is considered statistically significant. Results There was a strong correlation of HbA1c values with Hemoglobin levels in HPLC methods p = 0.001, r = 0.6, however no such correlation was seen in Nycocard method p = 0.6, r = 0.08. Conclusion Cation-exchange high performance liquid chromatography (HPLC) is the latest method introduced in our country Nepal. Therefore, interference caused by Hemoglobin variants needs to be evaluated by methods such as HPLC. In such situations, we may consider fructosamine, glycated serum albumin or self-monitoring of blood glucose as an adjunct to HbA1C measurements.

Introduction: Dashain, one of the national festivals in Nepal, celebrated with excessive consumption of high purine content foods, alcoholic and soft beverages. These foods have been associated with higher Serum Uric Acid (SUA) levels leading to hyperuricemia. This study was intended to evaluate the distribution pattern of SUA level a month before and after this festival for two consecutive years.   Methods and Materials: The data of 5818 patients visiting Clinical Biochemistry Laboratory, Tribhuvan University Teaching Hospital for SUA test (a month before and after Dashain festival for two consecutive years; 2017 - 2018 A.D.) were collected and analyzed. The statistical analysis was done using SPSS version 21. Continuous variables were expressed as mean ± SD taking 95% confidence interval and p values of <0.05 was considered to be statistically significant. Mann-Whitney U test was used to compare the variables.   Results: The mean SUA levels before and after Dashain in two consecutive years were 333.5 ± 112.1 μmol/L and 334.2±114.7 μmol/L in 2017 A.D. and 322.6 ± 103.9μmol/L and 343.2± 111.4 μmol/L in 2018 A.D. There was a significantly elevated level of the mean SUA level after Dashain festival in 2018 among both sexes (p-value <0.05). The age-wise distribution of mean SUA after the Dashain festival was consistent with increasing age among the study population.   Conclusion: The study concluded that the Dashain festival has an impact on increasing the SUA level.

Background Thyroid disorder is an important endocrine disorder in Nepal which is mostly due to environmental deficiency of iodine. The earliest and potentially most damaging result of iodine deficiency is neonatal hypothyroidism and cretinism characterised by learning disabilities and poor motivation to achieve. Methods We selected one thousand known cases of thyroid disorders who visited biochemistry department of shree Birendra Hospital, chaunni for routine tests. A detailed history was obtained and free triiodothyronine (fT3), thyroxine (fT4) and thyroid stimulating hormone (TSH) estimation was done in Seimens CP Chemiluminiscence Immunoassay analyser. Result Puffiness of face, hoarseness of voice and weight gain were the presenting features in hypothyroid patients, whereas weight loss and restlessnes were predominant features in hyperthyroid patients. In our study the prevalence of hypothyroidism and hyperthyroidism was 27% and 12.5% respectively. Conclusion None of our patients had visible neck swellings or goiter which had subsided after salt iodination program in Nepal as environmental deficiency of iodine was the primary factor for development of goiter in Nepal.

Introduction: The measurement of glycated hemoglobin (HbA1c) is an established procedure in evaluating long-term glycemic control in diabetic patients. There are many factors like temperature, pH, lifespan of protein, substrate concentrations and hemoglobin levels that influence HbA1c estimation by any methods. The aim of the study is to estimate HbA1c by High Performance Liquid Chromatography (HPLC) and immunochromatography analyzer and find the influence of hemoglobin in HbA1c by both the methods. Methods: This was a descriptive, cross-sectional study carried out in the department of Biochemistry of Shree Birendra Hospital, Chhauni, Kathmandu over a period of two months from May 2021 to June 2021. We selected patients with type 2 diabetes mellitus. HbA1c was measured in EDTA blood samples by Bio-Rad D10 (HPLC method) and Nycocard (Immunochromatography method) whereas hemoglobin was estimated using Horiba Penta XLR fully automated hematology analyzer. Results: In our study of 100 known cases with type 2 diabetes mellitus, the mean hemoglobin level was 14 ± 2.09 g/dL. The mean HbA1c value obtained by Nycocard and HPLC analyzer were 7 ± 1.95 % and 7.39 ± 2.21% respectively. We found that there was a strong correlation of HbA1c values with hemoglobin levels in HPLC method p = 0.001, r = 0.6. However, we found no such correlation by Nycocard method p = 0.6, r = 0.08. Conclusion: There was a positive correlation of hemoglobin with HbA1c values obtained by HPLC method however no such variation was seen with immunochromatography method. This suggests that estimating HbA1c by HPLC methods may show decreased HbA1c with decreased hemoglobin levels and increased HbA1c with increased hemoglobin levels.