Introduction: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Serum lactate is useful in predicting the prognosis of critically ill patients. Elevated blood lactate levels as well as delayed clearance have been linked to higher mortality in sepsis. Shock index is a simple and effective bedside assessment means of gauging the degree of shock and is an important predictor of identifying high-risk patients. Monitoring lactate levels may aid clinicians in understanding tissue perfusion and detecting unrecognized shock and making prompt therapy adjustments. This study aimed to find out the mean serum lactate levels in patients with sepsis presenting to the Department of Emergency Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted at a tertiary care centre among the patient with sepsis presenting to the emergency department from 1 September 2022 to 30 November 2022. Ethical approval was obtained from the Institutional Review Committee of a tertiary care centre (Reference number: 26082022/02). History taking and detailed examination were done. Blood was sent for serum lactate and other parameters as proforma was sent. The shock index was calculated. Convenience sampling was done. Point estimate and 95% confidence interval were calculated. Results: Among 53 sepsis patients, the mean serum lactate level in sepsis patients was 2.84+2.02 (male: 2.83+1.70 and female: 2.85+2.42). Conclusions: The mean serum lactate level in patients with sepsis is similar as compared the studies done in similar settings.

Background: Metabolic syndrome, a cluster of metabolic abnormalities which bears increased risk for cardiovascular diseases and diabetes mellitus, requires early screening, diagnosis, and timely intervention. Prevalence varies with age, gender, degree of obesity, and increased propensity for type 2 diabetes mellitus. Objectives: To find out the prevalence of metabolic syndrome among individuals with hypertension and/or diabetes seeking medical evaluation in general practice outpatient department of Kathmandu Medical College Community Hospital. Methods: This cross-sectional analytical study was conducted among 100 participants collected by convenience sampling at general practice outpatient department of Kathmandu Medical College Community Hospital, Duwakot, Bhaktapur, Nepal. Physical examination was done and investigations were sent. Metabolic Syndrome was diagnosed using US National Cholesterol Education Program Adult Treatment Panel. Data collection was done from 2019 July to 2019 December. Study population was patients with either hypertension and/or diabetes seeking medical evaluation, age of 18 years or above, both genders, no known comorbidity other than those under medication for hypertension and diabetes. Data analysis was done with SPSS v.16 and two-sample t-test or Chi-square test applied as appropriate. A p-value <0.05 taken as statistically significant. Results: Out of 100 individuals, 73 were found having metabolic syndrome. It was more common among male (38, 52.1%), obese people of age 40-59 years (42, 57%), and among patients with high body mass index (26.93±2.74). Conclusion: The prevalence of metabolic syndrome was found significantly high among patients with hypertension or diabetes. Therefore, it is important to diagnose this condition on time to prevent subsequent complications.

Introduction: Acute organophosphorus pesticide poisoning is widespread and the most common in many developing countries, including Nepal. Through the inhibition of acetylcholinesterase, organophosphorus poisoning is characterised by the clinical picture of acute cholinergic crisis. Many researchers have shown increased levels of liver enzymes and decreased levels of serum cholinesterase in organophosphorus poisoning, however, very little work has been done in Nepal that studies the correlation between serum cholinesterase and liver enzymes in organophosphorus poisoning. The aim of the study is to find out the mean cholinesterase level among organophosphorus poisoning patients visiting the Emergency Department in a tertiary care centre. Methods: This was a descriptive cross-sectional study done among 94 organophosphate poisoning cases visiting the emergency department of a tertiary care centre from August 2021 to August 2022 after obtaining approval from the Institutional Review Committee (Reference number: 04102021/06). Convenience sampling was done. Blood workups were done for cholinesterase and liver function tests. Point estimate and 90% Confidence Interval were calculated. Results: The mean cholinesterase level among organophosphorus poisoning patients was 1978.82±1878.22 (1660.17-2297.47, 90% Confidence Interval). Conclusions: The mean cholinesterase level among organophosphorus poisoning patients was similar when compared to other studies done in similar settings.

Background: Epistaxis is one of the most common emergencies and a very difficult problem to tackle especially in Primary Health Centers or Health Posts in rural areas of Nepal. The objective of the study was to identify blood group and platelet count with the occurrence of nasal bleeding. Materials and Methods: A prospective study was carried out among 96 patients visiting Kathmandu Medical College and Teaching Hospital in Emergency Department and ENT Department with epistaxis from October 2021 to October 2022. Ethical clearance was obtained from IRC Kathmandu Medical College Teaching Hospital (reference no: 0609202105). A blood sample was sent for blood groups and platelet count. Convenience sampling was used. Data were entered in Microsoft Excel 2016 and analyzed in Statistical Package for Social Sciences version. Results: The age group of 20-29 years was found to be the commonest age group presented with epistaxis. The commonest blood group with epistaxis was found to be O+ve and platelet count was found to be within the normal range in the majority of the cases. Conclusions: Epistaxis was found to be more common among patients with O+ve than non ‘O’ blood groups. Patients with Blood group O+ve need to be investigated further for coagulation profile before any kind of procedure.