Papers by Dr. Madhab Lamsal
Annals of Clinical Chemistry and Laboratory Medicine, 2021
From ancient time urine has been considered as a substance of importance and examination for phys... more From ancient time urine has been considered as a substance of importance and examination for physical wellbeing. Evidences from the ancient civilizations including the Egyptian, Sumerian, Babylonian and Eastern Civilizations such as Vedic cultures support the use of urine as an index of physical and mental well-being. Classified as coloured, black, frothy, cloudy and sweet, urine used to be correlated with different disease conditions such as jaundice, kidney diseases, diabetes etc. These practices have been carried on even by the alchemists and have now formed as an integral constituent of clinical laboratory diagnostics. Modern approach to urinalysis can be credited to Dr. Richard Bright, MD, who in 1827 by performing urine examinations related to vol-ume, colour, pH, protein (but not cast) corre-lated his findings to several diseases and clini-cal picture including edema, proteinuria etc. Urinalysis combines the expertise from vari-ous disciplines including biochemistry, pa-tholo...
This work describes a liquid chromatography- electrospray tandem mass spectrometry method for det... more This work describes a liquid chromatography- electrospray tandem mass spectrometry method for detection of terlipressin in Wistar rat plasma in the low nano-gram range. Terlipressin is a synthetic analogue of the antidiuretic hormone arginine vasopressin and it might be used when Arginine vasopressin (AVP) is not readily available. For experimental evaluation of the pharmacokinetics of terlipressin, rats can be injected 3.0 µg/kg or 6.0 µg/kg i.v. of terlipressin and blood can be collected for Mass spectrometry characterization of terlipressin which can be performed with a high-resolution Orbitrap-based mass spectrometer.
Journal of BP Koirala Institute of Health Sciences, 2021
Background: Left ventricular diastolic dysfunction (LVDD) represents the first stage of diabetic ... more Background: Left ventricular diastolic dysfunction (LVDD) represents the first stage of diabetic cardiomyopathy and is initially subclinical. Early diagnosis enables earlier treatment and stops further progression of the disease. Tissue Doppler Imaging (TDI) is a new diagnostic modality with high sensitivity and specificity to know ventricular diastolic function. N-terminal pro brain natriuretic peptide (NT-proBNP) is a cardiac neurohormone that can be used to identify the changes in ventricular diastolic function. We aimed to estimate the concentration of NT-proBNP and correlate its value with TDI for LVDD in asymptomatic type 2 Diabetes Mellitus. Methods: In this comparative cross-sectional study, we enrolled 100 asymptomatic type 2 diabetic patients and 100 healthy people aged 30-60 years. In both groups, NT-proBNP levels were measured and the presence of LVDD was determined by TDI. The primary outcome parameter was the level of NT-proBNP in diabetics and healthy people. The seco...
Journal of the American Academy of Nurse Practitioners, 2010
Purpose: To shed light on several epidemiological terms for better understanding of diagnostic te... more Purpose: To shed light on several epidemiological terms for better understanding of diagnostic testing measures by using a mythical condition, ''purple mange.'' Data sources: Scientific literature related to epidemiology and statistical tests. Conclusions: Nurse practitioners (NPs) use the concepts of sensitivity (SEN), specificity (SPEC), positive predictive value (PPV), and negative predictive value (NPV) daily in primary care and specialty areas. In addition, PPV and NPV vary with the prevalence of a condition. At times, NPs misunderstand the meaning of these terms.
Journal of Nepal Medical Association, 2021
Introduction: Vitamin D deficiency is an emerging risk factor for cardiovascular diseases. Very f... more Introduction: Vitamin D deficiency is an emerging risk factor for cardiovascular diseases. Very few studies have been done to find out vitamin D deficiency status among cardiovascular patients in Nepalese setup. This research aims to find out the prevalence of vitamin D deficiency among patients of acute coronary syndrome admitted in a tertiary care center of eastern Nepal. Methods: This was a descriptive cross-sectional study conducted among patients of acute coronary syndrome admitted in a tertiary care hospital from 1st February 2018 to 31st July 2018. Ethical clearence was taken from Institutional Review Committee of B.P. Koirala Institute of Health Sciences (Reference number: 259/074/075-IRC). Convenience sampling method was used. Data was entered in Microsoft Excel and analyzed using Statistical Package for the Social Sciences version 25. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: A total of 33 (64.7%)...
Indian Pediatrics, 2015
A cross-sectional study was conducted in remote hilly areas (Shree Antu and Ranke) of eastern Nep... more A cross-sectional study was conducted in remote hilly areas (Shree Antu and Ranke) of eastern Nepal to assess iodine status among school children aged 6-12 years. Urinary iodine excretion was estimated in 292 urine samples. The median urinary iodine excretion was 187.52 ug/L, and 33.6% children have insufficient urinary iodine excretion.
International Journal of Medicine in Developing Countries
International journal of biomedical research, 2017
Background and Objectives: Hepatitis is a common cause of jaundice. Hepatitis A and Hepatitis E a... more Background and Objectives: Hepatitis is a common cause of jaundice. Hepatitis A and Hepatitis E are enterically transmitted viral diseases. This study investigated an outbreak of viral hepatitis at Biratnagar, Morang district, Nepal, during April 2014. Materials & Methods: An expert team from Microbiology and Public health of BPKIHS inspected the area and blood samples from 90 suspected cases of jaundice were obtained and subjected for IgM and IgG antibody detection against HAV and HEV. Water samples from 10 different areas of affected region were also collected and checked for presence of coliform by membrane filtration method to confirm the suspicion of fecal contamination of water supply. Results: An outbreak Hepatitis E and Hepatitis A occurred in Biratnagar. Out of 90 blood samples, 45 were reactive for hepatitis E IgM, nine were reactive for Hepatitis A IgM. Three samples among these were reactive for both Hepatitis A and Hepatitis E. The liver function tests of the positive c...
Medical Research Journal
Introduction: Systemic lupus erythematosus (SLE) is a complex autoimmune disease with no single s... more Introduction: Systemic lupus erythematosus (SLE) is a complex autoimmune disease with no single specific and sensitive test available for its diagnosis. Adenosine deaminase (ADA) is an enzyme that can act as an indicator of cellular immunity reflecting the extent of inflammation. The aim of this study was to investigate the role of serum adenosine deaminase activity and its association with antinuclear antibodies (ANA) and anti-dsDNA (anti-double stranded deoxyribonucleic acid) in SLE patients. Material and methods: In this study, we included 36 diagnosed case of SLE as per the American Rheumatology Association (ARA) criteria and 30 healthy control. Serum ADA activity was measured by a spectrophotometric technique based on Giusti and Gallanti. ANA and Anti ds-DNA were measured by indirect Enzyme-Linked Immune Sorbent Assay (ELISA). Normal values of serum ADA activity, ANA and anti ds-DNA was < 25 IU/L, <1 0 U/mL and <25 IU/mL respectively. Results: The mean ADA activity (37.03 ± 13.03 IU/L) in SLE patients was higher as compared to control (18.23 ± 10.12 IU/L), and the difference was statistically significant (p < 0.001). Median values of ANA and anti-dsDNA in SLE patients was 16.9 (8.5, 42.8) and 24.7 (20.5, 45.0) respectively. Serum ANA was positive in 25 out of 36 cases, anti-dsDNA was positive in 17 out of 36 cases and ADA was positive in 29 out of 36 cases. We observed a weak positive correlation between ANA and anti-dsDNA (r = 0.46, p = 0.005), whereas a moderate correlation between ANA and ADA (r = 0.525, p = 0.001) in SLE patients. Conclusion: Serum ADA was significantly higher in SLE patients as compared to control and more specific than autoantibodies. Determination of ADA activity is a reliable, cost-effective, and easy test that can be used as an alternative parameter for diagnosing and evaluating disease activity in SLE patients.
Journal of Oral Biology and Craniofacial Research
Journal of Universal College of Medical Sciences
INTRODUCTION: Brain is particularly vulnerable to oxidative free radicals. Oxidative stress might... more INTRODUCTION: Brain is particularly vulnerable to oxidative free radicals. Oxidative stress might primarily or secondarily be involved in the pathogenesis of Bipolar Affective Disorder. Therefore this study was aimed to estimate…
International Journal of Scientific Reports
Iodine deficiency is one of most common micronutrient deficiencies worldwide, the consequences of... more Iodine deficiency is one of most common micronutrient deficiencies worldwide, the consequences of excess iodine should not be ignored. Both chronic iodine excess and iodine deficiency can result in thyroid dysfunction in populations, especially children and pregnant women if not corrected. This is because children and pregnant women are very vulnerable to iodine deficiency and sensitive to iodine changes
Indian Heart Journal
Background Tobacco consumption is considered as one of the major risk factors for cardiovascular ... more Background Tobacco consumption is considered as one of the major risk factors for cardiovascular (CV) morbidity. However, the effect of paan masala tobacco (PMT) (a type of smokeless tobacco) consumption has not been well studied in our context. Our study is aimed to find an association of CV risk factors between PMT users and nonusers and to correlate those parameters with urinary cotinine level, a degradation product of nicotine occurring in tobacco. Methods This comparative cross-sectional study was carried out among 200 participants. The effect of PMT use on CV risk factors such as blood pressure (BP), lipid profile, and body mass index was measured against urine cotinine level. Statistical tests used were χ2 test for categorical variable, independent t-test, Mann–Whitney U test, and Spearman's correlation applied for numerical variable, and multivariate regression analysis was performed as required. The level of significance was set at p < 0.05. Result Mean BP, total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and median cotinine level were found to be significantly higher in PMT users than in controls (p < 0.001). Urinary cotinine level was positively correlated with mean BP, TC, TG, and LDL-C in PMT users (p < 0.001). Similarly, the odds of having hypercholesterolemia and increased diastolic BP was also significantly higher in PMT users (p < 0.001). Conclusion PMT use has an adverse effect on CV risk parameters and there is a rational of cotinine measurement for screening CV risk among PMT users.
BMC Research Notes
Objective: Pan Masala containing Tobacco (PMT) use contributes significantly to the overall world... more Objective: Pan Masala containing Tobacco (PMT) use contributes significantly to the overall world tobacco burden especially in south Asian country like Nepal. Oxidative stress caused by it may leads to cardiovascular disease, peripheral vascular disease, hypertension, etc. Therefore, this work proposes to study the antioxidant and oxidative stress along with cardiovascular morbidity in PMT users. Results: Hundred PMT users and 80 non-user controls with age and sex matched were enrolled. There was a significant difference in blood pressure, albumin, uric acid, vitamin C, vitamin E, malondialdehyde (MDA), total cholesterol, triglycerides, low density lipoprotein cholesterol between the two groups (p < 0.001). We observed statistically significant (p < 0.001) decrease in antioxidant and increase oxidative stress in PMT users. Duration and quantity of PMT user were significantly associated with the MDA level.
Thyroid Research
Background: Aberrant iodine intake and thyroid autoimmunity affect thyroid function. Deficiencies... more Background: Aberrant iodine intake and thyroid autoimmunity affect thyroid function. Deficiencies of iodine including thyroid disorders have serious impact on child physical and mental development. This study was conducted to investigate iodine nutrition, thyroid function and thyroid autoimmunity in the Nepalese children, and explore the association of thyroidal autoimmunity with iodine nutrition and thyroid dysfunction. Methods: Five schools from Udayapur district of eastern Nepal were selected for the study. A total of 213 school children aged 6-12 years were enrolled, and anthropometric data, urine samples and blood samples were collected. Urinary iodine concentration (UIC), free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), and antithyroglobulin antibody (TgAb) was measured. Independent T test, Man-Whitney test, Chi-square test and Fisher's Exact test were used for testing statistical significance. Spearman's correlation analysis was done to find association between variables. Results: The median UIC with IQR, mean ± SD fT3, mean ± SD fT4, median TSH and TgAb with IQR was 150.0 μg/L (102.8; 204.0), 2.49 ± 0.83 pg/ml, 1.33 ± 0.42 ng/dl, 2.49 mIU/L (1.58; 4.29), and 21.40 IU/ml (15.54; 31.20) respectively. Elvated TgAb (≥30 IU/ml, thyroid autoimmune condition) was seen in 25.8% (n = 55) children. UIC was less than 100 μg/L in 17.4% (n = 37) of the children. Subclinical hypothyroidism, overt hypothyroidism and sublinical hyperthyroidism was seen in 1.4% (n = 3), 3.3% (n = 7) and 3.8% (n = 8) children respectively. A strong association of TgAb with UIC (r = − 0.210, p = 0.002) and thyroid hormones; fT3 (r = − 0.160, p = 0.019), fT4 (r = − 0.275, p < 0.001), and TSH (r = 0.296, p < 0.001) was seen. The relative risk for thyroid autoimmunity in children with UIC less than 100 μg/L was 1.784 (95% CI: 1.108-2.871, p = 0.024). Similarly, children with thyroid autoimmunity had higher relative risk [7.469 (95% CI: 2.790-19.995, p < 0.001)] for thyroid dysfunction. Conclusions: School children of eastern Nepal have adequate iodine nutrition. Thyroid autoimmunity is very common, while thyroid dysfunction is sparse in children. An association of thyroid autoimmunity with iodine nutrition and thyroid dysfunction was seen in children.
BMC Research Notes
Objectives: Deficiency as well as excess dietary iodine is associated with several thyroid disord... more Objectives: Deficiency as well as excess dietary iodine is associated with several thyroid disorders including Grave's disease and goitre. Previously, cross sectional studies conducted among school children in Nepal showed high prevalence of iodine deficiency. In contrast, recently, few studies have revealed emerging trends of excess urinary iodine concentration in children. This paper, reports excess urinary iodine excretion and thyroid dysfunction among school age children from eastern Nepal. Results: It was a community based cross sectional study in which we measured urinary iodine excretion levels among school age children at baseline and after educational program. The educational program consisted of audiovisual and pamphlets on thyroid health. We also screened them for thyroid function status by physical examination and measuring serum thyroid hormones. Our results show that 34.4% of the children had excess urinary iodine concentration above the WHO recommended levels. Overall, 3.2% of the children were identified to have thyroid dysfunction. Urinary iodine concentration was significantly different between types of salt used and between salt iodine content categories.
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Papers by Dr. Madhab Lamsal