Introduction: Diabetes Mellitus has become one of the common metabolic disorders characterized by hyperglycemia, associated with deficiency or resistance to insulin and shows abnormality in exocrine activity of pancreas. Pancreas is mixed gland that is both an endocrine and an exocrine gland with clusters of endocrinal, islet cell dispersed among exocrine acinar cells. Defects in islets cells in diabetes effect the exocrine secretion of the pancreas. Methods: Hospital based case-control study was conducted. Total sample size was 388. Out of which 194 were known cases of type 2 diabetic patients attending Manipal Teaching Hospital for medical checkup whereas 194 were Non Diabetic individuals with age and sex matched. Self-administer question was used to collected data from case and control. Three ml fasting blood samples were collected and centrifuged. Serum amylase was analyzed by using a semi automated analyzer. All estimates data were analysis statistically by using SPSS 22.0 full version. Results: Serum amylase levels were found significantly low in diabetic patients as compared to the Non-Diabetic (r = -0.313, p-value <0.001). Similarly, present study also showed negative correlation between serum amylase levels and duration of diabetes with Non-Diabetic (r = -0.388, p <0.001). Status of serum amylase and fasting sugar level was found to different among age groups, sex and ethnic groups. Conclusions: The increasing in duration of diabetes decreases the level of serum amylase which suggests a possible exocrine-endocrine relationship in this disease. Similarly, the level of serum amylase and fasting blood sugar vary among age group, sex and ethnicity. Thus, measurement of serum amylase can be an additional informative parameter for the assessment of chronicity and progress of the illness as well as the response to therapy.
Background: International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) guidelines recommend every laboratory establish its own reference intervals (RIs) to promote precision medicine. However, Nepalese diagnostic laboratories rarely establish RIs for routine biochemical test parameters and use them while reporting the test results. Thus, there is a dearth of population and method-specific RIs of several biochemical parameters in Nepal. This study thus aimed to establish dry chemistry-based RIs of routine LFTs for the adult population of Gandaki Province, Nepal. Materials and Methods: This was a priori method for the establishment of RIs which enrolled a cohort of 272 healthy adults from the Gandaki Province of Nepal to establish RIs of LFTs as per the recommendation of IFCC guidelines. The RIs were estimated using non-parametric statistical tools and presented as RI based on the percentile method. Our established RIs were compared to those supplied by reagent kit manufacturers by comparing calculated out-of-range (OOR) values. Results: Total and sex-specific reference intervals were established for the routine liver function test parameters. For general population established RIs include: Total protein 68.0-69.0g/L; Albumin 39.0-52.0g/L; Globulin 27.0-42.0g/L; A/G ratio 1.1-1.8; total bilirubin 5.13-25.65𝝁mol/L; Unconjugated bilirubin 1.71- 17.10 𝝁mol/L; Conjugated bilirubin 0.00-10.26 𝝁mol/L; AST 20.0-43.2U/L; ALT 11.0-53.0 U/L; AST/ALT ratio 0.7-2.1; ALP 42.0-135.4U/L. The overall 95% RI s for these parameters showed significant sex differences (p < 0.05) for Albumin, Globulin, A/G ratio, AST, ALT and AST/ALT ratio. The RIs established for LFT parameters were found to vary significantly according to the age and sex of the study subjects. Moreover, established RIs in this study also differed from the currently adopted external RIs while observing out-of-range results. Conclusion: The present study for the first time established the dry chemistry-based RIs of routine LFTs for the adult population of Gandaki Province of Nepal. This RIs were different from the currently adopted external RIs supplied by manufacturers. Hence the diagnostic lab from Gandaki province is recommended to follow this RI while reporting the results of routine liver function tests.
Introduction: Diabetic mellitus (DM) is a group of metabolic disorders where glucose is underused, producing hyperglycemia, which is associated with renal dysfunction. Abnormal renal function is indicated by an abnormality in various biochemical parameters, among them serum urea, creatinine, and urinary microalbumin. In diabetic mellitus, these mentioned markers are usually correlated with the severity of kidney damage. Objective: The objectives of the studies were to compare the level and direction of urea, microalbumin, and other study parameters such as creatinine and serum glucose among diabetic and non-diabetic individuals in Butwal, Nepal. Materials and Method: This was a cross-sectional comparative study of type-2 diabetic and non-diabetic individuals who came to the National Path Lab (A-grade reference lab) in Butwal sub-metropolitan area, Rupandehi, for routine blood tests. A total of 100 samples were collected using the simple random sampling method, and study parameters were determined using standard laboratory protocols. Results: Among the studied samples, 40 were diabetic and 60 were not. The mean SD of serum urea, creatinine, and urine microalbumin for diabetic patients was 53.50 7.68, 1.71 0.23, and 33.0 8.25, respectively, and 20.60 5.12, 0.73 0.19, and 11.73 4.517, respectively, for non-diabetic individuals. There were correlations between serum urea, creatinine, and urinary microalbumin among the diabetic patients. The r-values of urea, creatinine, and microalbumin were 0.703, 0.572, and 0.674, respectively. It is also statistically significant in diabetic and non-diabetic individuals (p-value 0.001) with serum urea, creatinine, and urinary microalbumin. Conclusion: This study suggested that there were correlations between serum urea, creatinine, and urinary microalbumin in diabetic patients and a statistically insignificant relationship between urinary microalbumin and serum creatinine in diabetic and non-diabetic individuals among various age groups in the study population. Key words: Creatinine, Diabetes mellitus, Diabetic Nephropathy, Microalbumin, Urea
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