tIgE levels, FNO and AEC levels are higher in asthma, specifically in the atopic phenotype, as compared to normal. Total serum IgE levels have moderate correlation with FNO and AEC but FNO and AEC are weakly correlated.

FNO levels were higher in bronchial asthma (despite disease control) than in normal non-smoking adults and subjects with stable chronic obstructive pulmonary disease. Levels of FNO were similar between the chronic obstructive airway disease and normal groups.

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Background: Metabolic syndrome represents a constellation of metabolic derangements including insulin resistance, diabetes mellitus, obesity, dyslipidaemia and cardiovascular disease. Since it is associated with higher risk of coronary artery disease and diabetes mellitus, timely detection is important. Objectives: The main objective of the study was to find out the prevalence of metabolic syndrome in individuals undergoing comprehensive cardiac and general medical check-up at Kathmandu Medical College Teaching Hospital. The other objectives were to find the gender and ethnic prevalence of this condition. Methods: This is a hospital based cross-sectional study conducted at Kathmandu Medical College Teaching Hospital among 389 healthy participants of both gender and above 20 years of age who underwent comprehensive cardiac and general medical check-up. Metabolic Syndrome was diagnosed using US National Cholesterol Education Program Adult Treatment Panel III. Results: Out of the 389 subjects, 56 persons were found to be having metabolic syndrome (14.40%). Metabolic syndrome was more common in female and obese people and the prevalence did not differ with ethnicity. Conclusion: The prevalence of metabolic syndrome in the present study has been found to be 14.40 %. It is important to diagnose this condition in time so that subsequent complications can be prevented.Journal of Kathmandu Medical College Vol. 2, No. 3, Issue 5, Jul.-Sep., 2013 Page: 112-116DOI: http://dx.doi.org/10.3126/jkmc.v2i3.9934Uploaded date : 2/28/2014

Introduction: The use of personal protective equipment can be burdensome and the risk of COVID-19 infection for this group is high. This study details to evaluate how prepared Health Care Workers consider themselves to be regarding the delivery of infection prevention and control procedures in their place of work. Method: This is a cross-sectional study conducted at Kathmandu Medical College Teaching Hospital in September 2020. A questionnaire was given to participants along with the information about the study. Service demand, skills, beliefs about capabilities, beliefs about consequences, intentions, environmental context and resources, social influences, emotion, WHO Wellbeing (over the last two weeks) were taken as dependent variables. Result: Out of 112 participants, 58(51.7%) were doctors and 54(48.3%) nurses; 65(58.1%) female and 47(41.9%) were male. The mean age was 31.2±4.1 y. Service demand was scored lowest (mean 0.7 out of 7) and beliefs about consequences were scored highest (mean 5.7 out of 7). Conclusion: Healthcare workers agreed that personal protective equipment at work is sufficiently effective to prevent the spread of COVID-19. They were not confident that the health care center at present can manage or can continue to manage the current patient surge related to COVID-19.

Scrub typhus is a rickettsial zoonosis caused by Orientia tsutsugamushi which can cause focal or disseminated vasculitis & perivasculitis in various body systems. It is endemic in many parts of Nepal & has been neglected & under-detected. We clinically assessed six patients from a intensive care unit in a tertiary hospital in Nepal that tested positive for scrub typhus using IgM ELISA & analyzed their profiles. Out of six patients, three were male & three were female with a mean age of 44.6 years. All six patients had chief complaints of fever & myalgia. Four patients presented with eschar. Three patients presented with septic shock while one presented with septicemia and meningoencephalitis. Only one patient had elevated white cell counts. Four out of six patients had transaminitis. Thrombocytopenia was present in two patients. Hypoalbuminemia was present in three patients. All cases tested negative for dengue, malaria, brucella, Leptospira, leishmania, salmonella & tuberculosis. This study points out the need for raising the index of suspicion & early screening of scrub typhus in patients with fever & laboratory findings of liver dysfunction or thrombocytopenia even with normal white cell counts.

Background: C-reactive protein in both pleural fluid and serum has been found to be higher in tubercular pleural effusion than in other causes of pleural effusion. Objectives: The main aim of this study was to find out the diagnostic value of C-reactive protein in patients withlymphocytic pleural effusion. Methodology: A cross-sectional study was conducted in 90 patients with pleural effusion who underwent thoracocentesis at Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal. The complete biochemical tests of pleural fluid and serum were performed. The C-reactive protein concentrations of both pleural fluid and serum were then measured from samples from patients with lymphocytic exudative pleural effusion. Results: Ninety patients with exudative lymphocytic pleural effusion were included. Male patients were 56 (62.2%) and female were 34 (37.8%) with the male to female ratio of 1.64. Mean age of the patients was 51±21.54 (Mean ± Standard Deviation). The pleural fluid C-reactive protein levels in tubercular pleural effusion were higher (48.87±24.19 mg/dl) compared to non-tubercular group (38.30±17 mg/dl; p<0.001). Similarly, the serum fluid C-reactive protein levels in tubercular pleural effusion were higher (29.60±13mg/dl) compared to non-tubercular group (18.14±9.2mg/dl; p< 0.001). The sensitivity of pleural fluid C-reactive protein level in diagnosing tubercular pleural effusion was 86%. Conclusion: Simple and inexpensive test like C-reactive protein is useful in the diagnostic workup of lymphocytic pleural effusions. High C-reactive protein levels are very suggestive of tubercular pleural effusion.

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