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

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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Background and Aims: Shift work has been growing more prevalence and involves irregular working hours when compared to daytime work schedule. This study aims to assess sleep quality, its functional outcome, excessive daytime sleepiness and incidence of obstructive sleep apnea between shift and non-shift workers. Methods: The study candidates were randomly drawn Nepalese, from age 18 years and older, and were enrolled between January 2018 to January 2019. The subjects were divided into either: Shift work or Non-Shift work. The assessment measures were done with Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), STOP-BANG and FOSQ-10 (Functional Outcome of Sleep Quality – 10), using a standard form. Results: A total of 358 participants were included in the main study (176 Non-shift workers, and 182 Shift-workers). The mean BMI among the two group were not significantly different (p =0.43). There was significant difference with 25% Non-Shift workers and 41.21% of Shift workers were found to have Abnormal Sleepiness in the Epworth Sleepiness Scale score (p=0.004). Shift workers showed comparatively higher values for Epworth Sleepiness scale compared to Non-Shift workers in Mann-Whitney analysis, with mean rank 194.11 versus 164.39, respectively, p=0.006. Similarly, 26.29% Non-Shift workers and 36.72% Shift workers were found to have abnormal FOSQ-10 scores, χ2 (1) =4.44, p=0.035. 7.95% of Non-Shift workers and 6.59% of Shift-workers were found to have high risk of OSA in STOP BANG questionnaire, with no significant association, p=0.725. Conclusions: Shift work caused excessive daytime sleepiness and had worse functional outcome but did not increase probability of obstructive sleep apnea.

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.