Annals of Clinical Chemistry and Laboratory Medicine <p>Annals of Clinical Chemistry and Laboratory Medicine (ACCLM) is an official Journal of Nepalese Association for Clinical Chemistry. ACCLM is a peer-reviewed, biannual journal also accessed through <a title="NACC" href="" target="_blank" rel="noopener"></a>. ACCLM is indexed in <a title="Google Scholar" href="" target="_blank" rel="noopener">Google Scholar</a>, <a href="" target="_blank" rel="noopener">Indian Science Publications</a> and <a href="">CNKI Scholar</a></p> <p>ACCLM is now accepting <a href="/index.php/ACCLM/information/authors" target="_blank" rel="noopener">online submissions</a>.</p> en-US <p>Authors who publish with this journal agree to the following terms:</p><ol><li>The author transfers copyright to the Nepalese Association for Clinical Chemistry.</li><li>The journal publishes the work under a <a href="" target="_new">Creative Commons Attribution License</a> that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal and under the same share-alike license used here.</li><li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li><li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See <a href="" target="_new">The Effect of Open Access</a>).</li></ol> (Dr Prabodh Risal) (Sioux Cumming) Wed, 22 Aug 2018 11:50:10 +0000 OJS 60 Influenza: An Emerging and Re-emerging Public Health Threat in Nepal <p>Influenza virus type A and B are responsible for seasonal epidemics as well as pandemics in human. Influenza A viruses are further divided into two major groups namely, low pathogenic seasonal influenza (A/H1N1, A/H1N1 pdm09, A/H3N2) and highly pathogenic influenza virus (H5N1, H5N6, H7N9) on the basis of two surface antigens: hemagglutinin (HA) and neuraminidase (NA). Mutations, including substitutions, deletions, and insertions, are one of the most important mechanisms for producing new variant of influenza viruses. During the last 30 years; more than 50 viral threat has been evolved in South-East Asian countriesof them influenza is one of the major emerging and re-emerging infectious diseases of global concern. Similar to tropical and sub-tropical countries of Southeast Asia; circulation of A/H1N1 pdm09, A/H3N2 and influenza B has been circulating throughout the year with the peak during July-November in Nepal. However; the rate of infection transmission reach peak during the post-rain and winter season of Nepal.</p> Bishnu Prasad Upadhyay ##submission.copyrightStatement## Wed, 22 Aug 2018 11:49:32 +0000 Catheter Associated Urinary Tract Infection: Prevalence, Microbiological Profile and Antibiogram at a Tertiary Care Hospital <p class="Default"><strong>Background:</strong> Catheter associated Urinary tract infections (CAUTI) are the most common nosocomial infection. Though urinary tract catheterization is an important aspect of medical care, its inappropriate use may lead to significant morbidity and mortality, increased hospitalization and financial burden. This study was carried out to identify the etiological agents of UTI and its antibiogram among inpatients with indwelling catheters.</p><p class="Default"><strong>Methods:</strong> A total of 136 urine samples were collected over a period of 10 months. Microscopic and macroscopic examinations were performed. Isolation, identification and antimicrobial susceptibility testing was performed by standard microbiological methods. Statistical analysis of data was done by chi-square test.</p><p class="Default"><strong>Results:</strong> Out of the 136 patients, 17 (12.5%) developed catheter-associated UTI. Development of significant bacteriuria was not affected by sex, age, urine pH or antibiotic intake however there was significant association be-tween significant pyuria and significant bacteriuria (p&lt;0.001<em>). E coli </em>accounted for 35.3% followed by <em>Klebsiella </em>spp and <em>Enterococcus </em>spp. Cotrimoxazole was the most effective amongst antibiotics tested followed by Nitrofurantoin . Gram negative bacteria were least sensitive to Ampicillin.</p><p class="Default"><strong>Conclusion:</strong> This study suggests urine culture and sensitivity should be done among the catheterized patients on regular basis. Unnecessary urethral catheterization should be avoided to reduce catheter-related complications.</p> Prashamsa Karkee, Devi Dhital, Surendra Kumar Madhup, Jatan Bahadur Sherchan ##submission.copyrightStatement## Wed, 22 Aug 2018 11:49:39 +0000 Effect of Disease Modifying Agent on Oxidant and Antioxidant Status in Rheumatoid Arthritis <p class="Default"><strong>Background:</strong> Rheumatoid Arthritis is a chronic disease and a leading cause of disability in people with advancing age. Disease modifying antirheumatic drugs have become the mainstay of management in rheumatoid arthritis. Among these drugs, methotrexate the most frequently used agent has a proven anti-inflammatory action and is known to slow down the progression of the disease. Hence the present study is undertaken to evaluate the effect of methotrexate on the oxidant and antioxidant status in patients with rheumatoid arthritis on methotrexate.</p><p class="Default"><strong>Methods:</strong> A total of 40 rheumatoid arthritis patients and 40 controls were enrolled for the study. The rheumatoid arthritis patients were further divided into patients on methotrexate (group I) and patients without methotrexate (group II). The lipid peroxidation index -Malondialdehyde and total antioxidant activity, superoxide dismutase and glutathione levels were analyzed in all the participants.</p><p class="Default"><strong>Results: </strong>A significant increase in total antioxidant activity (p = 0.048) and decrease in lipid peroxidation (p = 0.04) was found in methotrexate treated arthritis patients compared to patients without methotrexate. A significant negative correlation (p=0.01) was found between MDA and total antioxidant activity in both groups of patients whereas, the antioxidant enzyme superoxide dismutase was positively correlated with lipid peroxide levels. <strong></strong></p><p class="Default"><strong>Conclusion: </strong>In conclusion low dose methotrexate seems to act as an effective anti-inflammatory drug and may also play an important role in minimizing the oxidative stress in rheumatoid arthritis. Serum total antioxidant activity is significantly raised in subjects with altered liver function profile.</p> Ramprasad Kowsalya, Ashok Prabhu ##submission.copyrightStatement## Wed, 22 Aug 2018 11:49:48 +0000 Histopathological study of Uterine Leiomyoma in Hysterectomy Specimens <p class="Default"><strong>Background:</strong> Uterine leiomyoma is the most common benign neoplasm in women of reproductive age group. Hysterectomy is a mode of therapy in uterine Leiomyoma. The objective of this study was to evaluate the histopathological changes in hysterectomy specimens with uterine leiomyomas.</p><p class="Default"><strong>METHODS: </strong>This is a retrospective study of one hundred sixty eight patients who underwent hysterectomy for uterine leiomyoma.</p><p class="Default"><strong>Results:</strong> Uterine leiomyoma was most common in the age group of 41-50 years (54.76%). Most common location of leiomyoma was intramural (51.2%). Degenerative changes were seen in 10.72% cases. Hyaline degeneration was the most common type of degeneration (7.14%). Proliferative endometrium was the most common endometrial pattern (63.1%) in uterine leiomyoma. Associated malignant lesions were observed in 1.8 % cases of uterine leiomyoma.</p><p class="Default"><strong>CONCLUSION: </strong>Uterine leiomyoma is associated with degenerative changes and coexistent benign and malignant patholologies. Histopathological examination of hysterectomy specimens should be done to confirm the diagnosis and rule out other pathologies, especially malignant lesions.</p> Sushma Bhatta, Sunita Bhandari, Bidur Prasad Osti ##submission.copyrightStatement## Wed, 22 Aug 2018 11:49:56 +0000 Pattern of Antibody Titer Against Salmonella Enterica in Apparently Healthy Individuals <p class="Default"><strong>Background:</strong> Enteric fever is a serious health problem in developing countries including Nepal. Widal test is the routinely used for diagnosis of enteric fever. This study aimed to determine the baseline antibody titers for <em>Salmonella typhi </em>and <em>paratyphi </em>A, B in healthy individuals of Western Region of Nepal.</p><p class="Default"><strong>Methods: </strong>A total 150 blood samples were collected from the healthy individuals and pattern of antibody titer was measured using standard quantitative tube method.</p><p class="Default"><strong>Results: </strong>Among 150 blood samples, 103 had shown significant antibody titers (≥ 1:20). The significant proportion (10.7%) of the individuals had anti-O titer ≥ 1:80. Similarly, 86 had anti-H titers of ≥ 1:20 to <em>S. enteric </em>serotype <em>typhi</em>, 23 had a titer of ≥1:80 and 4 had a titer of ≥1:160 respectively. We found 10% and 1.3% for <em>paratyphi A </em>and <em>B</em>, anti-H titers of ≥ 1:20respectively</p><p class="Default"><strong>Conclusion: </strong>This study concludes that, there should be need to change in the cutoff levels for antibody titer against <em>S. </em>t<em>yphi </em>to &gt; 1:80 for both anti-O and anti-H titers for Western Development Region of Nepal.</p> Umesh Prasad Gupta, Kapilesh Jadhav, Nischal Shrestha, Subash Baral, Amit Kumar Parajuli, Sandeep Adhikari ##submission.copyrightStatement## Wed, 22 Aug 2018 11:50:02 +0000