Comparison of lipid profile parameters and oxidized low-density lipoprotein between normal and preeclamptic pregnancies in a tertiary care hospital in Nepal

Introduction: Preeclampsia is a pregnancy-specific complication that significantly contributes to maternal and perinatal morbidity and mortality worldwide, even more so in developing countries such as Nepal. The potential contribution of dyslipidemia and elevated levels of oxidized low-density lipoprotein (oxLDL) in the pathogenesis of preeclamptic pregnancies has been observed in several studies. The aim of this study was to compare the maternal lipid profile parameters and particularly oxLDL between preeclamptic and healthy pregnancies and also correlate oxLDL with other lipid profile parameters. Patients and methods: A total of 54 preeclamptic women were selected as cases for this cross-sectional study. Age and gestational week-matched 60 pregnant women were enrolled as controls. Preeclampsia was defined as per Australasian Society Consensus Statement research definition. The serum lipid parameters were measured using automated enzymatic systems and a competitive enzyme-linked immunosorbent assay was used to determine oxLDL concentrations in the serum. Student’s t-test was used to compare oxLDL levels between preeclamptic and healthy pregnancies, and Pearson’s correlation analysis was carried out to assess the relation between oxLDL and other variables. Results: The mean values of serum total cholesterol, triglyceride, non-high-density lipoproteincholesterol (non-HDL-c) and oxLDL were significantly higher in the preeclamptic cases (P<0.01). However, the levels of low-density lipoprotein cholesterol (LDL-c and HDL-c) did not significantly differ between the two groups. oxLDL had a significant positive correlation (P<0.01) with total cholesterol, triglyceride, LDL-c and non-HDL-c, and a negative correlation with HDL-c. Conclusion: The atherogenic type of dyslipidemia and high oxLDL levels are associated with preeclamptic pregnancies. The lipid parameters, however, seem to be poor markers of the severity of preeclampsia. Further prospective studies are needed to see if the observed dyslipidemia has a causal role in preeclampsia and imparts a long-term cardiovascular risk

Status of vitamin D and parameters of calcium homeostasis in renal transplant recipients in Nepal: a cross sectional study

Abstract Background Vitamin D, apart from being an important part of the “calcium-vitamin D-parathyroid hormone” endocrine axis, has diverse range of “non-calcemic” biological actions. A high prevalence of vitamin D deficiency has been observed in renal transplant recipients (RTRs) worldwide. This study aimed to determine the prevalence of hypovitaminosis D in Nepalese RTRs and interrelations between serum 25-hydroxyvitamin D [25(OH) D] and other biochemical parameters. Methods A total of 80 adult RTRs visiting a university hospital were enrolled in this cross sectional study. Serum 25(OH) D and intact parathyroid hormone (iPTH) were measured using Enhanced Chemiluminiscent Immunoassay. The RTR population was categorized into recent transplant recipients (≤1 year) and long term recipients (> 1 year). The vitamin D status was defined as per NKF/KDOQI guidelines. SPSS version 20.0 was used to analyze the data. Appropriate statistical tests were applied to compare variables between groups and establish correlation. P < 0.05 was considered to be statistically significant. Results The mean age of the recipients was 38.11 ± 11.47 years (68 males, 85.0%). Chronic glomerulonephritis was the leading cause of CKD. The two RTR groups (recent and long term) didn’t differ in demographic and biochemical characteristics. 83.75% of the recipients had PTH levels above the upper limit of the recommended range for their stage of CKD. 57.5% had hypocalcemia and none of the recipients had hypercalcemia. The median serum 25(OH) D was 24.15 ng/ml (8.00–51.50 ng/ml). Only 27.5% had sufficient vitamin D status whereas 53.8% were vitamin D insufficient and 18.8% were vitamin D deficient, the distribution almost comparable in the 2 transplant group. The serum 25(OH) D was not significantly affected by the time post-transplant, gender and sunlight avoidance. There was a significant negative correlation between serum 25(OH) D and iPTH (Pearson’s r = − 0.35, P = 0.001), but not so with the graft function. Conclusion There is a high prevalence of vitamin D insufficiency in RTRs. The deficiency status is not corrected despite of nutritional improvement and normalization of GFR post-transplantation and likely exacerbates secondary hyperparathyroidism. Vitamin D supplementation coupled with sensible sun exposure could be important strategies in optimization of the vitamin D status in this population

Study of Adverse Drug Reaction of Anti-Depressants in Adult Patients: A Nepalese Perspective

Background of the study: Depression is a prevalent mental disorder characterized by various symptoms, including low mood, lack of pleasure, changes in appetite and sleep, and difficulty concentrating. Antidepressants are commonly used to manage depression as well as other related disorders, such as anxiety and somatoform disorders. This study aimed to investigate the adverse drug effects experienced by adult patients who were using antidepressants at Chitwan Medical College Teaching Hospital in Nepal. Methods: This study was a retro-prospective, observational study consisting of 117 adult patients under antidepressant medication. The adverse drug profile for the patients was collected using an antidepressant side effect checklist developed by the NHS foundation trust. Statistical analysis was performed using SPSS version 20. Result: The study group consisted of adult patients using antidepressants at Chitwan Medical College Teaching Hospital, Chitwan, Nepal. The mean age of the group was 40.9 ± 12.8, with 63.2% females and 36.7% males. The most common conditions for which antidepressants were prescribed were depression (49.5%), anxiety disorder (31.6%), and somatoform disorder (13.6%). Amitriptyline was the most commonly used medication in monotherapy (64.1%), followed by escitalopram and sertraline. Dry mouth, weight gain, drowsiness, blurred vision, problems with sexual function, and an increase in appetite were the most commonly reported adverse effects. The incidence of certain adverse effects was higher in the multiple therapy group than in the monotherapy group (p Conclusion: The incidence of adverse drug effects is high in patients taking antidepressants, especially those receiving multiple medications. Educating patients about common side effects and prescribing monotherapy whenever possible are crucial in reducing the incidence