Clinical Biochemistry

The Department of Clinical Biochemistry provides qualitative and quantitative testing facility for a wide range of core biochemistry and specialized investigations in body fluids such as blood, serum or plasma, urine, & other fluids. Comprehensive state-of-the-art technology (fully automated instruments), highly standardized procedures, meticulously documented quality control, extremely competent laboratory staff, relevant, accurate results and timely reporting set Department of Clinical Biochemistry right at the forefront of diagnostic laboratories in Nepal.

At present we do more than 165 different analyses (tests) and many of these tests services provided are not offered elsewhere in Nepal.

Our faculties are involved in teaching and mentoring undergraduates (medical, dental, nursing, physiotherapy & human biology) students in biochemistry subjects including molecular biology and genetics . Interdisciplinary research are conducted and the outcomes of these are shared in national and international scientific meetings, congress and conferences.

Patient Care

Dedicated Quality Assured Service:

Patient samples are tested only when daily control runs are acceptable according to the set West guard rules. We perform daily internal quality control (IQC) by using:
- Lyphochek assayed chemistry control from Bio-Rad Laboratories, USA (for core biochemistry).
- Assayed Universal Control Serum (DIACON) from DIALAB GmBH Diagnostics, Austria (for core biochemistry).
- Lyphochek immunoassay plus control from Bio-Rad Laboratories, USA (for specialized parameters).
- Diamond control material, Diamond diagnostic, USA (for ISE analyzer).
We are participating in monthly External Quality Assurance Scheme (EQAS) programme:
- With Department of Clinical Biochemistry with Christian Medical College (CMC), Vellore, India (for core biochemistry, immunological parameters and HbA1c since 2005.
- With Asian Network for Clinical Laboratory Standardization and Harmonization, Asian Quality Assurance Survey Program (AQuAs), South Korea since 2010.
- With National Public Health Laboratory (NPHL), Teku, Kathmandu Nepal since 2014 for selective core biochemistry tests.
Turnaround Time (TAT): With exceptional turnaround time of 2 hours 30 minutes for almost all (160) parameters , reporting is remarkably efficient.
Introduction of analysis of unusual parameters for the first time in Nepal have made it possible to get cost- effective , less turnaround time (just 2.5 hours) for reporting and helped reduce our dependency in foreign laboratories.
The following biochemical parameters have been introduced for the first time in Nepal:
Brahms Procalcitonin (PCT), 25-OH- Vitamin D-Total assay, 1-84 Parathyroid hormone (PTH), Osteocalcin assay, bone alkaline phosphatase (BAP) ostease, N-tact PTH II, Human growth hormone (hGH), Insulin, Sex Hormone Binding Globulin (SHBG), Aldosterone, Direct Renin, Adrenocorticotropic hormone (ACTH), Estradiol II Gen, Progesterone II Gen, Prolactin XT,Thyroid peroxidase antibody ( Anti-TPO), Antithyroglobulin antibody (Anti TG), thyroglobulin (TG), Calcitonin II Gen, Thymidine Kinase, tissue polypeptide antigen- monoclonal (TPA-M), CA-125 II, PSA (total &free), B2-microglobulin, non-specific esterase (NSE), S-100, anti-cyclic citrullinated peptide antibody (Anti-CCP), Ultra-TSH, tissue transglutaminase (tTG) IgA ,Cardiolin IgG & IgM,C3 & C4, Cystatin-C, Apo-A1, Apo-B, Lipoprotein (a), hS CRP,Ceruloplasmin, Lamda light chain, high resolution serum protein electrophoresis, hemoglobin electrophoresis and Anti HBs II have been introduced in 2011.
SOP: All testing are performed following standard operating procedures and updated regularly.

Laboratory Setup

Laboratory Information Management System (LIMS): A technology that transfers lab data directly from test performing machine to the software that generates reports.

For Routine biochemical and few special parameters:

BA 400 – A fully Automatic Analyzer for Clinical Chemistry and Turbidimetry tests by Biosystems, Spain.
Vitros 350- A fully automatic Dry chemistry analyzer, by Ortho Clinical Diagnostics, USA.
Hb-Vario-For Glycosylated Hemoglobin (HbA1c) test, based on High Performance Liquid Chromatography (HPLC) by Erba Diagnostic Mannhheim GmbH, Germany.
Lablife Robochem Fully automated random access biochemistry analyzers by RFCL Diagnova / Avantor, India.
Gesan Chem 200- an Automatic Analyzer for Clinical Chemistry and Turbidimetry Immunochemistry Tests by Gesan Production Srl, Italy.
Electrolyte analyzers (i-Smart 30) multi-usable cartridge-based electrolyte analyzer by I-SENS Inc., South Korea.
Medica Easylyte ISE electrolyte analyzer by Medica Corporation,USA.

For Immunological & Special parameters:

Integrated Clinical Chemistry and Immunoassay
LIAISON® analyzer with chemiluminescence technology (CLIA) technology by Dia Sorin, S.p.A, Italy.
DAX 50 ELISA washer, DAX 800 ELISA reader & Stat Fax 2200 Incubator/Shaker by Diagnostic Automation / Cortez Diagnostics Inc., USA.
Lab Life eR2007 Microplate ELISA Reader and Washer by RFCL Diagnova / Avantor, India.
Mispa i2- Specific protein analyzer by Agappe, Switzerland.
Cellas electrophoresis system for Serum protein and Hemoglobin by Cleaver Scientific Ltd, United Kingdom.

Point-of-care testing (POCT) device:

i-Chroma II Immunoassay with Point of Care Testing (POCT) by BodiTech Med Inc.,S Korea.
Nycrocard Immunoassay with Point of Care Testing (POCT) by Axis Shield Nycocard, Norway.

Academic Activity

Our faculties are continuously involved in teaching-learning activities for medical undergraduates (MBBS & BDS), Nursing undergraduates (BSc in Nursing & Bachelor in Nursing) and paramedical undergraduates (BSc in Human biology & Bachelor in Physiotherapy) at Kathmandu University School of Medical Sciences (KUSMS) .

Teaching learning methods include lectures, practical classes, demonstration classes and clinical laboratory exposure supervision.

Research and Significant Achievements

The faculties are engaged in applied research and have contributed significantly to researches that have got national as well as international acclaim.

The research areas focused are : Acute and chronic liver diseases, diabetes, metabolic syndrome, thyroid dysfunction and other endocrine disorders and biomarkers & total quality management (TQM) in laboratory medicine .

Our research have been published in national and international journals. The faculties are actively engaged in leading numerous national and international level workshops and conferences related to clinical biochemistry, endocrinology & hepatology and have represented Dhulikhel Hospital in professional forums.

Future Plan

To establish clinical biochemistry laboratory as paradigm in context of Nepal by:

Introduce techniques for Therapeutic Drug Monitoring (TDM) parameters.
Introduce the inventory management for reagent Stock Maintenance.
Expanding the ranges of biochemical parameters and their interpretation e.g., Salivary Cortisol, Interferon-g receptor, TSH-receptor antibodies, Scl-70 etc.
Documentation for ISO certification accreditation.
Quality control of POCT devices e.g. Glucometer, Nycocard etc.
Extend the area of research and make further improvements in quality service.