Department of Pathology & Laboratory Medicine

The medical service in Nepali Army started in 1982 B.S. (1925 A.D.) with the establishment of the Trichandra Military Hospital (TCMH) at Mahankal. Later in 2045 B.S. the establishment of Shree Birendra Hospital (SBH) in chhauni, Kathmandu.

SBH is 635 bedded hospital with multi-specialty services catering for the health care needs of army personnel, ex- army personnel. Simultaneously, since the day of establishment this hospital is providing laboratory services. Clinical laboratory is situated within the premises of SBH. This laboratory aims to provide various services like; Biochemistry, Hematology, Clinical pathology, Serology & immunology, Microbiology, Histopathology, cytopathology and Blood Bank throughout the year and round the clock (24/7).

Existing Scenario in Laboratory Services in Shree Birendra Hospital

Department of Laboratory Medicine of Shree Birendra Hospital includes various subunits:

  • Biochemistry: General Chemistry & Immunochemistry
  • Pathology: Histopathology,Cytopathology, Hematology & Blood Bank
  • Microbiology: Bacteriology, Mycology, Mycobacteriology, Infectious diseases serology & Parasitology.
  • Molecular Diagnostic Laboratory: PCR for SARS-CoV-2 diagnosis



Services

Department of laboratory medicine provides following services:

SN Name of Services provided Remarks
1. Biochemistry  

2.

Blood bank  
3. Clinical Pathology  
4. Cytopathology  
5. Hematology  
6. Histopathology  
7. Microbiology  

Turn Around Time:

  • All the emergency samples are dispatched within 2 hours of receivable.
  • All the samples of inpatient same day within 4 to 6 hours of receivable.
  • Blood cross-match with 1.30 hours after receivable.

Name of Test

Reporting Day

Reporting time

Routine Biochemistry & Haematology Test

Next day

After 10 am

Peripheral Blood Smear(PBS), Reticulocyte/ APTT/ DCT

Same day

 

Rapid Test for Anti-HIV, HBsAg, Anti-HCV

Same day

 

Direct Coomb’s Test

Next day

After 10 am

Routine Urine & Stool examination

Next day

After 10 am

Widal test/PSA/Anti-HEV/Anti-HAV

Next day

After 10 am

Cytology

Next day

After 10 am

FNAC

Next day

After 10 am

Bone marrow

Next day

After 10 am

Anti HIV/HBsAg/Anti HCV (ELISA)

After 24 hours of receiving time (receiving time 8am)

After 10 am

Thyroid Function Test(TFT)/HbA1C /Microalbumin/ Urine Chemistry

Sunday & Thursday

After 10 am

Gram stain

Next day
(CSF reporting on same day)

After 10 am

AFB stain

Next day
(CSF reporting on same day)

After 10 am

KOH mount

Next day
(CSF reporting on same day)

After 10 am

Urine Culture

After 2-3 days

After 10 am

Culture: Sputum/Pus aspirate/Wound Swab/ Body Fluid/ Stool and others

After 2-4 days

After 10 am

Blood Culture

After 5 days

After 10 am

Biopsy

After 4-6 days

After 10 am

Sub Departments

Department of laboratory medicine has following sections:

SN Name of Sub Department/Sections Remarks
1. Pathology  

2.

Biochemistry  
3. Microbiology  
4. Molecular Diagonastic  
5. Transfusion Medicine  

Biochemistry unit:

  • Routine Biochemistry (Cobas, Roche analyser)

Blood Sugar
Renal Function Test (RFT);Urea, Creatinine
Liver Function Test (LFT); Alanine transaminase(ALT),Aspartate transaminase(AST), Alkaline phosphatase(ALP), Total Bilirubin, Direct Bilirubin, Gamma glutamyltransferase(γGT)
Lipid Profile (Total Cholesterol, Low density lipoprotein(LDH), Triglycerides, High density lipoprotein(HDL)
Amylase, Lipase, Uric acid, Lactate dehydrogenase(LDH)
Electrolytes (Sodium(Na+), Potassium( K+), Calsium(Ca++), Magnisium( Mg ++)
Ferritin, Iron Profile (Iron, Total Iron Binding Capacity)
Cardiac enzymes (CK-MB, CK-NAC, Troponin I)

  • Immunoassays (Siemens advia-centaur analyser)

Thyroid Function tests (FT3, FT4, TSH)
Prostate specific antigen (PSA)

  • Glucose Challenge Test (Cobas, Roche analyser)

OGTT – 75 mgs/ 100 gms

  • Body Fluid Analysis(Cobas, Roche analyser)

Cerebrospinal Fluid (CSF), Pleural Fluid, Peritoneal fluid, Pericardial fluid
Protein, Sugar, Lactate dehydrogenase(LDH), Adenosine deaminase(ADA)

  • 24-hour urine (Cobas, Roche analyser)

Calcium, Protein, Phosphorus, Urea, Creatinine

  • HbA1C (HPLC based-Biorad D10 analyser)
  •  Quantitative /Qualitative Serological tests (GPP-100, Gold-site analyser)

Anti-StreptolysinO(ASO),C-reactive Protein(CRP),Rheumatoid Factor(RA), D-dimer

  • Drugs of Abuse Analysis 

Benzodiazepine, Opiates, Barbiturates, Cannabis, Amphetamine, Cocaine


Pathology Unit:

1.  Histopathology Services:
i.  Histopathology Unit at Department of laboratory at Shree Birendra hospital has established modern histopathology laboratory which is fully equipped to provide high quality histopathology services. 
ii.  Histopathology is the study of diseased tissue such as suspected cancer for example breast lumps or specimens of bowel or endoscopic, colonoscopic biopsy, skin biopsy, kidney biopsy or biopsies from central nervous system.
iii.  At our centre, we do processing and reporting of all kind of small, medium and large biopsies along with large complex biopsies.
iv.  We do wide range of reporting in histopathology section that includes oncopathology, dermatopathology, neuropathology, gynepathology, renal pathology, bone pathology, oral and head and neck pathology, Gastropathology reporting and many more.

2.  Cytopathology Services:
i.  Cytopathology is the study of cells in any part of the body and plays a key role in clinical diagnosis of cancerous and pre-cancerous disease states, benign tumors and some infectious diseases. 
ii.  This field encompasses a wide range of techniques for a variety of tissues. 
iii.  At our centre, we do processing and reporting of cytology specimens that includes  sputum samples, pleural fluid, peritoneal fluid, urine and other body fluid analysis for total count and malignant cell cytology.
iv.  Gynecology cytopathology processing and reporting for screening of cervical pathology and intraepithelial lesions or malignancy for prevention of cervical cancer also falls under cytopathology services which is also performed in our institute.
v. We also provide Fine needle aspiration cytology (FNAC) Services.  This is used to take cells from palpable nodules in organs or tissue to categorise the type of lesion responsible for its occurrence which helps in making diagnosis and provide guidance on treatment.  This is also done to the lesion where biopsy is not required every time and diagnosis can be made by FNAC alone.

3.  Hematology Services:
i.  Hematology Unit in Department of laboratory at Shree Birendra Hospital is well equipped with excellent automated cell counters and coagulometers. 
ii.  The section of hematology provides a broad range of services for the diagnosis and treatment of blood and bone marrow disorders including leukemias.
iii.  Coagulation studies done in our centre provides diagnosis is of various bleeding disorders.  It helps to assess the risk of excessive bleeding or developing clots (thrombosis) in blood vessels. 

4.  Blood Bank Services:
i.  Blood bank services in SBH, department of Laboratory medicine is a category ‘D’ blood transfusion centre setup and its main function is to store Whole blood and blood components.
ii. Currently its storage capacity is 150 pint. Cross matching, blood group typing and direct Coombs test are regularly done.

Microbiology Unit

  • Bacteriology:
  • This laboratory is meant for identification of varieties of pathogenic bacteria from various samples like Urine, Blood, Sputum, Bronchoalveolar Lavage (BAL), Endotracheal aspirate,Bronchial wash, Wound Swab & Pus Aspirate,Pleural fluid, Peritoneal fluid, Pericardial fluid, Joint aspirate, Cerebrospinal fluid,tissue, vaginal discharge, high vaginal swab, urethral discharge and swab, stool.
  • In this laboratory, antibiotic sensitivity is provided by both conventional disc diffusion and automated Minimum Inhibitory Concentration (MIC) by automated system (Vitek 2 compact).
  • Gram staining, Acid Fast Bacilli(AFB) staining, India ink, KOH mount and Modified ZN staining for Leprae bacilli and Oocyst for coccidian species (Cryptosporidium, Isospora, Cyclospora) are performed
  • Coliform count in drinking water also performed
  • Mycobacteriology:
  • Acid Fast Bacilli (AFB) stain of various samples like Sputum, Bronchoalveolar lavage(BAL), Endotracheal secretion, pleural fluid & pus aspirate are performed to diagnose Mycobacterium tuberculosis
  • Gene Xpert testing for identification of Mycobacterium tuberculosis and detection of Rifampicin sensitivity
  • Infectious disease serology
  • Enzyme-linked immunosorbent assay (ELISA) based test for diagnosis of HIV antibody, Surface Antigen of Hepatitis B(HBsAg), Hepatitis C antibody are performed.
  • Immunochromatographic assay for diagnosis of HIV antibody, Surface Antigen of Hepatitis B(HBsAg), Hepatitis C antibody, Hepatitis A and Hepatitis E antibody (IgM) are also performed.
  • Treponema palladium haemagglutinationassay (TPHA) and Rapid Plasma Reagin tests are performed.
  • Parasitology
  • Identification of various pathogenic parasites and helminths are performed.

Molecular Diagnostic Unit:

This unit has recently been established in year 2077-04-07. This unit was established with the aim to diagnose Pandemic of SARS-CoV-2 by Polymerase Chain Reaction(PCR) method. Since the day of establishment, this unit is continuously working for diagnosis of SARS-CoV-2 and had reported more than forty five thousand PCR reports. This laboratory is highly demanding unit in modern medicine, in near future once pandemic settles down our plan is to establish it as full fledge Molecular Diagnostic Laboratory for diagnosis of various cancers, genetic diseases and infectious diseases.

Specialists

Faculty

Degree

Designation

Brig Gen Dr Eva Piya

MBBS, MD Pathology

Professor

Lt Col Dr Amar Narayan Shrestha

MBBS, MD Pathology, Fellow Clinical Hematology

Associate Professor

Lt Col Dr Kavita Karmacharya

MBBS, MD Pathology

Associate Professor

Maj Dr Ganesh Parajuli

MBBS, MD Pathology

Assistant Professor

Maj Dr Shova Kunwar

MBBS, MD Pathology, Fellow Gastroenterology

Assistant Professor

Maj Dr Renu Shrestha

MBBS, MD Pathology

Assistant Professor

Maj Dr Suman Gurung

MBBS, MD Pathology

Assistant Professor

Working Schedule

Sunday to Thursday: 0900-1600 reporting & validation of reports in respective section by respective consultants.

Friday: 0900-1400 reporting & validation of reports in respective section by respective consultants.

Biochemistry Unit:

 

9-10 am

10am-12pm

12pm-4pm

Sunday to Friday

Quality Control, Calibration Check, Validation of reports from wards & ICU

Academic session

Validation of reports from OPD

Pathology Unit:

 

9-11 am

11am-12pm

12pm-4pm

Sunday to Friday

Histopathology reporting,
Cytopathology reporting,
Hematology reporting

Academic session

Validation of reports. Histopathology Haematology
Cytopathology
Hematology reporting

Microbiology Unit

 

9-10 am

10am-11pm

11pm-4pm

Sunday to Friday

AFB & Gram staining reporting,
Identification & Antibiotic Susceptibility reporting
Validation of serology reports

Academic session

Validation of bacteriology section reports
AFB & Gram stain reporting and validation
KOH and modified ZN staining reporting and validation
Gene-xpert report validation

Note:On Saturday reporting done by on duty Doctor from each section.

Faculty Members

Faculty

Degree

Designation

Brig Gen Dr Eva Piya

MBBS, MD Pathology

Professor

Lt Col Dr Amar Narayan Shrestha

MBBS, MD Pathology, Fellow Clinical Hematology

Associate Professor

Lt Col Dr Kavita Karmacharya

MBBS, MD Pathology

Associate Professor

Maj Dr Ganesh Parajuli

MBBS, MD Pathology

Assistant Professor

Maj Dr Shova Kunwar

MBBS, MD Pathology, Fellow Gastroenterology

Assistant Professor

Maj Dr Renu Shrestha

MBBS, MD Pathology

Assistant Professor

Maj Dr Suman Gurung

MBBS, MD Pathology

Assistant Professor

Microbiology Unit:

Faculty

Degree

Designation

Lt Col Dr Raina Chaudhary

MBBS, MD Microbiology

Associate Professor

Lt Col Dr Sabita Bhatta

MBBS, MD Microbiology

Assistant Professor

Major Dr Alina Singh

MBBS, MD Microbiology

Assistant Professor

Biochemistry Unit:
Faculty

Degree

Designation

Major Dr Prachi Raymajhi

BDS, MD Biochemistry

Assistant Professor

Major Dr Arbinda Mohan Bhattarai

MBBS, MD Biochemistry

Assistant Professor

Dr Salina  Pradhananga

MBBS, MD Biochemistry

Registrar