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