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Papers by Prabin Adhikari

Research paper thumbnail of Association Between COVID-19 Infection and New-Onset Diabetes in a Tertiary Care Hospital in Kathmandu

Nepal Medical College journal, Jul 7, 2023

In severe acute respiratory syndrome coronavirus 2 infections, reduced numbers of insulin secreto... more In severe acute respiratory syndrome coronavirus 2 infections, reduced numbers of insulin secretory granules in beta cells and impaired glucose-stimulated insulin secretion have been observed, with insulin resistance and the onset of diabetes in them. This study was conducted to find the association between COVID-19 infection and new-onset diabetes. This was a crosssectional study conducted in the Department of Internal Medicine at Nepal Medical College Teaching Hospital, for a duration of 6 months (July to December 2021). A total of 38 new-onset diabetes patients with a confirmed history of COVID-19 infection were enrolled in the study using a non-probability convenient sampling technique. Ethical clearance was taken from the Research and Institutional Review Committee, Nepal Medical College Teaching Hospital (Reference No.068-077/078). Venous blood was collected and fasting blood glucose, post-prandial blood glucose, and HbA1c were measured. Data were analyzed in the Statistical Package for Social version 20.0. Analytical data were compared using Z-test for the parametric values and the Chi-Square test for the nonparametric values. Statistical significance was defined as a p-value of less than 0.05. As per clinical severity, 22 had mild, 13 had moderate and three had severe COVID-19 infection. The mean fasting blood sugar was 169.84 ± 40.72 mg/dl and the mean postprandial blood sugar was 249.92 ± 72.46 mg/dl. The mean HbA1c was 7.92 ± 1.11%. Out of 38 patients, 36 had a history of systemic steroid use and hyperglycemia was significantly associated with steroid use (Z=1.97, P=0.024).

Research paper thumbnail of Serum Aminotransferases Level in Patients with Type 2 Diabetes Mellitus attending a Tertiary Care Center, Kathmandu

Nepal Medical College journal, Dec 31, 2018

Nonalcoholic fatty liver disease is increasing with the rise in obesity and metabolic risk factor... more Nonalcoholic fatty liver disease is increasing with the rise in obesity and metabolic risk factors like diabetes mellitus. Type 2 diabetics are highly prone to deranged liver function test. Increase in serum aminotransferases level is an indicator of hepatocellular injury. The aim of this study is to correlate serum aminotransferases level with anthropometric measurements, diabetic retinopathy and types of treatment received in diabetics. A total of 236 patients (142 females) of age more than 40 years with type 2 diabetes attending Nepal Medical College and Teaching Hospital between February 2016 and January 2017 were included in this cross-sectional observational study. Blood samples were sent for fasting blood sugar, HbA1c and serum aminotransferases tests. Body mass index and waist hip ratio were measured as per standard protocol. Fundoscopy was done in all patients. Pearson and independent t-test were applied to see the correlation between the variables. The mean HbA1c was 8.01± 2.08. In the sub group analysis, serum aminotransferases level was significantly high in patients with poor glycemic control, higher body mass index and waist hip ratio (p value < 0.001). Patients with diabetic retinopathy also had higher serum aminotransferases level (p value < 0.001). Pearson correlation between HbA1c with serum alanine aminotransferases level was significant (r=0.76, n=5, p value < 0.001).

Research paper thumbnail of Screening of Thyroid Disorder among Pregnant Ladies in a Tertiary Hospital of Nepal

Nepal Medical College journal, Nov 26, 2019

Thyroid disorders (TD) are the second most common endocrine disorders seen in pregnancy. Many phy... more Thyroid disorders (TD) are the second most common endocrine disorders seen in pregnancy. Many physiological changes in pregnancy lead to hypothyroidism in pregnancy. Hypothyroid in pregnancy is associated with many adverse maternal and fetal outcomes. Objective of this study was to find the prevalence of TD in pregnancy in Nepal Medical College Teaching Hospital (NMCTH), Antithyroid Peroxidase Antibody (TPO-Ab) positive cases with hypothyroidism and to evaluate maternal fetal outcome in hypothyroid pregnancies. This was a prospective hospital based observational study. The study was done in Department of Obstetrics and Gynecology, NMCTH from August 2018 to July 2019. Among 420 pregnant ladies 71.0% were euthyroid, 25.7% were hypothyroid (25.2% of subclinical and 0.5% overt), 3.3% were hyperthyroid (0.7% of overt) and 6.4% were TPO-Ab positive with hypothyroidism. Inspite of treatment, Gestational hypertention, Pre-eclampsea and LSCS is significantly high in hypothyroid pregnancy than euthyroid pregnancy. High prevalence of hypothyroidism in this study necessitates universal screening of TD at first trimester of pregnancy.

Research paper thumbnail of Subclinical Hypothyroidism among Patients with COVID-19 Infection in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association, Jun 1, 2023

Introduction: Hypothyroidism occurs as a consequence of chronic autoimmune inflammation of the th... more Introduction: Hypothyroidism occurs as a consequence of chronic autoimmune inflammation of the thyroid gland, which occurs due to the reduced function in the secretion of thyroid hormones. The coronavirus disease infection has shown many complications in all organic systems, during the acute phase of infection and in the post-COVID-19 period. SARS-CoV-2 may induce thyroid dysfunction that is usually reversible, including subclinical and atypical thyroiditis. The aim of this study was to find out the prevalence of subclinical hypothyroidism among patients with COVID-19 infection in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Internal Medicine of a tertiary care centre from 1 September 2022 to 28 February 2023 after obtaining ethical approval from the Research and Institutional Review Committee (Reference number: 15-079/080). Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 38 patients with COVID-19, subclinical hypothyroidism was seen among 23 (60.53%) (44.99-76.07, 95% Confidence Interval). Conclusions: The prevalence of subclinical hypothyroidism among COVID-19 patients was found to be similar to other studies done in similar settings.

Research paper thumbnail of Kala Azar- A Diagnostic Dilemma - A Case Report

Medical Journal of Shree Birendra Hospital, 1970

Research paper thumbnail of Drug Induced Rowell’s Syndrome: A Rare Presentation

Nepal Medical College journal, Apr 2, 2024

Research paper thumbnail of Diabetes Mellitus among Patients with Non-alcoholic Fatty Liver Disease Visiting the Outpatient Department of Internal Medicine in a Tertiary Care Centre

Journal of Nepal Medical Association

Introduction: Diabetes mellitus is a chronic metabolic illness which is mainly associated with re... more Introduction: Diabetes mellitus is a chronic metabolic illness which is mainly associated with reduced physical activity and obesity. Diabetes mellitus and non-alcoholic fatty liver disease may coexist and synergistically lead to poor clinical outcomes. The aim of the study was to find out the prevalence of diabetes mellitus among patients with non-alcoholic fatty liver disease in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients with non-alcoholic fatty liver disease in the outpatient department of Internal Medicine of a tertiary care centre between 1st January 2022 and 29th June 2023. Convenience sampling was done. A convenience sampling technique was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 150 patients with non-alcoholic fatty liver disease, diabetes mellitus was seen among 18 (12%) (6.80-17.20, 95% Confidence Interval). Diabetes mellitus was more prevalent in males 12 (66.67%) in patient...

Research paper thumbnail of Role of CBC Parameters in COPD with Acute Exacerbation in a Tertiary Care Center

Nepal Medical College Journal, 2019

Chronic obstructive pulmonary disease (COPD) is a major global health problem. It is a complex di... more Chronic obstructive pulmonary disease (COPD) is a major global health problem. It is a complex disease characterised by chronic inflammation in the airways by noxious particles. Episodes of increased symptoms called as acute exacerbations are associated with accelerated decline in the lung function. Blood cultures to find out the causative organism in these cases are time consuming. Complete Blood Count (CBC) parameters like Total leukocyte count (TLC), hemoglobin (Hb), platelet count, Mean Platelet Volume (MPV), Platelet Distribution Width (PDW) are found to be related with COPD and its acute exacerbation. An observational hospital based descriptive study was conducted for a period of six months in the Department of Pathology and Medicine of a tertiary care centre. A total of 144 patients of COPD with acute exacerbation (AECOPD) were included in the study. The mean age of the patients was 70.47 ± 9.49 years with female preponderance (61.1%). Though mean hemoglobin level (13.25 ± 2....

Research paper thumbnail of Adult Onset Still’s Disease: A Diagnostic Dilemma

Nepal Medical College Journal, 2021

Adult-onset Still’s disease (ASD) is a rare clinical entity with unknown etiology, characterized ... more Adult-onset Still’s disease (ASD) is a rare clinical entity with unknown etiology, characterized by arthritis, fever, evanescent rash and other systemic presentations. This case report describes a 19-year-old male who presented with sore throat, fever, arthritis, evanescent rash, raised liver enzymes and hyperferritinemia. It also reveals the diagnostic dilemma faced during the diagnosis of the disease. He was diagnosed to have ASD based on Yamuguchi criteria after the exclusion of other potential diagnoses. Patient was treated with prednisolone and there was a good response with improvement in symptoms and laboratory indices.

Research paper thumbnail of Clinical, Bacteriological and Radiological Study of Community Acquired Pneumonia Cases at Tertiary Medical Center in Kathmandu, Nepal

Nepal Medical College Journal, 2020

Community-acquired pneumonia (CAP) remains a common and serious illness, in spite of the availabi... more Community-acquired pneumonia (CAP) remains a common and serious illness, in spite of the availability of potent new antimicrobials and effective vaccines. Despite Nepal being one of the four developing countries accounting for 40.0% of global acute respiratory infections, studies on CAP are limited and the status of adult pneumonia in our community is unknown. This cross-sectional study reviewed the clinical, bacteriological, radiological profile of 100 cases of adult CAP and followed them during the hospital stay for the outcome. The age group with the highest incidence was 60-79 years with females (55.0%) being more affected than males (45.0%). Risk factors were present in 86.0% of cases, chronic obstructive pulmonary disease (COPD), and smoking was the most common, each present in 43.0% of cases. The most common presenting feature was cough (89.80%) followed by sputum production (78.60%), fever (67.30%), shortness of breath (63.30%), chest pain (38.80%), gastrointestinal symptoms...

Research paper thumbnail of Correlation between Serum-Ascites Albumin Gradient and Esophageal Varices in Portal Hypertension due to Cirrhosis of Liver

Nepal Medical Journal, 2021

Introduction: Cirrhosis of the liver is a major health problem in our country. Patients with cir... more Introduction: Cirrhosis of the liver is a major health problem in our country. Patients with cirrhosis are at risk of developing esophageal varices and variceal bleeding with high mortality. They must undergo routine upper gastrointestinal endoscopy to screen for the presence of varices. This poses an economic, social, and medical burden. Thus, this warrants a non-invasive predictor of esophageal varices in a cirrhotic patient. The aim of this study was to find the correlation between SAAG and esophageal varices in portal hypertension due to cirrhosis of liver. Methods: Patients (45 males and 35 females) above 18 years of age and with cirrhosis of the liver underwent cross sectional observational study at Nepal Medical College Teaching hospital between October 2015 and December 2017 AD. Serum albumin and ascitic fluid albumin were analyzed on the same day and serum-ascites albumin gradient (SAAG) was calculated. Upper GI endoscopy was done to evaluate for the presence of esophageal...

Research paper thumbnail of Role of fasting and postprandial hypertriglyceridemia and its association with carotid intima media thickness in Type II diabetes patients

Journal of Advances in Internal Medicine, 2018

Background and aim: Type 2 diabetes mellitus is associated with the development of premature arte... more Background and aim: Type 2 diabetes mellitus is associated with the development of premature arteriosclerosis and a higher cardiovascular morbidity and mortality. Diabetic dyslipidaemia is believed to play an important role in the pathogenesis of accelerated atherosclerosis in this condition. B-mode ultrasound enables non-invasive, direct visualization of the arterial wall. The aim of this study was to correlate intima media thickness of the carotid artery (CIMT) quantification as a reliable marker of atherosclerotic burden in diabetes patients.Method: It was a Cross Sectional Study done on 50 patients in the age group of 30-70 years with type II Diabetes Mellitus of more than 5 years duration without hypertension. Carotid Intima Media Thickness (CIMT) was measured using an echotomographic system with a 7.5-MHz linear transducer probe. With the carotid bulb and the longitudinal projection of the common carotid artery 2cmx from carotid bulb, the site of the greatest thickness includi...

Research paper thumbnail of Common reasons for hospitalization among adult patients with diabetes in a private medical college in Kathmandu

Nepal Medical College journal : NMCJ, 2012

Diabetes Mellitus is one of the important non communicable disease affecting the adult population... more Diabetes Mellitus is one of the important non communicable disease affecting the adult populations around the world. Incidence of diabetes increasing in South Asia. Nepal is also experiencing increasing in diabetes disease burden. Diabetes mellitus is one of the important causes of hospital admission in the western world. In this study we evaluated the causes of hospital admission amongst diabetic population. Most common cause is of diagnosis is some forms of infections commonest (20%) being urinary tract infections. Ten out of total 69 patients had septicemia. Six patients out of 69 had sputum positive pulmonary tuberculosis only one patient presented with metabolic complications of diabetes i.e. diabetic ketoacidosis. Coronary artery disease with heart failure was present in 14 patients. Five patients had diabetic nephropathy and 3 had retinopathy. This shows that infections is the major cause of hospital admission for diabetics followed by heart failure. Tuberculosis is important...

Research paper thumbnail of Profile of ascites patient admitted in Nepal Medical College Teaching Hospital

Nepal Medical College journal : NMCJ, 2012

Ascites is one of the frequently encountered problems in internal medicine. Common causes of asci... more Ascites is one of the frequently encountered problems in internal medicine. Common causes of ascites are portal hypertension including cirrhosis of liver and congestive heart failure, hypoalbuminemia associated with nephrotic syndrome, intra-abdominal malignancy and abdominal tuberculosis. We evaluated 43 patients presented with ascites in Nepal Medical College Teaching Hospital (NMCTH). After history taking, clinical examination, imaging studies and laboratory evaluation alcoholic liver disease and abdominal tuberculosis were diagnosed in 19 and 5 patients restively. Constrictive pericarditis was diagnosed in 2 patients and 2 patients were suffering from HCV related liver disease. Present study revealed alcoholic liver disease as the commonest cause of ascites.

Research paper thumbnail of Subclinical hypothyroidism as a cause of leg swelling in patients attending tertiary level hospital in Kathmandu

Journal of Pathology of Nepal

Background: Peripheral edema is one of the common causes of visit to medical outpatient departmen... more Background: Peripheral edema is one of the common causes of visit to medical outpatient department. After history taking and investigations few patients are left without diagnosis. This study was designed to find if there is any association between pedal edema and subclinical hypothyroidism when there is no other systemic disease is found.Materials and Methods: This is a cross-sectional observational hospital based study done in one of Medical colleges in Kathmandu for a period of 2 years .All patient coming to medical OPD for the first time with bilateral painless limb swelling were evaluated data were tabulated and analyzed using Ms Excel.Results: Out of 300 patients, 146 patients were exclude from history and clinical evaluation, 154 patients underwent laboratory evaluation. After investigations 46 patients were left without any other systemic disease. Out of them only 3 were male. About 40% of them are overweight or obese. 57% of them had high TSH level, which was significantly ...

Research paper thumbnail of Association Between COVID-19 Infection and New-Onset Diabetes in a Tertiary Care Hospital in Kathmandu

Nepal Medical College journal, Jul 7, 2023

In severe acute respiratory syndrome coronavirus 2 infections, reduced numbers of insulin secreto... more In severe acute respiratory syndrome coronavirus 2 infections, reduced numbers of insulin secretory granules in beta cells and impaired glucose-stimulated insulin secretion have been observed, with insulin resistance and the onset of diabetes in them. This study was conducted to find the association between COVID-19 infection and new-onset diabetes. This was a crosssectional study conducted in the Department of Internal Medicine at Nepal Medical College Teaching Hospital, for a duration of 6 months (July to December 2021). A total of 38 new-onset diabetes patients with a confirmed history of COVID-19 infection were enrolled in the study using a non-probability convenient sampling technique. Ethical clearance was taken from the Research and Institutional Review Committee, Nepal Medical College Teaching Hospital (Reference No.068-077/078). Venous blood was collected and fasting blood glucose, post-prandial blood glucose, and HbA1c were measured. Data were analyzed in the Statistical Package for Social version 20.0. Analytical data were compared using Z-test for the parametric values and the Chi-Square test for the nonparametric values. Statistical significance was defined as a p-value of less than 0.05. As per clinical severity, 22 had mild, 13 had moderate and three had severe COVID-19 infection. The mean fasting blood sugar was 169.84 ± 40.72 mg/dl and the mean postprandial blood sugar was 249.92 ± 72.46 mg/dl. The mean HbA1c was 7.92 ± 1.11%. Out of 38 patients, 36 had a history of systemic steroid use and hyperglycemia was significantly associated with steroid use (Z=1.97, P=0.024).

Research paper thumbnail of Serum Aminotransferases Level in Patients with Type 2 Diabetes Mellitus attending a Tertiary Care Center, Kathmandu

Nepal Medical College journal, Dec 31, 2018

Nonalcoholic fatty liver disease is increasing with the rise in obesity and metabolic risk factor... more Nonalcoholic fatty liver disease is increasing with the rise in obesity and metabolic risk factors like diabetes mellitus. Type 2 diabetics are highly prone to deranged liver function test. Increase in serum aminotransferases level is an indicator of hepatocellular injury. The aim of this study is to correlate serum aminotransferases level with anthropometric measurements, diabetic retinopathy and types of treatment received in diabetics. A total of 236 patients (142 females) of age more than 40 years with type 2 diabetes attending Nepal Medical College and Teaching Hospital between February 2016 and January 2017 were included in this cross-sectional observational study. Blood samples were sent for fasting blood sugar, HbA1c and serum aminotransferases tests. Body mass index and waist hip ratio were measured as per standard protocol. Fundoscopy was done in all patients. Pearson and independent t-test were applied to see the correlation between the variables. The mean HbA1c was 8.01± 2.08. In the sub group analysis, serum aminotransferases level was significantly high in patients with poor glycemic control, higher body mass index and waist hip ratio (p value < 0.001). Patients with diabetic retinopathy also had higher serum aminotransferases level (p value < 0.001). Pearson correlation between HbA1c with serum alanine aminotransferases level was significant (r=0.76, n=5, p value < 0.001).

Research paper thumbnail of Screening of Thyroid Disorder among Pregnant Ladies in a Tertiary Hospital of Nepal

Nepal Medical College journal, Nov 26, 2019

Thyroid disorders (TD) are the second most common endocrine disorders seen in pregnancy. Many phy... more Thyroid disorders (TD) are the second most common endocrine disorders seen in pregnancy. Many physiological changes in pregnancy lead to hypothyroidism in pregnancy. Hypothyroid in pregnancy is associated with many adverse maternal and fetal outcomes. Objective of this study was to find the prevalence of TD in pregnancy in Nepal Medical College Teaching Hospital (NMCTH), Antithyroid Peroxidase Antibody (TPO-Ab) positive cases with hypothyroidism and to evaluate maternal fetal outcome in hypothyroid pregnancies. This was a prospective hospital based observational study. The study was done in Department of Obstetrics and Gynecology, NMCTH from August 2018 to July 2019. Among 420 pregnant ladies 71.0% were euthyroid, 25.7% were hypothyroid (25.2% of subclinical and 0.5% overt), 3.3% were hyperthyroid (0.7% of overt) and 6.4% were TPO-Ab positive with hypothyroidism. Inspite of treatment, Gestational hypertention, Pre-eclampsea and LSCS is significantly high in hypothyroid pregnancy than euthyroid pregnancy. High prevalence of hypothyroidism in this study necessitates universal screening of TD at first trimester of pregnancy.

Research paper thumbnail of Subclinical Hypothyroidism among Patients with COVID-19 Infection in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association, Jun 1, 2023

Introduction: Hypothyroidism occurs as a consequence of chronic autoimmune inflammation of the th... more Introduction: Hypothyroidism occurs as a consequence of chronic autoimmune inflammation of the thyroid gland, which occurs due to the reduced function in the secretion of thyroid hormones. The coronavirus disease infection has shown many complications in all organic systems, during the acute phase of infection and in the post-COVID-19 period. SARS-CoV-2 may induce thyroid dysfunction that is usually reversible, including subclinical and atypical thyroiditis. The aim of this study was to find out the prevalence of subclinical hypothyroidism among patients with COVID-19 infection in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Internal Medicine of a tertiary care centre from 1 September 2022 to 28 February 2023 after obtaining ethical approval from the Research and Institutional Review Committee (Reference number: 15-079/080). Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 38 patients with COVID-19, subclinical hypothyroidism was seen among 23 (60.53%) (44.99-76.07, 95% Confidence Interval). Conclusions: The prevalence of subclinical hypothyroidism among COVID-19 patients was found to be similar to other studies done in similar settings.

Research paper thumbnail of Kala Azar- A Diagnostic Dilemma - A Case Report

Medical Journal of Shree Birendra Hospital, 1970

Research paper thumbnail of Drug Induced Rowell’s Syndrome: A Rare Presentation

Nepal Medical College journal, Apr 2, 2024

Research paper thumbnail of Diabetes Mellitus among Patients with Non-alcoholic Fatty Liver Disease Visiting the Outpatient Department of Internal Medicine in a Tertiary Care Centre

Journal of Nepal Medical Association

Introduction: Diabetes mellitus is a chronic metabolic illness which is mainly associated with re... more Introduction: Diabetes mellitus is a chronic metabolic illness which is mainly associated with reduced physical activity and obesity. Diabetes mellitus and non-alcoholic fatty liver disease may coexist and synergistically lead to poor clinical outcomes. The aim of the study was to find out the prevalence of diabetes mellitus among patients with non-alcoholic fatty liver disease in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients with non-alcoholic fatty liver disease in the outpatient department of Internal Medicine of a tertiary care centre between 1st January 2022 and 29th June 2023. Convenience sampling was done. A convenience sampling technique was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 150 patients with non-alcoholic fatty liver disease, diabetes mellitus was seen among 18 (12%) (6.80-17.20, 95% Confidence Interval). Diabetes mellitus was more prevalent in males 12 (66.67%) in patient...

Research paper thumbnail of Role of CBC Parameters in COPD with Acute Exacerbation in a Tertiary Care Center

Nepal Medical College Journal, 2019

Chronic obstructive pulmonary disease (COPD) is a major global health problem. It is a complex di... more Chronic obstructive pulmonary disease (COPD) is a major global health problem. It is a complex disease characterised by chronic inflammation in the airways by noxious particles. Episodes of increased symptoms called as acute exacerbations are associated with accelerated decline in the lung function. Blood cultures to find out the causative organism in these cases are time consuming. Complete Blood Count (CBC) parameters like Total leukocyte count (TLC), hemoglobin (Hb), platelet count, Mean Platelet Volume (MPV), Platelet Distribution Width (PDW) are found to be related with COPD and its acute exacerbation. An observational hospital based descriptive study was conducted for a period of six months in the Department of Pathology and Medicine of a tertiary care centre. A total of 144 patients of COPD with acute exacerbation (AECOPD) were included in the study. The mean age of the patients was 70.47 ± 9.49 years with female preponderance (61.1%). Though mean hemoglobin level (13.25 ± 2....

Research paper thumbnail of Adult Onset Still’s Disease: A Diagnostic Dilemma

Nepal Medical College Journal, 2021

Adult-onset Still’s disease (ASD) is a rare clinical entity with unknown etiology, characterized ... more Adult-onset Still’s disease (ASD) is a rare clinical entity with unknown etiology, characterized by arthritis, fever, evanescent rash and other systemic presentations. This case report describes a 19-year-old male who presented with sore throat, fever, arthritis, evanescent rash, raised liver enzymes and hyperferritinemia. It also reveals the diagnostic dilemma faced during the diagnosis of the disease. He was diagnosed to have ASD based on Yamuguchi criteria after the exclusion of other potential diagnoses. Patient was treated with prednisolone and there was a good response with improvement in symptoms and laboratory indices.

Research paper thumbnail of Clinical, Bacteriological and Radiological Study of Community Acquired Pneumonia Cases at Tertiary Medical Center in Kathmandu, Nepal

Nepal Medical College Journal, 2020

Community-acquired pneumonia (CAP) remains a common and serious illness, in spite of the availabi... more Community-acquired pneumonia (CAP) remains a common and serious illness, in spite of the availability of potent new antimicrobials and effective vaccines. Despite Nepal being one of the four developing countries accounting for 40.0% of global acute respiratory infections, studies on CAP are limited and the status of adult pneumonia in our community is unknown. This cross-sectional study reviewed the clinical, bacteriological, radiological profile of 100 cases of adult CAP and followed them during the hospital stay for the outcome. The age group with the highest incidence was 60-79 years with females (55.0%) being more affected than males (45.0%). Risk factors were present in 86.0% of cases, chronic obstructive pulmonary disease (COPD), and smoking was the most common, each present in 43.0% of cases. The most common presenting feature was cough (89.80%) followed by sputum production (78.60%), fever (67.30%), shortness of breath (63.30%), chest pain (38.80%), gastrointestinal symptoms...

Research paper thumbnail of Correlation between Serum-Ascites Albumin Gradient and Esophageal Varices in Portal Hypertension due to Cirrhosis of Liver

Nepal Medical Journal, 2021

Introduction: Cirrhosis of the liver is a major health problem in our country. Patients with cir... more Introduction: Cirrhosis of the liver is a major health problem in our country. Patients with cirrhosis are at risk of developing esophageal varices and variceal bleeding with high mortality. They must undergo routine upper gastrointestinal endoscopy to screen for the presence of varices. This poses an economic, social, and medical burden. Thus, this warrants a non-invasive predictor of esophageal varices in a cirrhotic patient. The aim of this study was to find the correlation between SAAG and esophageal varices in portal hypertension due to cirrhosis of liver. Methods: Patients (45 males and 35 females) above 18 years of age and with cirrhosis of the liver underwent cross sectional observational study at Nepal Medical College Teaching hospital between October 2015 and December 2017 AD. Serum albumin and ascitic fluid albumin were analyzed on the same day and serum-ascites albumin gradient (SAAG) was calculated. Upper GI endoscopy was done to evaluate for the presence of esophageal...

Research paper thumbnail of Role of fasting and postprandial hypertriglyceridemia and its association with carotid intima media thickness in Type II diabetes patients

Journal of Advances in Internal Medicine, 2018

Background and aim: Type 2 diabetes mellitus is associated with the development of premature arte... more Background and aim: Type 2 diabetes mellitus is associated with the development of premature arteriosclerosis and a higher cardiovascular morbidity and mortality. Diabetic dyslipidaemia is believed to play an important role in the pathogenesis of accelerated atherosclerosis in this condition. B-mode ultrasound enables non-invasive, direct visualization of the arterial wall. The aim of this study was to correlate intima media thickness of the carotid artery (CIMT) quantification as a reliable marker of atherosclerotic burden in diabetes patients.Method: It was a Cross Sectional Study done on 50 patients in the age group of 30-70 years with type II Diabetes Mellitus of more than 5 years duration without hypertension. Carotid Intima Media Thickness (CIMT) was measured using an echotomographic system with a 7.5-MHz linear transducer probe. With the carotid bulb and the longitudinal projection of the common carotid artery 2cmx from carotid bulb, the site of the greatest thickness includi...

Research paper thumbnail of Common reasons for hospitalization among adult patients with diabetes in a private medical college in Kathmandu

Nepal Medical College journal : NMCJ, 2012

Diabetes Mellitus is one of the important non communicable disease affecting the adult population... more Diabetes Mellitus is one of the important non communicable disease affecting the adult populations around the world. Incidence of diabetes increasing in South Asia. Nepal is also experiencing increasing in diabetes disease burden. Diabetes mellitus is one of the important causes of hospital admission in the western world. In this study we evaluated the causes of hospital admission amongst diabetic population. Most common cause is of diagnosis is some forms of infections commonest (20%) being urinary tract infections. Ten out of total 69 patients had septicemia. Six patients out of 69 had sputum positive pulmonary tuberculosis only one patient presented with metabolic complications of diabetes i.e. diabetic ketoacidosis. Coronary artery disease with heart failure was present in 14 patients. Five patients had diabetic nephropathy and 3 had retinopathy. This shows that infections is the major cause of hospital admission for diabetics followed by heart failure. Tuberculosis is important...

Research paper thumbnail of Profile of ascites patient admitted in Nepal Medical College Teaching Hospital

Nepal Medical College journal : NMCJ, 2012

Ascites is one of the frequently encountered problems in internal medicine. Common causes of asci... more Ascites is one of the frequently encountered problems in internal medicine. Common causes of ascites are portal hypertension including cirrhosis of liver and congestive heart failure, hypoalbuminemia associated with nephrotic syndrome, intra-abdominal malignancy and abdominal tuberculosis. We evaluated 43 patients presented with ascites in Nepal Medical College Teaching Hospital (NMCTH). After history taking, clinical examination, imaging studies and laboratory evaluation alcoholic liver disease and abdominal tuberculosis were diagnosed in 19 and 5 patients restively. Constrictive pericarditis was diagnosed in 2 patients and 2 patients were suffering from HCV related liver disease. Present study revealed alcoholic liver disease as the commonest cause of ascites.

Research paper thumbnail of Subclinical hypothyroidism as a cause of leg swelling in patients attending tertiary level hospital in Kathmandu

Journal of Pathology of Nepal

Background: Peripheral edema is one of the common causes of visit to medical outpatient departmen... more Background: Peripheral edema is one of the common causes of visit to medical outpatient department. After history taking and investigations few patients are left without diagnosis. This study was designed to find if there is any association between pedal edema and subclinical hypothyroidism when there is no other systemic disease is found.Materials and Methods: This is a cross-sectional observational hospital based study done in one of Medical colleges in Kathmandu for a period of 2 years .All patient coming to medical OPD for the first time with bilateral painless limb swelling were evaluated data were tabulated and analyzed using Ms Excel.Results: Out of 300 patients, 146 patients were exclude from history and clinical evaluation, 154 patients underwent laboratory evaluation. After investigations 46 patients were left without any other systemic disease. Out of them only 3 were male. About 40% of them are overweight or obese. 57% of them had high TSH level, which was significantly ...