NepMed is a Nepal MEDLINE(Medical Literature Analysis and Retrieval System Online) by Nepal Health Research Council(NHRC) in collaboration with Nepal Medical Association. It includes bibliographic information for articles from academic biomedical journals covering medicine, dentistry, nursing, pharmacy, dentistry veterinary medicine, and allied health sciences.
Recent Submissions
Complications of Arterio-Venous Fistula in Patients Undergoing Haemodialysis
(Government of Nepal; Nepal Health Research Council; Ramshah Path, Kathmandu, Nepal, 2022) Agrawaal, Krishna Kumar
Abstract
Background: Vascular access is required for hemodialysis and arterio-venous fistula is the preferred access. Various guidelines have recommended monitoring and surveillance of arterio-venous fistula as the standard of care. This study looked into usefulness of clinical examination to detect complications of arterio-venous fistula.
Methods: The study was conducted in the from February 2022 till September 2022 under Nephrology unit, Departement of Internal Medicine at Universal College of Medical Sciences. Ethical clearance was taken. Patients undergoing hemodialysis were enrolled in the study. After informed and written consent, clinical examination of arterio-venous fistula was done by look, listen and feel method. Data was collected as per the approved performa. Statistical analysis was done using Statistical Package for the Social Sciences software version 17.
Results: Total enrolled study population was 73. Mean age of the study population was 47.45 years ± 14.60 years with a Male: Female ratio of 1.3:1. Complications were seen in a total of 33 patients with an overall rate of 45.2%. The mean duration of AVF creation was 32.68 ± 24.56 months. Most common complication of arterio-venous fistula was overall stenosis 18 (24.7%).
Conclusions: There is a higher rate of complications of arterio-venous fistula. Monitoring and surveillance of arterio-venous fistula should be performed as a standard of care in every hemodialysis centre.
Keywords: Arterio-venous fistula; complication; hemodialysis
Ultrasound Measurement of Fetal Kidney Length in Normal Pregnancy and its Correlation with Gestational Age
(Government of Nepal; Nepal Health Research Council; Ramshah Path, Kathmandu, Nepal, 2022) Koirla, Sapana; Adhikari, Kapil; Devkota, Karun
Abstract
Background: To establish a nomogram of fetal kidney length for a normal pregnancy from 20 to 41 weeks of gestational age.
Methods: A prospective cross-sectional study was carried out in the Department of radio-diagnosis and imaging BPKIHS, Dharan. 400 kidneys of 200 fetuses between the gestational age 20 to 41 weeks were scanned. Renal measurement was performed by ultrasonography.
Results: Analysis was performed on data obtained from 200 normal fetuses. Size charts for right, left and mean fetal kidney length with standard deviation were presented for each weeks of gestation from 20 weeks to 41 weeks. The difference in renal length between right and left side was statistically not significant.There was significant correlation between gestational age and fetal kidney length (r=0.947, p=0.001).
Conclusions: Fetal kidney length can be used as an adjunct parameter for estimation of gestation age.
Keywords: Fetal kidney; gestational age; ultrasound
Assessment of Thyroid Dysfunction During Different Trimester of Pregnancy
(Government of Nepal; Nepal Health Research Council; Ramshah Path, Kathmandu, Nepal, 2022) Prajapati, Sunita; Prajapati, Gayatri; Shrestha, Vikram; Shrestha, Sujata
Abstract
Background: Thyroid dysfunction is frequently seen in pregnant women and is associated with complications like miscarriage, gestational hypertension, placental abruption, pre mature delivery and fetal growth retardation and even causes impaired neuropsychological development of fetus. This study is carried out to assess the prevalence of thyroid disorder during different trimester of pregnancy.
Methods: Serum samples were collected from 124 pregnant women attending Patan Academy of Health Science for ante natal visit. Free thyroxine free triiodothyronine and thyroid stimulating hormone were performed by chemiluminescent assay.
Results: Out of 124 pregnant women, euthyroidism was seen in 79% (n =98) followed by subclinical hypothyroidism (10%, n=13) and primary hypothyroidism (8%, n=10). Subclinical hyperthyroidism and primary hyperthyroidism accounts for 1% (n=1), and 2% (n=2) respectively. Although, thyroid disorder was found to be more prevalent in third trimester (38.4%, n=10) but the distribution in first and second trimester (34.6%, n= 9, 27%, n= 7 respectively) were also significant. Mean fT3 and fT4 level were found to be negatively correlated with trimester (r=-0.19, p=0.027 and r=-0.29, p=0.001 respectively) whereas positive correlation of trimester was seen with TSH (r=0.08, p=0.35).
Conclusions: Hypothyroidism is more common in pregnant women visiting tertiary care hospital. Different complication can be minimized if diagnosis is done early.
Keywords: Hypothyroidism; pregnant; thyroid stimulating hormone; trimester, gestational week
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