Browsing by Author "Adhikary, L"
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Publication Detection and co-ordinated care management of chronic kidney disease at Kathmandu Medical College Teaching Hospital(Kathmandu University, 2005) Adhikary, L; Simkhada, RObjective: The objective of our study was to analyze the detection parameters, categorization and co-ordinated management of Chronic Kidney Disease (CKD). The presenting clinical features, common lab investigations, applied treatment protocols and noticed complications were recorded. Methodology: A total of 40 patients of various stages of CKD on the basis of National Kidney Foundation (NKF), Kidney Disease Outcome Quality Initiative (K/DOQI) guideline were included in the study. Result: Out of them 24(60%) were males and 16(40%) were females. Constitutional symptoms like anorexia, nausea and generalized weakness were common presenting complaints present in 37(92.5%) patients and were associated with features of anaemia, metabolic acidosis and fluid overload in stage 5 CKD patients. The average age of presentation was 51.3 years. Among 40 patients 21(52.5%) were managed conservatively, 17((42.5%) were advised for Renal Replacement Therapy (RRT) through dialysis.2 (5%) patient expired during the treatment. The average duration of hospital stay was 5.6 days. Diabetes Mellitus was the most common cause18 (45%), followed by Hypertension 14 (35%) and Chronic Glomerulonephritis (CGN) 5 (12.5%) leading to CKD. The patients were advised for regular follow up at Nephrology clinic. Keywords: Chronic Kidney Disease, NKF, K/DOQI guideline, Diabetes Mellitus, Hypertension, Renal Replacement TherapyPublication Role of CaCO3 alone and CaCO3 plus Vitamin D3 in terms of Calcium Phosphorus Product in Chronic Kidney Diseases(Nepal Health Research Council, 2011) Adhikary, L; Acharya, S; Acharya, LBackground: CaCO3 alone and CaCO3 plus vitamin D3 metabolites are commonly prescribed in CKD patients. The objective of this study is to analyze the changes in Ca x P product, calcium level and phosphorus level in CKD patients receiving calcium carbonate alone and calcium carbonate with vitamin D3 in combination. Methods: A prospective, cross sectionalstudy among CKD patients under maintenance hemodialysis two times a week were studied over a period of one year. The patients were divided into two groups receiving oral CaCO3 alone and CaCO3 plus vitamin D3 once a day. The patients were followed for 1 month and result of Ca x P product was analyzed accordingly. Results: Mean decrease of Ca x P product in CaCO3 group is (50.42+/-8.85 to 47 +/-6.63) in one month, p value =0.001(0.6-5) and CI- 95%. There is also significant reduction of phosphorus level in CaCO3 group than CaCO3 plus vitamin D3 group. Mean decrease in phosphorus in CaCO3 group is (5.51+/-0.76 to 5.17+/- 0.05) in one month. P value =0.01(0.14-0.53) and CI 95%. Conclusions: There is a significant decrease in Ca x P product and phosphorus level was observed in CKD patients taking CaCO3 alone. Keywords: calcium carbonate, calcium phosphorus product, chronic kidney disease, vitamin.Publication Successful management of idiopathic rapidly progressive glomerulonephritis with corticosteroids and cytotoxic agent(Kathmandu University, 2005) Adhikary, L; Simkhada, RA 19 years old, male patient presented with symptoms of smoky urine for 2 weeks, puffiness of face and diminished urine output for 3 weeks associated with occasional lower abdominal and flank pain. Patient’s history, clinical findings and available investigations were strongly suggestive of Idiopathic Rapidly Progressive Glomerulonephritis. The patient showed excellent response to glucocorticoid and cytotoxic agent. Key words: Idiopathic Rapidly Progressive Glomerulonephritis, Glucocorticoid, Cytotoxic agent.