Browsing by Author "Gauli, Basanta"
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Publication Clinical profile and outcome of Dengue fever in Medical Intensive Care Unit of a Tertiary Level Hospital: An Observational Study(Nepal Medical Association, 2025) Koirala, Eliza; Deo, Gopendra Prasad; Adhikari, Shital; Gauli, Basanta; Bajracharya, AkritiAbstract Introduction: Dengue fever poses a significant public health challenge in Nepal, with increasingsevere cases requiring intensive care. Limited data exist on the clinical profile and outcomes of critically ill dengue patients in resource-limited settings. This study is aimed to characterize the clinical features, outcomes and complications of dengue patients admitted to a tertiary Intensive care unit in Nepal. Methods: A prospective observational study was conducted at from August to September 2024 after ethical approval. We enrolled 104 serologically confirmed dengue patients (aged ≥16 years) admitted to the Medical Intensive care unit. Exclusion criteria included co-infections with other tropical diseases. Data on demographics, clinical presentation, laboratory parameters (including platelet counts, liver enzymes), organ dysfunction (SOFA score), and outcomes were collected. Descriptive data analysis was used to report frequency, proportion, measure of central tendency and measure of dispersion based on nature of data. Results: The cohort (median age 41 years, 54.8% male) exhibited severe manifestations: thrombocytopenia (median platelets count 49,000/μL; IQR: 30,250–85,000 per μL), hepatic injury 86 (82.7%); median AST 176.5 U/L, ALT 208.5 U/L), and moderate organ dysfunction (median SOFA score 4). Hypertension 27 (25.96%) and diabetes 23 (22.12%) were common comorbidities. Despite 22 (21.2%) developing multi-organ dysfunction syndrome, mortality was remarkably low 1 (0.96%). Conclusions: Dengue fever cases peak during the month of August and September in endemic areas (Chitwan and surrounding district). Mortality could be reduced in severe dengue with appropriate critical care, highlighting the need to strengthen ICU capacity in endemic regions.Publication Study of Point of Care Lung Ultrasound in Patients with Acute Respiratory Failure Authors(Nepalese Respiratory Society, 2022) Puri, Niraj; Adhikari, Shital; Bhattarai, Madhur Dev; Gauli, Basanta; Gurung, Sailesh; Patel, Sunil; Wagley, PratikAbstract: Introduction: An acute dyspnea has been a common cause of hospital admission throughout history. When formulating a treatment plan based on limited clinical information, a rapid diagnosis is important. Bedside maneuvers and tests that deliver rapid and reliable results represent a cornerstone of diagnostics medicine. Methods: This was a one-year cross-sectional research conducted at Chitwan Medical College Teaching Hospital. Consecutive patients with acute dyspnea whom were admitted for ≤ 6 hours were included in the study. A 5MHz micro-convex probe was used as the optimal single probe. Data entry and descriptive analysis were done in IBM SPSS version 20.0. Point estimate at 95% confidence interval was calculated along with frequency and descriptive statics. Results: Pneumonia was the most common overall ultrasound diagnosis with combined frequency of 47%. With a Positive Predictive Value of 94.11% and Negative Predictive Value of 97.01%, anterior pneumonia exhibited a sensitivity of 94.11% and specificity of 97.11%. Similarly, Posterior Lateral Alveolar Points (PLAPS) pneumonia had a sensitivity of 94.11% and specificity of 98.08%, with a PPV of 94.11% and NPV of 98.80% respectively. The clinical accuracy for pulmonary edema was the greatest with 96.77%. while COPD/asthma had least accuracy with 81.25%. Conclusions: POCUS of the lung, has a high sensitivity and specificity, especially for evaluation of acute causes of dyspnea such pulmonary edema and pneumonia. It is more sensitive than Chest X ray alone and should be integrated while making clinical diagnosis.