Browsing by Author "Jha, SK"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Publication Association of Different Biochemical and Hemodynamic Characteristic with Type 2 Diabetes Mellitus and Hypertension in Nephrolithiasis Patients(Kathmandu University, 2023) Katwal, BM; Gautam, N; Shrestha, S; Adhikari, R; Baral, H; Jha, SK; Jha, GABSTRACT Background Although Nephrolithiasis is a common condition caused by a wide variety of metabolic or environmental disturbances, its being one of the major factor of morbidity. Incidence of kidney stone disease (KSD) is highly affected by metabolic disorders and change in blood pressure and glucose. Objective To find out association of different biochemical and hemodynamic parameters with various glycemic status and hypertension in kidney stone disease. Method A cross sectional study was conducted in patients diagnosed as nephrolithiasis by using re¬nal ultrasonography and underwent nephrectomy between January 2019 to January 2021 in Shahid Dharmabhakta National Transplant Centre (SDNTC). A total of 100 subjects with 60 male and 40 females were enrolled. Glycemic status was categorized based on criteria of American Diabetes Association (ADA) and hypertension was defined as BP ≥ 140/90 mm Hg in right arm supine position. All biochemical and hemodynamic profile was carried out following standard protocol. Result Out of 100 patients enrolled, pre-diabetes accounted for 31% followed by diabetes (4%). However, hypertension comprised of 66% in total subjects. Serum urea, cholesterol and triglyceride level were found to be increased by 84.6%, 67.7% and 64.7% respectively in diabetes followed by increase of 3.9%, 19.5% and 3.1% respectively in prediabetes when compared to normal glycemic condition in nephrolithiasis subjects. Serum fasting blood glucose, creatinine and uric acid level was observed significantly higher (p=0.003, p=0.004, p < 0.001 respectively) in hypertensive patients. Duration of hospital stay was also seen positively correlated with hypertension. Conclusion Not only diabetes, prediabetes also manifests the increased risk of kidney stone disease along with hypertension. There is significant impairment in renal function and lipid profile based on diabetes mellitus and hypertension. Early identifying these systemic diseases, different biochemical and hemodynamic parameters and proper treatment accordingly may minimize risk and prevent serious complication in these patients. KEY WORDS Diabetes mellitus, Hypertension, NephrolithiasisPublication Clinical Profile and Outcome of Infective Endocarditis patients admitted in tertiary care center in eastern part of Nepal(Institute of Medicine, 2016) Sherpa, K; Shah, P; Khati, Y; Jha, SK; Sharma, SK; Karki, PAbstract Introduction: Data regarding the pattern and outcome of infective endocarditis from developing countries are sparse and there have been few studies in our part of the world understanding the clinical profile and outcome of patients with infective endocarditis. Methods: It was a hospital based descriptive retrospective cross-sectional with the objective on clinical profile and outcome of infective endocarditis patients admitted in tertiary care center in eastem part of Nepal. The study included cases admitted in department of internal medicine ward, BPKIHS with diagnosis of infective endocarditis from year 2008 to 2015. Results: A total of 20 patients were diagnosed as case of infective endocarditis during the period from 2008 to 2015 in department of internal medicine. The median age of study group was 31 years (range 14-56). Male to female ratio was 9:1. Among various risk factors, history of Intravenous drug use was the main risk factor present in 50% of patients, followed by definite rheumatic heart disease in 40% of study population. Fever, Chills and sweats were main symptom present in all patients anemia in 90 %, heart murmur in 80%, anorexia in 45%, myalgia in 35%, splenomegaly in 15%, neurological manifestation, clubbing, Roth's s and embolic phenomenon in 5% of patients. The most common valve involved was tricuspid valve, present in 50% patient, followed by mitral valve in 35% patient and aortic valve in 15% of patients. Anemia was most common laboratory abnormalities present in 90% of the patients followed by leukocytosis in 80% of patients, microscopic hematuria and disarranged renal function test was present in 40% of the patients. Blood culture positivity was seen in 30% of cases and the pathogen isolated was Staphylococcus aureus. Prior antibiotic treatment was received by 40% of patients. Acute Renal failure was the main complication appeared which was present in 25% of patients followed by Neurological manifestations in 5% and peripheral embolic phenomenon was present 5% of patients. Conclusion: The spectrum of our infective endocarditis patients differ from those seen in the west in terms of epidemiology, predisposing factors, microbiology, complications, and outcome. Fever, pallor and heart murmur were most common symptoms and acute renal failure was the most common complication. Majority of our patients improve despite having lack of surgical backup. Culture-negative endocarditis continues to have a high prevalence in developing countries like Nepal, largely due to prior antibiotic use before clinical presentation.Publication Correlation between Sonoelastographic, Doppler and Histopathological Findings in Chronic Kidney Disease Patients in Tertiary Care Centre(Kathmandu University, 2022) Jha, SK; Lohani, B; Pant, AD; Chataut, D; Regmi, D; Bhatta, U; Gautam, N; Jha, GABSTRACT Background Ultrasound (USG) with Doppler examination of intrarenal vessels is the imaging modality of choice employed in patients with renal failure and is commonly performed early in the clinical course. The pulsatility index (PI) and the resistive index (RI) of downstream renal artery have been found to correlate with renal vascular resistance, filtration fraction and effective renal plasma flow in chronic renal failure. Pathological process in any tissues alters their elastic properties which can be assessed non-invasively through newer technique like elastography. Objective To correlate the findings obtained by sonoelastographic, doppler and histopathological studies in chronic kidney disease patients. Method Study was done in 146 patients referred to Department of Radiodiagnosis and Imaging, TUTH for native renal biopsy. Renal sonographic morphology (length, echogenicity, cortical thickness), Sonoelastography (Young’s modulus) and Doppler parameters (peak systolic velocity, resistive index) were assessed. The grading of estimated GFR (eGFR) was calculated based on chronic kidney disease (CKD) criteria. Result Among 146 patients, 63 (43.2%) were females and 83 (56.8%) were males. Maximum patients were in age group of 41-50 years (25.3%) followed by age group 51-60 years (24%). Mean age of patient was 42.06±14.70 for males and 39.57±12.54 females. Maximum mean Young’s modulus was seen in eGFR stage G1 with 46.57±19.51 kPa followed by in stage G3a with 36.46±10.01 kPa and observed to be statistically non-significant (p=0.172). However, statistical significance difference was noted between the resistive index and elastographic measurement of Young’s modulus (r=0.462, p=0.0001). Minimum mean cortical thickness was seen in eGFR stage G5 with 4.42±1.48 mm followed by stage G4 with 5.57±1.24 mm (p= 0.0001). Cortical thickness is decreasing as eGFR stage was increasing in our study (p=0.0001). Resistive index is increasing with decrease in renal size (r=-0.202, p=0.015). Conclusion Ultrasonography along with doppler study and elastography have limited role in diagnosing the pathology of chronic kidney disease, however, it has significant role in the disease progression. KEY WORDS Chronic kidney disease, Doppler, Elastography, Resistive index, Ultrasonography