Browsing by Author "KC, P"
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Publication Aberrant Shape of the Heart, “Gourd Shaped”: A Rare Case of Localized Constrictive Pericarditis(Kathmandu University, 2024) Rajbhandari, S; Joshi, S; Bhattarai, N; KC, P; Rajthala, P; Khadka, S; Neupane, NP; Aryal, M; Rajlawot, KABSTRACT Calcific constrictive pericarditis results commonly from the tubercular lesions in developing countries. The localized calcifications associated with the calcific constrictive pericarditis on its own is rare and the calcification along the atrioventricular groove distorting the heart to a shape of gourd is extremely rare. We present a case to highlight the importance of the early diagnosis of the condition. We have approached the patient with echocardiography and commuted tomography for the diagnosis and hemodynamic evaluation. Early treatment is equally important for this condition, as the calcific constrictive pericarditis is curable with pericardiectomy. However, there lacks a clear consensus for the pericardiectomy in patients with localized calcification and medical therapy can be initiated. KEY WORDS Constrictive pericarditis, Computed tomography, Echocardiography, PericardiectomyPublication Assessing Drug Utilization in the Emergency Medicine Department at a Tertiary Care Teaching Hospital Using WHO Drug Use Indicators(Kathmandu University, 2024) Jha, N; Manandhar, T; Oli, E; KC, P; Jha, AK; Karki, PS; Hada Batajoo, K; Shankar, PRABSTRACT Background Patients might need urgent care in critical cases. Limited resources and limited manpower are limitations seen in developing countries. Very few studies have been conducted on drug utilization in the emergency department in Nepal. Objective To find out the drug utilization pattern and the cost of medicines in emergency medicine department as per WHO drug use indicators. Method The study design was a hospital based retrospective cross-sectional study done at the emergency department of KIST Medical College and Teaching Hospital, Lalitpur, Nepal. The study population were patients visiting the emergency department. The data was collected during the period from April to June 2023. Data was collected for one month from each quarter for the year 2023 from the medical records of the patients from the medical records section. A structured proforma was used for the data collection process. Census sampling method was used. Result Maximum patients, 257 (25.1%) were from age group 21-30 years. Females were slightly more than males, 537 (50.5%). The top three diagnosis among the admitted patients were soft tissue injury, 148 (13.9%), dengue fever, 138 (12.9%) and viral fever, 51 (4.7%). Maximum patients, 346 (32.5%) were given two therapeutic classes of drugs, followed by only one therapeutic class of drug for 251 (23.6%) patients. The common classes of drugs prescribed for the patients were analgesics, 639 (60.1%) followed by intravenous fluids, 410 (38.5%) and antiulcer drugs, 377 (35.4%). The total cost of drugs used was calculated as Rs. 305126.4 (2280.99 USD) and the average cost per patient was Rs. 297.97 NPR; 2.23 USD. The WHO drug prescribing indicators showed maximum percentage, (85.4%) of encounters with injection prescribed followed by the percentage of drugs prescribed from the Nepalese National List of Essential Medicines 81.71%. Conclusion On the basis of the findings from this study injection prescribing, and the number of drugs prescribed per encounter showed considerable deviation from the standards recommended by the WHO. Hence, it is important for the hospital to design and implement a system to promote judicious prescribing and injection medication administration. KEY WORDS Drug utilization, Emergency department, WHO core drug use indicators, NepalPublication Gastric Neoplasm: A Clinicopathological Study in the Tertiary Care Center of Nepal(Kathmandu University, 2024) Basnet, D; Makaju, R; Gurung, RB; Gautam, N; Shrestha, B; Maharjan. PB; KC, PABSTRACT Background Gastric carcinoma is the commonest upper gastrointestinal malignancy contributing to global burden of cancer morbidity and mortality. Objective The objective is to study distribution of the gastric neoplasm according to age, sex, symptom, gross appearance, histological type and degree of differentiation. Method This was a retrospective study done from January 2022 to December 2023 in the Department of Pathology, Dhulikhel Hospital - Kathmandu University Hospital (DH - KUH). Relevant clinical data of the patients were obtained from the histopathological records of the patient from the pathology department and biopsies stained with Haematoxylin and Eosin were studied under the light microscope. Result A total of 40 cases of gastric neoplasm were studied out of which 36(90%) were malignant and 4(10%) were benign epithelial tumors and precursor lesions. Most frequent presentation was dyspepsia, abdominal pain, vomiting, dysphagia, anemia, anorexia and weight loss. Male to female ratio was 1.4:1. The age of the patient ranged from 33 to 89 years with mean age of 63.3 ± 13.4 years. Most common site of gastric neoplasm was pyloric antrum. Ulceroproliferative growth was most common gross morphology. Malignant neoplasm were more common. Intestinal type adenocarcinoma consisted of 28 (70%) cases followed by diffuse type 6 (15%) and mixed type 1 (2.5%). Diffuse adenocarcinoma was more common in females. Moderately differentiated adenocarcinoma was the most common differentiation. Conclusion The present study provided a fair insight into the clinciopathological features of gastric neooplasm in our institution. KEY WORDS Adenocarcinoma, Diffuse type, Gastric, Intestinal type