Browsing by Author "Kafle, MP"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Publication Hypertension, as an iceberg disease in the high hilly areas of Nepal(Institute of Medicine, 2012) Lamsal, KS; Kafle, MPAbstract Introduction: Hypertension simply is usual blood pressure of 140/90 mm Hg or higher in otherwise normal individuals and even lower for certain high-risk patients. Its a common medical condition worldwide. It is the most important, commonest and correctible cardiovascular risk factor and one of the leading causes of death. Many factors like dietary, behavioral, psychological, environmental, genetic etc. have direct or indirect influence on hypertension. In this study we have analyzed the prevalence and different stages of hypertension in a remote and high hilly area of Nepal. Methods: The study was conducted in high hilly area adjoined to Solukhumbu and Dolakha districts. Altogether 600 participants were enrolled in the study. Participants having age more 18 years, regardless of symptoms, willing to give consent were involved. Demograghic data and blood pressure was recorded twice. The 1st reading was taken by trained nursing staff using standard Riva Rocci Sphygnomanometer after five minutes rest. The 2nd reading was taken by Physician and mean was calculated from both readings. Results: Among 600 patients involved in the study, the mean age was 48 years. Among them, 92 patients were having prehypertension including 53 male and 39 female. The stage I hypertension was found in 130 cases, out of them 77 were male and 53 were female. Whereas stage II hypertension was found in 84 cases, including 40 males and 44 females. Prehypertension was commonest among 40-49 years of age, stage I and stage II hypertension was commonest among 50-59 years. Systolic hypertension was more common in younger and elderly participants whereas diastolic hypertension was more common in middle age adults. Conclusion: In the study, the incidence of hypertension increases whose age was found between 50-59 with age till 50-59 years age group. Systolic hypertension was more common than diastolic hypertension in less than 30 years age group where as between 30-59 years diastolic blood pressure was more commonly found than systolic blood pressure. In the elderly of more than 60 years, again systolic hypertension is more predominant than diastolic hypertension. Keywords: hilly area, hypertension, prevalence, saltPublication Renal transplant in Nepal: medical complications in first three months(Institute of Medicine, 2013) Shrestha, S; Sigdel, MR; Raut, KB; Kafle, MP; Shah, DSAbstract Introduction: A successful renal transplant program was started in Nepal on August 8, 2008 in Tribhuvan University Teaching Hospital; and since then more than 200 live renal transplants have been done in our center. Methods: A prospective analysis was done of 50 consecutive renal transplant recipients (performed from June 29, 2011 to May 16, 2012), with a minimum of 3 months of follow up. All recipients were on tacrolimus, mycophenolate mofetil, and steroids. The outcomes of the study were medical complications that occurred within the study period. Results: The mean age of the recipients and donors were 36.0 ± 1.1 (range 15-59) and 48.3 ± 1.1 (range 22-65) years respectively. The fatal complications were one case each of hospital acquired pneumonia leading to sepsis, delayed graft function secondary to acute tubular necrosis, and community acquired pneumonia. The most common non-fatal infection in first month post-transplant was urinary tract infection, 24 episodes were identified in 20 recipients (40%). In 1 to 3 month post-transplant also, urinary tract infection was the most common non-fatal infection, 6 episodes occurred in 5 recipients (10%). 6 episodes of biopsy proven acute rejection occurred in 6 recipients (12%). Delayed graft function was observed in 2 patients (4%). New onset diabetes after transplant occurred in 6 patients (12%). Conclusion: The most common medical complication in first three months post-transplant was urinary tract infection, followed by acute rejection, new onset diabetes mellitus after transplant and delayed graft function. Keywords: receipient, renal, transplantPublication Urological complications after Kidney transplantation(Kathmandu University, 2010) Chalise, PR; Sharma, UT; Gyawali, PR; Shrestha, GN; Joshi, BR; Gurung, GS; Ghimire, RK; Kafle, MP; Sigdel, MR; Shah, DS; Raut, KB; SidharthABSTRACT Background Renal transplantation is a regular service at Tribhuvan University Teaching Hospital and complications have been known to occur after it. This study was conducted to assess complications after transplantation. Objectives To determine the incidence of urological complications after living related renal transplantation at Tribhuvan University Teaching Hospital. Methods A clinical study was performed (from August 2008 to July 2010) which included 50 living-related renal transplantations at Tribhuvan University Teaching Hospital. All the donors and recipients were evaluated preoperatively with necessary investigations and followed up postoperatively with standard hospital transplant protocol. The incidence of urological complications were documented and analyzed. Results Fifty living-related, renal transplantations were carried out during the study period. Seven doors had minor post operative complications; three had post operative fever, two had chest infections and each one had superficial surgical site infections and severe pain at incision site. Ureteroneocystostomy was performed with double J stent in all recipients. Urological complications were noted in 12 (24%) recipients. Clinical significant hematuria occurred in four cases. One patient had ureteric necrosis and urinary leak which required re-exploration post operatively. Two patients developed delayed ureteric stricture which were managed by antegrade Double J stenting and ureteric reimplantation. Peri-graft abscess occurred in two cases, which were drained percutaneously. surgical site infections was seen in one case. Conclusions Urological complications are inevitable in renal transplantation and our complications rate appears similar to that reported in literature. Key words double J stent, renal transplantation, urological complications