Browsing by Author "Karki, D"
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Publication Biochemical Parameters in Confirmed Covid-19 Patients: A Hospital Based Study from Eastern Nepal(Kathmandu University, 2021) Niraula, A; Gelal, B; Lamsal, M; Karki, D; Chhetri, RABSTRACT Background COVID-19 has posed a global threat to almost every part of the world. The disease has varied form of presentation and the modern medicine has still not been able to provide definite treatment for the disease. Objective To assess the biochemical parameters in confirmed patients of COVID-19 admitted at B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal. Method This is a retrospective hospital based cross-sectional study conducted in the Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Dharan from October to December, 2020. Convenient sampling technique was used to enroll the data of the patients for whom the biochemical parameters were requested by the clinicians. Routine biochemical tests were performed in Cobas c311 autoanalyzer. Result A total of 202 patients with confirmed COVID-19 infections and admitted at COVID Hospital, BPKIHS were enrolled. The findings depict an elevated liver enzyme (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma glutamyl transpeptidase and cardiac enzymes (creatine kinase-total and creatine kinase- MB) in the study population. Increased serum ferritin (1026.08±220.53), hs CRP (41.52±5.22) and lactate dehydrogenase 360 [303.50-526.75] was found in the patients. Also, majority of the patients (> 50%) had abnormal biochemical findings. Conclusion Biomarkers like C-reactive protein, lactate dehydrogenase and ferritin have shown significant clinical implications in effective management, monitoring, and assessment of the severity of disease in COVID- 19 patients. Simple and cost-effective markers like CRP, LDH, HbA1c could be used for monitoring the severity of COVID-19 infection. KEY WORDS Biomarkers, COVID-19, Ferritin, hs-CRP, InflammationPublication Psychiatric Comorbidity among Type 2 Diabetes Mellitus Patients(Kathmandu University, 2024) Acharya, M; Ghimire, RH; Karki, D; Poudel, SABSTRACT Background The co-occurrence of psychiatric conditions and diabetes mellitus is frequently observed. This coexistence manifests in various ways, leading to a diminished quality of life, heightened healthcare expenses, reduced treatment compliance, suboptimal blood sugar control, and an upsurge in visits to the emergency room. Objective To evaluate the prevalence of psychiatric comorbidity in patients with type 2 diabetes at a specialized medical center. Method We conducted a cross-sectional study, enrolling eligible type 2 diabetes patients who sought outpatient services. To evaluate the cognitive and emotional aspects of their illness, we employed the Mini International Neuropsychiatric Interview and ICD-10 guidelines. Convenience sampling method was used and 200 patients were included in the study. Their socio-demographic profile, presence of depression, and other psychiatric illnesses were studied. Result Among the total screened type 2 diabetes patients, 200 eligible individuals were included in the study. Depression emerged as the most prevalent psychiatric comorbid condition, affecting 30.5% of the patients. Notably, depression rates were slightly higher in female patients and those over 50 years of age. Furthermore, individuals with longer diabetes durations displayed a greater prevalence of depressive episodes, followed by other psychiatric illnesses. Conclusion A noteworthy proportion of diabetic patients exhibited comorbid psychiatric conditions. Depression was the most common among diabetics followed by other psychiatric illnesses. The presence of neuropsychiatric illness was commonly seen in diabetics at a later age of life, peaking after 6th decade. KEY WORDS Comorbidity, Diabetes mellitus type II, PsychiatryPublication Study of Dexmedetomidine in Caudal Block for Children Undergoing Inguino-scrotal Surgery(Kathmandu University, 2020) Gautam, B; Piya, B; Karki, DABSTRACT Background Caudal block is the most common anaesthetic technique employed in children for managing perioperative pain of inguino-scrotal surgery. However, despite using long- acting local anaesthetics, caudal analgesia lasts relatively shorter. Dexmedetomidine, an alpha-2 agonist, augments local anaesthetic action. Objective To assess the analgesic effect of caudal Dexmedetomidine. Method This is a randomized, double-blinded study conducted on otherwise healthy children (one to five years) undergoing elective inguino-scrotal surgery. General anaesthesia was administered and a laryngeal mask airway was inserted for assisting ventilation. The caudal block was applied using 0.8 milliliters/kilogram drug volume comprising either two milligrams/kilogram Bupivacaine in group A (n=42) or two milligrams/ kilogram Bupivacaine mixed with 0.75 micrograms/kilogram Dexmedetomidine in group B (n=42). Intraoperatively, inhaled Halothane, intravenous Fentanyl, fluids, and ventilation were titrated to maintain monitored hemodynamic variables within 15% from baseline values. The primary endpoint comprised the duration of analgesia, defined by a time when postoperative pain score (face, legs, activity, cry, consolability; FLACC scale) reached four out of ten. Perioperative events were studied for 24 hours. Student’s t-test and Chi-square test were used for analysis, with p-value less than 0.05 considered as significant. Result Demographic, surgical, and anaesthetic characteristics were similar between the groups. Duration of analgesia was significantly prolonged in group B (group B, 413±101 minutes; group A, 204±40 minutes). The intraoperative requirement for supplement Fentanyl was significantly reduced in group B. Adverse events were comparable between the groups. Conclusion Dexmedetomidine prolongs the duration of analgesia when mixed with caudal Bupivacaine, without increasing adverse events. KEY WORDS Adjuncts, Analgesia, Caudal block, Children, Dexmedetomidine, Paediatric