NepMed Repository :: Browsing by Author "Karki, Lochan"

Browsing by Author "Karki, Lochan"

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Chronic Kidney Disease among COVID-19 Patients Admitted in the Department of Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2023) Khadka, Milan; Karki, Lochan; Tamrakar, Rama; Oli, Milan Purna; Joti, Santosh; Khatri, Suman; Adhikari, Siddhant; Maharjan, Shrinkhala; KC, Poonam
Abstract Introduction: Comorbidities are frequently seen in admitted COVID-19 patients most common being hypertension, diabetes, cardiovascular diseases and chronic kidney disease. Chronic kidney disease is a slowly progressive chronic illness due to the gradual loss of kidney function or structure. The available data regarding the prevalence of chronic kidney disease and COVID-19 comorbidities is still limited. The aim of this study was to find out the prevalence of chronic kidney disease among COVID-19 patients admitted to the Department of Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was done in the Department of Medicine of a tertiary care centre. Data of medical records between 1 August 2020 to 1 December 2022 were reviewed retrospectively. The data was collected from 20 January 2023 to 20 March 2023. Ethical approval was obtained from the Institutional Review Committee (Reference number: 646/2079/80). Data on chronic kidney disease patients among COVID-19 patients were collected from the hospital records. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 584 COVID-19 patients admitted, the prevalence of chronic kidney disease was 43 (7.36%) (5.24-9.48, 95% Confidence Interval). A total of 30 (69.77%) were male and 13 (30.23%) were female with a mean age of 55±16.22 years. Conclusions: The prevalence of chronic kidney disease among COVID-19 patients admitted in the department of Medicine of a tertiary care centre was found to be slightly higher than other studies done in similar settings.
Chronic Obstructive Pulmonary Disease among Patients Admitted to the Department of Medicine in a Tertiary Care Centre
(Nepal Medical Association, 2023) Khadka, Milan; Karki, Lochan; Maharjan, Shrinkhala; Giri, Ganesh Kumar; Sherpa, Pasang; K C, Poonam; Adhikari, Siddhant; Oli, Milan Purna; Tamrakar, Rama; Joti, Santosh
Abstract Introduction: Chronic obstructive pulmonary disease is a prevalent respiratory condition with permanent and progressively decreasing airflow limitation. Chronic obstructive pulmonary disease causes more than 3 million deaths per year globally, making it the third leading cause of death globally. The aim of this study was to find out the prevalence of chronic obstructive pulmonary disease among patients admitted to the Department of Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was done in the Department of Medicine of a tertiary care centre. Data from 1 January 2022 to 30 December 2022 were collected between 15 June 2023 to 30 June 2023 from the hospital records and reviewed. Ethical approval was taken from the Institutional Review Committee. All the patients admitted to the Department of Medicine during the study period were included in the study. The patients with incomplete medical records were excluded from the study. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 280 patients, chronic obstructive pulmonary disease was found in 68 (24.29%) (19.27-29.31, 95% Confidence Interval) with a mean age of 70.62±10.39 years and a mean pack year of 16.72±7.67. Conclusions: The prevalence of chronic obstructive pulmonary disease among patients admitted to the Department of Medicine was similar to the other studies done in similar settings.
Common Echocardiographic Diagnoses in Patients at Tertiary Care Center: An Observational Study
(Nepal Medical Association, 2024) Koirala, Prabha Chapagain; Koirala, Richa; Karki, Lochan; Khadka, Milan; Amatya, Prasanna Bahadur; Gautam, Binayak; Poudel, Samir; Sherpa, Kunjang; Ghimere, Saroj; Bhandari, Rajendra; Koirala, Pragya
Abstract Introduction: Echocardiography is an indispensable tool for the diagnosis and management of cardiac patients. It is important to know the spectrum of cardiac abnormalities detected by echocardiography for the proper management of patients. The aim of this study was to evaluate the echocardiographic diagnosis of patients at a multispecialty tertiary care hospital and find out the prevalence of various cardiac diseases diagnosed via echocardiography. Methods: This was a retrospective cross sectional study carried out at the Echocardiography lab of National Academy of Health Sciences. Records of all patients who had done Echocardiography from February 2024 to April 2024 were analyzed. Ethical approval was obtained from Institutional Review Committee (Reference Number:1231/2080/81). Results: Out of 3593 cases, there were 1750 (48.71%) female and 1843 (51.29%) male. Normal echocardiographic study was seen in 1184 (32.95%). Mean age was 56.13±17.38 years. Left ventricle diastolic dysfunction was seen among 1428 (39.74%), followed by tricuspid regurgitation 1026 (28.55%) and pulmonary hypertension 497 (13.83%). Other findings were, left ventricular hypertrophy 204 (5.67%), Left ventricular systolic dysfunction 165 (4.59%), rheumatic heart disease 102 (2.83%) and, congenital heart disease was the lowest documented finding, seen in 30 (0.83%). Conclusions: Most common diseases diagnosed by echocardiography in our study were, diastolic dysfunction, tricuspid regurgitation and pulmonary hypertension.
Community-acquired Pneumonia among Elderly Patients Admitted to the Department of Medicine in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2023) Karki, Lochan; Khadka, Milan; Joti, Santosh; Adhikari, Siddhant; Tamrakar, Rama; Oli, Milan Purna; K C, Poonam; Maharjan, Shrinkhala; Maharjan, Shristi; Basnet, Rabin; Chauhan, Shanta; Basnet, Prapti
Abstract Introduction: Community-acquired pneumonia is an acute infection of lung tissue in an immunocompetent patient who have not recently been hospitalized or has been hospitalized for less than 48 hours and acquired it in the community. It continues to have a substantial effect on the elderly, who are impacted more often and severely than younger groups. It is the third most common hospital diagnosis in adults over the age of 65 years, and the sixth major cause of mortality in developed nations. The aim of this study was to find out the prevalence of community-acquired pneumonia among elderly patients admitted to the Department of Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was done in the Department of Medicine in a tertiary care centre where data were collected from 1 December 2021 and 1 December 2022 after obtaining ethical approval from the Institutional Review Committee (Reference number: 465/2079/80). Data on community-acquired pneumonia in the elderly was collected from the hospital records. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 385 patients, community-acquired pneumonia was seen in 14 (3.64%) (1.77-5.51, 95% Confidence Interval) with a mean age of 70.57±10.21 years. Conclusions: The prevalence of community-acquired pneumonia among elderly patients was found to be lower compared to other studies conducted in similar settings.
Correlation between Serum Albumin Level and Severity of Acute Ischemic Stroke: A Cross-Sectional Study
(Nepal Medical Association, 2024) Pantha, Binod; Khadka, Milan; Karki, Lochan; Koirala, Parimal
Abstract Introduction: Stroke is a leading cause of disability with devastating consequences. Serum albumin has emerged as a significant prognostic marker in various conditions, including stroke. This study aims to investigate the relationship between serum albumin levels and stroke severity and outcomes in patients with acute ischemic stroke (AIS). Methods: An observational, cross-sectional study was conducted over six months at Bir Hospital, among patients admitted in medicine ward after obtaining the ethical approval reference number 34/20081/82. Total population sampling was done. Serum albumin at the time of diagnosis was measured. Ischemic stroke severity was scored based on NIHSS score on admission and the functional outcome was evaluated as modified Rankin Scale (mRS). Finally, correlation of serum albumin with the severity and the outcome of stroke (mRS) was made. Results: The study of 37 patients showed significant correlation between serum albumin and NIHSS score. The study showed moderate to strong negative correlation between serum albumin levels and mRS scores. The mean serum albumin level was 3.5±0.40 mg/dl. Conclusion: Significant correlation of serum albumin level with clinical severity at the time of admission and with the outcome during discharge was found. Thus serum albumin has prognostic significance in acute ischemic stroke.
COVID-19 among Patients Visiting the Department of Emergency of a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2023) Shrestha, Mahendra Raj; Basnet, Ajaya; Maharjan, Rajendra; Chand, Arun Bahadur; Karki, Lochan; Singh, Subash; Ghimire, Sagar; Maharjan, Rupak
Abstract Introduction: Because of the unbridled transmissibility of the SARS-CoV-2 worldwide, researchers and healthcare professionals have set a common goal for timely diagnosis and future prevention of the disease. The aim of this study was to find out the prevalence of COVID-19 among patients visiting the Department of Emergency of a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among the individuals suspected COVID-19 who had visited the Department of Emergency of a tertiary care centre between 11 January 2021 and 29 December 2021. Ethical approval was taken from Ethical Review Board (Reference number: 2768). Socio-demographic details, clinical symptoms, and two nasopharyngeal swab samples (one in viral transport medium to run RT-PCR and the other for Ag-RDT) were collected from each individual. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among the 232 patients, COVID-19 was detected in 108 (46.55%) (40.13-52.97, 95% CI) by Ag-RDT. A total of 44 (39.63%) of age groups 31-40 years were predominantly infected with SARS-CoV-2. The mean age was 32.13±10.80 years and was mostly males 73 (65.77%). Fever was present in 57 (51.35%) and dry cough was present in 50 (45.05%) COVID-19 patients. Conclusions: The prevalence of COVID-19 among hospitalized individuals in this study was higher than in previous studies conducted in similar settings.
Diabetic Ketoacidosis among Diabetic Patients Admitted in the Department of Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2023) Karki, Lochan; Khadka, Milan; Oli, Milan Purna; Joti, Santosh; Tamrakar, Rama; Adhikari, Siddhant; Khatri, Suman; K C, Poonam
Abstract Introduction: Diabetic ketoacidosis is one of the most severe acute complications of diabetes mellitus characterised by hyperglycemia, hyperketonemia, and metabolic acidosis. Prompt diagnosis and treatment of diabetic ketoacidosis can decrease severity, hospital stay, and possible mortality. This study aimed to find out the prevalence of diabetic ketoacidosis among diabetic patients admitted to the department of medicine of a tertiary care centre. Methods: This descriptive cross-sectional study was conducted at a tertiary care centre. Data from 1 March 2022 to 1 December 2022 were collected between 1 January 2023 and 1 February 2023 from the hospital records. The ethical approval was taken from the Institutional Review Committee of the same institute (Reference number: 466/2079/80). All the diabetic patients admitted to the Department of Medicine during our study duration were enrolled for the study. Diabetic patients who left against medical advice and those with incomplete data were excluded from the study. Data were collected from the medical record section. Convenience sampling method was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 200 diabetic patients, the prevalence of diabetic ketoacidosis was 7 (3.5%) (3.47-3.53, 95% Confidence Interval) among which 1 (14.29%) patients had type I diabetes mellitus and 6 (85.71%) had type II diabetes mellitus patients and the mean HbA1C level was 9.77%. Conclusions: The prevalence of diabetic ketoacidosis among diabetes mellitus patients admitted to the department of medicine of a tertiary care centre was found to be higher than in other studies done in similar settings.
Human Papillomavirus among Women Undergoing Papanicolaou Smear Test in the Department of Gynaecologic Oncology of a Tertiary Care Centre
(Nepal Medical Association, 2023) Shrestha, Mahendra Raj; Basnet, Ajaya; Maharjan, Rajendra; Ghimire, Sagar; Khatri, Nisha; Shrestha, Arju; Karki, Lochan; Karmacharya. Saujanya
Abstract Introduction: In invasive cervical specimens or precursors, high-risk human papillomavirus Deoxyribonucleic acid may be detected to identify females at risk of developing cervical cancer. This study aimed to find out the prevalence of human papillomavirus among women undergoing Papanicolaou smear tests in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among women undergoing the Papanicolaou smear test in the Department of Gynaecologic Oncology, Nepal Armed Police Force Hospital, between 1 June 2022 and 15 November 2022. Ethical approval was obtained from the Ethical Review Board. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among the 199 women, 6 (3.02%) (0.64-5.40, 95% Confidence Interval) had human papillomavirus infection. The mean age of the infected females was 31.17±5.57 years. Human papillomavirus DNA for 16 and 18 were detected in 4 (66.67%) and 2 (33.33%) females, respectively. Conclusions: The prevalence of human papillomavirus in females was found to be lower than other studies done in similar settings.
Management and Leadership Development in Healthcare Professionals
(Nepal Medical Association, 2023) Karki, Lochan; Rijal, Badri; Hamal, Pawan Kumar; Khanal, Milan Chandra; Bhusal, Suzit
Abstract In the healthcare system, leadership has never been more crucial. Initiatives to improve health care in underdeveloped nations frequently fail, not for lack of clinical and public health understanding, but rather for lack of management ability. However, there are currently few possibilities for thorough leadership development at any level of career. This short communication highlights the success of the International Public Health Management Development Program by the Nepal Medical Association in conjunction with the Indian Embassy in Nepal, financed by the Ministry of External Affairs under the Indian Technical Education Corporation.
Migration of Medical Doctors from Nepal: Analyzing Trends and Policy Implications
(Nepal Medical Association, 2024) Karki, Lochan; Dhakal, Bikrant; Bhandari, Kailash Kumar; Bhusal, Suzit; Chaudhary, Ashlesha
Abstract One way migration of health care professionals especially from low-income countries like Nepal has become a concerning issue where the already fragile health system of the country faces challenges of losing skilled health care professionals to high-income countries. This trend analysis provides insights into the dynamics of Nepal's healthcare workforce migration, it offers a tailored understanding of factors influencing migration patterns, and its impact on the general population of the country and globally. It helps formulate targeted policies for workforce retention, resource planning, and addressing the country's healthcare needs and comparison with the global context. Analyzing the migration trends of medical professionals enhances medical literature by offering a comprehensive understanding of the factors affecting healthcare systems, public health, economics, education, and policy development. This knowledge plays a vital role in shaping future policies in the field of medicine in Nepal.

Browsing by Author "Karki, Lochan"

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