Browsing by Author "Karki, OB"
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Publication Association of Breast Cancer and Dyslipidemia in Nepali Women(Kathmandu University, 2025) Karki, OB; Timilsina, B; Ghimire, P; Pokharel, DABSTRACT Background Breast cancer, which is a multi-factorial disease is one of the primary causes of cancer-related mortality in women. The association of serum lipids with breast cancer is being debated. Objective To examine any possible association between fasting lipid profile and breast cancer in Nepali women. Method A case-control study was conducted among 36 breast cancer patients, 40 patients with benign breast lump and 38 apparently healthy control women from February 2022 to December 2024. Ethical clearance was obtained from institutional review committee (MEMG/IRC/500/GA) prior to study. A convenient sampling technique was used. Data entry and analysis were done using SPSS version 20. Chi-square tests and analysis of variance (ANOVA) were used for statistical comparisons of categorical and continuous data respectively. P-value of <0.05 was considered statistically significant. Result Of the 114 participants included in this study, 36 were malignant breast cancer patients, 40 were benign breast lump patients and 38 controls with the mean ages of 52.75 ± 10.39, 48.45 ± 12.78 and 45.80 ± 10.14 years respectively. The prevalence of dyslipidemia was 75%, 25% and 26.31%, among malignant breast cancer patients, benign breast lump patients and control group respectively with the mean value of triglyceride (160.01 ± 78.34, 111.75 ± 60.40 and 97.99 ± 31.34) respectively and the difference was statistically significantly (p < 0.001). In addition, the mean serum concentrations of total cholesterol were significantly different between the three groups (1588.36 ± 39.95, 132.09 ± 39.95 and 138.31 ± 45.34, p=0.020). Conclusion The overall prevalence of dyslipidemia was high in breast cancer patients in comparison to patients with benign breast lump or normal controls. KEY WORDS Breast neoplasms, Dyslipidemias, LipidsPublication Blood Requisition and Utilization Practice in Surgical Patients in a Teaching Hospital, Western Nepal(Kathmandu University, 2016) Karki, OBABSTRACT Background In surgical patients transfusion of blood is often a life-saving measure. Preoperative over-ordering of blood is very common and leads to holding up of the blood bank reserve and wastage of resources. Objective The main objective of this study was to evaluate the practice of cross-match and utilization of blood for general surgeries in a teaching hospital of Nepal, to identify the surgical procedures where type and screen can be introduced and to formulate a maximum surgical blood-order schedule for those procedures where a complete cross-match appears mandatory. Method Three hundred and eighty-eight patients of different general surgical procedures over a period of one year were evaluated. Blood units cross matched and units transfused intra-operative and post-operatively were recorded. Blood utilization was evaluated using the following indices: cross-matched to transfused ratio, transfusion probability and transfusion index. The maximum surgical blood-order schedule was calculated using Mead’s criterion. Result Of the 601 blood units arranged for 388 patients, only 108 units were transfused in 81 patients. The cumulative non-utilisation of cross-matched blood was 82%. Based on these data, the maximum surgical blood-order schedule was calculated for seven common surgical procedures where cross-matching was justified. Conclusion Unwarranted cross-matching of blood is done in most procedures, especially cholecystectomies, hernia operations, breast surgeries, skin grafting, thyroidectomies etc. where a group and screen is adequate. Implementation of the recommended maximum surgical blood-order schedule and introduction of type and screen for eligible surgical procedures is a safe, effective and economic solution. KEY WORDS Blood, cross-match, group and screenPublication Effectiveness of Mannheim Peritonitis Index in Predicting the Morbidity and Mortality of Patients with Hollow Viscus Perforation(Kathmandu University, 2018) Karki, OB; Hazra, NK; Timilsina, B; Kunwar, DABSTRACT Background Peritonitis due to hollow viscus perforation is one of common surgical emergency. Its accurate diagnosis and management is a challenge to every surgeon. This led to the development of disease severity grading systems that would aid in management and appropriately predict possible outcome. Objective Evaluation of Mannheim Peritonitis Index (MPI) score for predicting the morbidity and mortality in patients with peritonitis due to hollow viscus perforation. Method Prospective study of 126 patients operated for perforation peritonitis in Manipal College of Medical Sciences, Pokhara, Nepal from May 2015 to April 2018. Mannheim Peritonitis Index score was calculated for each patient. Data was analysed for predicting mortality and morbidity using SPSS 20. Pearson’s Chisquare was used as a statistical test and considered as significant difference if p ≤ 0.05. Result Perforated appendix (35.7%), peptic ulcer perforation (31%) and truma (19%) were common causes of perforation peritonitis. Mean score was 18.55. The overall mortality and morbidity was 9% and 43% respectively with Mannheim Peritonitis Index scores of ≤ 20, 21-29, and ≥ 30 had a mortality of 0%, 14%, and 46% respectively. Presence of generalized peritonitis, organ failure at time of admission, type of intra peritoneal exudate carried more significance in predicting the mortality and morbidity in the post op period than other variables. Conclusion Mannheim Peritonitis Index is a simple and specific scoring system for predicting the mortality in patients with secondary peritonitis. Increasing scores are associated with poorer prognosis, needs intensive management. KEY WORDS Mannheim peritonitis index, Morbidity, Mortality, Perforation peritonitis