Browsing by Author "Khadka, D"
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Publication First Successful Independent Peroral Endoscopic Myotomy (POEM) for Achalasia Cardia: A Milestone Case Report from Nepal(Kathmandu University, 2025) Purbey, BK; Karki, S; Khanal, A; Khadka, D; Singla, V; Adhikari, SABSTRACT Achalasia cardia is an uncommon esophageal motility disorder characterized by failure of relaxation of the lower esophageal sphincter and loss of peristalsis in the lower part of the esophagus. Peroral Endoscopic Myotomy (POEM) has emerged as a minimally invasive intervention equivalent to Heller myotomy and an effective treatment modality. We present the first successful solo peroral endoscopic myotomy procedure performed in Nepal by an interventional gastroenterologist, who has managed a 45-year-old patient with long-standing dysphagia and a history of failed pneumatic dilatation with success. The procedure was uneventful. The patient showed symptomatic improvement postoperatively with minimal reflux. This case highlights the feasibility and safety of independently performed peroral endoscopic myotomy in a resource-limited setting. It shows the diaspora of interventional gastroenterology in Nepal and begins a new era for the same. KEY WORDS Achalasia cardia, Dysphagia, Eckardt score, Peroral endoscopic myotomy (POEM)Publication Relation between Serum Intact Parathyroid Hormone Level and Hematocrit in Chronic Kidney Disease Patients(Kathmandu University, 2015) Adhikary, LP; Pokhrel, A; Yadava, SK; Khadka, D; Thakur, RABSTRACT Background Anemia is a common complication of chronic kidney disease. There are various causes of anemia in chronic kidney disease patients on hemodialysis. Secondary hyperparathyroidism is one of the less recognized causes of anemia in chronic kidney disease patients. Objectives The main objective of the study is to find the correlation between intact parathyroid hormone and hematocrit level in chronic kidney disease (CKD) patients undergoing hemodialysis. Method Verbal consent was taken from all the participants. Eighty participants between the age of 29 and 70 years with chronic kidney disease having indication of hemodialysis were included in this study. Hematocrit was measured by bioelectrical impedance method and serum intact parathyroid hormone was by using Chemi Luminescence Immuno Assay (CLIA) method. Result A weak reverse correlation was found between serum intact parathyroid level and hematocrit (r= -0.33). Conclusion In chronic kidney disease patient, there is reverse correlation between level of serum intact parathyroid and hematocrit level. This association may have clinical relevance in assessing the cause of unexplained low hemoglobin level in CKD patients. KEY WORDS Anemia, chronic kidney disease, hematocrit, intact parathyroid hormone, secondary hyperparathyroidism.