Browsing by Author "Koirala, Eliza"
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Publication Clinical profile and outcome of Dengue fever in Medical Intensive Care Unit of a Tertiary Level Hospital: An Observational Study(Nepal Medical Association, 2025) Koirala, Eliza; Deo, Gopendra Prasad; Adhikari, Shital; Gauli, Basanta; Bajracharya, AkritiAbstract Introduction: Dengue fever poses a significant public health challenge in Nepal, with increasingsevere cases requiring intensive care. Limited data exist on the clinical profile and outcomes of critically ill dengue patients in resource-limited settings. This study is aimed to characterize the clinical features, outcomes and complications of dengue patients admitted to a tertiary Intensive care unit in Nepal. Methods: A prospective observational study was conducted at from August to September 2024 after ethical approval. We enrolled 104 serologically confirmed dengue patients (aged ≥16 years) admitted to the Medical Intensive care unit. Exclusion criteria included co-infections with other tropical diseases. Data on demographics, clinical presentation, laboratory parameters (including platelet counts, liver enzymes), organ dysfunction (SOFA score), and outcomes were collected. Descriptive data analysis was used to report frequency, proportion, measure of central tendency and measure of dispersion based on nature of data. Results: The cohort (median age 41 years, 54.8% male) exhibited severe manifestations: thrombocytopenia (median platelets count 49,000/μL; IQR: 30,250–85,000 per μL), hepatic injury 86 (82.7%); median AST 176.5 U/L, ALT 208.5 U/L), and moderate organ dysfunction (median SOFA score 4). Hypertension 27 (25.96%) and diabetes 23 (22.12%) were common comorbidities. Despite 22 (21.2%) developing multi-organ dysfunction syndrome, mortality was remarkably low 1 (0.96%). Conclusions: Dengue fever cases peak during the month of August and September in endemic areas (Chitwan and surrounding district). Mortality could be reduced in severe dengue with appropriate critical care, highlighting the need to strengthen ICU capacity in endemic regions.Publication Rheumatic Heart Disease among Pregnant Women with Cardiac Diseases in a Tertiary Care Center of Nepal: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Sharma, Basant; Koirala, Eliza; Regmi, Sudhir; Dhungana, Jaya; Neupane, Bandana Khanal; Bhattarai, SurajAbstract: Introduction: Cardiac disease in pregnancy is a major cause of maternal mortality and morbidity in women, particularly in resource limited countries like Nepal. Rheumatic Heart Disease is the commonest cardiac disease complicating pregnancy. There is very limited data and evidence from Nepal regarding rheumatic heart disease complicating the pregnancy. The study aims to find out the prevalence of rheumatic heart disease among cardiac disease patients in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among 41 women with cardiac disease who delivered babies at Chitwan Medical College from 1st January 2018 to 31st December 2019, after taking ethical approval from the Institutional Review Committee. A convenient sampling method was used. Statistical Package for the Social Sciences was used for data analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 41 pregnant women with cardiac disease, 32 (78%) (95% Confidence Interval = 65.32-90.68) had rheumatic heart disease. The mean age of the affected pregnant women was 24.9±4.49 years. Out of 32 patients with rheumatic heart disease, postpartum haemorrhage was the most common maternal complication 5 (15.6%) followed by hypertension 4 (9.7%). Conclusions: Rheumatic Heart Disease was highly common among pregnant women with cardiac disease.