Browsing by Author "Lama, Urmila"
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Publication Metabolic Signature and Obstructive Sleep Apnea in Nepalese Patients(Nepalese Respiratory Society, 2023) Verma, Avatar; Bhatta, Narendra; Mishra, Deebya Raj; Shahi, Rejina; Uprety, Augraj; Aryal, Prakash; Yadav, Devesh Kumar; Lama, UrmilaAbstract: Introduction: Untreated Obstructive Sleep Apnea (OSA) causes sleep related symptoms and also causes increased incidence of RTA, cardiovascular diseases and all cause mortality. Currently OSA has been recognized as the consequence of number of interrelated metabolic and oxidative pathologies. As there are limited data of association of OSA with metabolic stress and its correlation with severity of OSA, study of metabolic profile of these patients in view of defining the Metabolic signature of OSA was carried out in eastern Nepal. Objectives: To study metabolic profile of OSA and its association with clinical severity. Methods: Hospital based descriptive cross sectional study. Biochemical profile results related to metabolic –oxidative pathway of the OSA patients were obtained. Quantitative and qualitative data were obtained. Quantitative data were compared using Mann–Whitney test while qualitative variables compared using Pearson χ2. Correlation was carried out using Pearson and Spearman’s test. P-value<0.05 considered significant. Results: 33 patients of OSA were enrolled. Majority of patients had deranged metabolic and oxidative parameters despite mild OSA. Among metabolic stress parameters, most commonly deranged were decreased high density lipoprotein (HDL), increased mean arterial pressure (MAP), waist circumference (WC) and raised fasting blood sugar (FBS). Increased MAP and increased WC was significantly corelated with severity. Conclusion: Besides symptom complex, OSA is also harbinger of metabolic stress that can lead to various cardiometabolic diseases and premature mortality thus early recognition and treatment can mitigate these consequences.Publication Ultrasound-Guided Percutaneous Transthoracic Biopsy by Pulmonologists(Nepalese Respiratory Society, 2024) Verma, Avatar; Bhatta, Narendra; Shahi, Rejina; Lama, Urmila; Aryal, Prakash; Pantha, Srijan; Hamal, Sangita; Mishra, Deebya RajAbstract: Background: Ultrasound-guided transthoracic needle biopsy (USG-TTNB) is a simple and safe procedure carried out to obtain a tissue sample for confirmation of the diagnosis of various thoracic pathologies. These procedures are usually carried out by radiologists in our country. However, there is good efficacy and fewer complications even in the hands of chest physicians, as shown by many studies published abroad. Considering this, the study is carried out to evaluate outcomes of USG-TTNB by pulmonologists in Nepal. Objective: To study the efficacy and complications associated with USG-guided transthoracic needle biopsies performed by pulmonologists. Methods: Retrospective analysis of 77 patients undergoing USG-TTNB by pulmonologists at BPKIHS from November 2019 to November 2023 were analyzed. The efficacy of the procedure and the complication rate were derived. Efficacy was calculated as proportion of the patients who had undergone the biopsy and resulted in a clinically contributory specimen. Results: Mean age: 62.5 ± 13.7 years; 63.6% female. Transthoracic Fine Needle Aspiration showed a diagnostic yield of 82.6 % of patients, whereas that of trucut biopsy was 86.7 % with a combined diagnostic yield of 94 %. Pneumothorax occurred in four (5.2 %) of patients, and hemothorax occurred in two (2.6 %) of patients. Conclusion: USG-guided percutaneous transthoracic biopsy by a pulmonologist is a procedure with good diagnostic yield and a lower complication rate.