Browsing by Author "Nepali, Rabin"
Now showing 1 - 5 of 5
Results Per Page
Sort Options
Publication Anuria, an Atypical Presentation of Leptospirosis: A Case Report(Nepal Medical Association, 2022) Khanal, Shambhu; Pokhrel, Biraj; Pokhrel, Madalasha; Thapa, Rukshar; Nepali, RabinAbstract: Leptospirosis, an underreported disease, is a highly prevalent spirochaetal zoonotic disease in both tropical and temperate climates. Symptoms can range from mild illness to potentially life-threatening infection. Laboratory tests are nonspecific. Microbiological confirmation is not widely available in endemic developing countries like Nepal. We need to rely on the serologic test, which has its own pitfalls in the initial days of illness. Here, we report a case of 56 years old female from the western region of Nepal who presented with fever, jaundice and anuria. She initially tested negative for leptospirosis but was later found to be positive in the second week of illness. Unlike the usual non-oliguric renal failure in leptospirosis, she presented with anuria requiring haemodialysis and subsequently had a good recovery with treatment. We highlight the importance of clinical suspicion and logical interpretation of serologic tests based on its timing from the onset of illness.Publication Compliance with Social Distancing, Facial Mask, Sanitizer/Hand Washing against COVID-19(Institute of Medicine, Tribhuvan University, 2024) Kayastha, Jyoti; Kayastha, Prakash; Nepali, Rabin; Kayastha, UshaAbstract: Introduction: At the end of 2019, a novel coronavirus spread rapidly, resulting in a global pandemic. Many countries have employed various nonpharmaceutical interventions, including social distancing, mask use, and sanitizer/hand hygiene measures (SMS). Previous studies have reported that compliance with these preventive measures varied widely. So, this study was conducted to assess the compliance with social distancing, mask use, and sanitizer/soap use measures in Biratnagar. Methods : This was a descriptive cross-sectional study conducted from September to November 2021 among 310 individuals at a hospital, supermarket, and vegetable market in Biratnagar. Using convenience sampling, mask use, social distancing, and hand hygiene was observed. Individuals not following SMS measures were asked about their reasons for non-compliance. Results : Among 310 individuals, 84.19% used masks, but only 86.97% of them wore them correctly. Surgical masks were used by 93.1%, while 6.9% used cloth masks. Social distancing was followed by 20.96%, and 31.29% used hand sanitizer. Common reasons for noncompliance included discomfort with masks, cost of sanitizer, lack of handwashing facilities, absence of social distancing markings, and poor adherence by others. Conclusion : Compliance of face mask was relatively high, while compliance with social distancing and sanitizer use was low highlighting the need for improved public awareness, better infrastructure, and stricter enforcement. In low-resource settings like Nepal, the continued promotion of SMS measures is essential for managing current health threats and preventing future outbreaks of respiratory illnesses.Publication Correlation of Differential Function and Glomerular Filtration Rate Estimated from Computed Tomography based Renal Volume and Diuretic Renogram in Living Renal Donor(Institute of Medicine, 2022) Rai, Bipendra DK; Gnyawali, Diwas; Poudyal, Sujeet; Pradhan, Manish; Chapagain, Suman; Luitel, Bhoj R; Chalise, Pawan R; Gyawali, Prem R; Sharma, Uttam K; Nepali, Rabin; Gurung, GhanashyamABSTRACT Introduction: In renal transplant, serum creatinine and isotope studies are used for determination of donor glomerular filtration rate (GFR). Studies have shown computed tomography measured renal volume can also be used. Our main objective was to assess the accuracy of volume based estimated GFR (vGFR) with diethylene triamine penta acetic acid (DTPA) measured GFR in living kidney donors. Methods: An observational analytical study was conducted from July 2018 to June 2019 in Department of Urology and Kidney Transplant Surgery and Department of Radiodiagnosis in Tribhuvan University Teaching Hospital where a total of 38 eligible potential donors were evaluated and serum creatinine level, computed tomography with contrast and DTPA renogram were used to measure GFR and differential function. Results: The mean age of the donors were 42.8±10.9 years with 70% of donors being females. Renal volume was not statistically different between male and female donors. There was moderate correlation between volume based and DTPA based GFR (r=0.76) and differential function (r=0.71). Compared to creatinine, volume based GFR estimate showed better correlation to DTPA renogram. There was no significant difference in differential function estimated by DTPA and volume based estimates (p = 0.96). The upper and lower limit of agreement between the volume based and DTPA based differential function was –4.7 and 4.6 respectively. Conclusion: GFR measurement by CT volume overestimates total GFR compared to DTPA renogram but it has better correlation than creatinine based estimates. It can be used to estimate the differential function of the donor kidney. Keywords: Computed tomography, DTPA, glomerular filtration rate, renal transplant, renal volumePublication Outcome of ABO-Incompatible Living Donor Kidney Transplantation: A Single Center Observational Study from Nepal(Institute of Medicine, 2023) Hamal, Saurav S; Nepali, Rabin; Poudyal, Sujeet; Shah, Dibya SABSTRACT Introduction: Kidney transplantation is the most effective treatment for end-stage renal disease (ESRD) patients. However, the increasing number of ESRD patients and the limited availability of living and cadaveric donors has led to a growing waiting list for kidney transplantation. ABO-incompatible transplantation has emerged as an alternative for these patients in Nepal. Methods: This was an observational study of all the patients who underwent kidney transplantation from March 2017-Feb 2019. Data on demography of recipients and donor, blood group, human leukocyte antigen mismatch, induction agent, post-operative complications and creatinine clearance at discharge and one-year post-transplant were collected and analysed. Then we compared patient and kidney graft survival at one year between ABO incompatible and ABO compatible recipients. Results: During the study period, there were total of 124 kidney transplant recipients among them 12 were ABO incompatible and 112 were ABO compatible recipients. The study showed slightly lower patient and graft survival in ABO-incompatible recipients than ABO compatible recipients (83.3% vs 99.2%, p<0.001). However, death-censored graft survival were similar in both groups (100%,p<0.001). The graft function at one year measured by creatinine clearance was better in ABO-incompatible recipients than ABO-compatible recipients (67.1±11.75 vs 61.87±12.82, p<0.001). Postoperative complications were slightly higher, however, complications at one year were lower in ABO-incompatible recipients. Conclusion: The study showed that living donor ABO-incompatible kidney transplant recipients have a good outcome at one year but is associated with greater risks of patient and graft loss at early transplant period compared to ABO-compatible recipients. Keywords: ABO incompatible; graft survival; infection; kidney transplantation; patient survival; rejectionPublication Relapsing Parvovirus B19 Infection after Intravenous Immunoglobulin in Renal Transplant Recipient: A Case Report(Institute of Medicine, 2023) Nepali, Rabin; Chalise, Pawan R; Shah, Dibya SinghABSTRACT Parvovirus B19 has special affinity to erythroid progenitor cells leading to destruction and inhibition of erythropoiesis. One of its presentations is pure red cell aplasia in patients receiving immunosuppressive medications after organ transplantation. Intravenous immunoglobulin (IVIG) and reduction of immunosuppressive medication has been used for treatment but the effects of IVIG may be temporary. Here we present a case of Relapsing infection due to Parvovirus B19 after IVIG in a renal transplant recipient in Nepal. This case shows that in renal transplant patients presenting with anemia and low reticulocyte count, Parvovirus B19 infection should be suspected. Treatment with IVIG has good results but there may be relapse of infection. KeywordsParvovirus B19; intravenous immunoglobulin; renal transplant; relapse;