Browsing by Author "Neupane, NP"
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Publication Aberrant Shape of the Heart, “Gourd Shaped”: A Rare Case of Localized Constrictive Pericarditis(Kathmandu University, 2024) Rajbhandari, S; Joshi, S; Bhattarai, N; KC, P; Rajthala, P; Khadka, S; Neupane, NP; Aryal, M; Rajlawot, KABSTRACT Calcific constrictive pericarditis results commonly from the tubercular lesions in developing countries. The localized calcifications associated with the calcific constrictive pericarditis on its own is rare and the calcification along the atrioventricular groove distorting the heart to a shape of gourd is extremely rare. We present a case to highlight the importance of the early diagnosis of the condition. We have approached the patient with echocardiography and commuted tomography for the diagnosis and hemodynamic evaluation. Early treatment is equally important for this condition, as the calcific constrictive pericarditis is curable with pericardiectomy. However, there lacks a clear consensus for the pericardiectomy in patients with localized calcification and medical therapy can be initiated. KEY WORDS Constrictive pericarditis, Computed tomography, Echocardiography, PericardiectomyPublication Correlation between Estimated Glomerular Filtration Rate (eGFR) and Sonographic Findings in Patients with Chronic Kidney Disease(Institute of Medicine, 2016) Neupane, NP; Lohani, BAbstract Introduction: Ultrasound can also be used as a non-invasive modality for the evaluation and grading of the chronic kidney diseases. This study aims to correlate the various sonographic parameters with the various grades of CKD based on the eGFR. Methods: The study was a cross sectional study conducted over a period of one year. Study population was adult patients (between 20 to 60 years) with chronic renal disease not undergoing renal replacement therapy. Patients with liver disease and fatty changes in liver in ultrasound and patient with ascites were excluded from the study. Estimated glomerular filtration rate (eGFR) was calculated by using Cockcroft- Gault (CG) equation and CKD classified according to Kidney Disease Improving Global Outcomes (KDIGO) 2004. Ultrasound was performed for all patients and data were entered in a predesigned proforma. Data analysis was done using SPSS 21.0. Results: A total of 138 patients met the inclusion criteria and were included in the study. The mean renal length in our study was 9.03cm (±0.83) on right and 9.00cm (±0.82) on the left side. The mean renal cortical thickness of right kidney was 1.037±0.20 cm and of left kidney was 1.039-±0.20 cm. Renal length and renal cortical thickness demonstrated a negative correlation with grade of CKD while renal echogenicity grading demonstrated a positive correlation with CKD grade. Conclusions: Renal Ultrasound may be used to grade and monitor progress of chronic kidney disease. Keywords: Chronic Kidney Disease, Estimated Glomerular Filtration Rate (eGFR), Renal Length, Ultrasound, Renal cortical thicknessPublication Measurement of Portal Vein Diameter, Peak Systolic Velocity and Pulsatility Index by Ultrasound Doppler Evaluation in Asymptomatic Nepalese Population(Institute of Medicine, 2017) Songmen, S; Panta, Om B; Neupane, NP; Ghimire, RKAbstract Introduction: Portal vein diameter and Doppler studies give hemodynamic information that can correlate with disease status. Their normal values are not established in Nepalese population. This study aims to establish the normal values of portal vein diameter, PSV and PI in Nepalese population and study their variability with age, gender and ethnicity. Methods: Cross-sectional hospital based study. All adults more than 20 years of age attending ultrasound OPD of Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu for general health checkup were included. Patients with liver disease, cardiac disease and ascites were excluded. A single observer took all measurements. Data were entered in a predesigned proforma and analysis was performed with SPSS 21.0. Results: Two hundred patients were included in the study. The mean age was 44.34+12.9 years. The mean portal vein diameter was 10.41+1.18mm. The mean portal vein PSV was 33.35+9.3cm/s and PI was 0.76+0.07. There was a positive correlation of portal vein diameter with age (r=0.345; p<0.001). Also, mean portal vein diameter was significantly higher in males (10.9+0.99mm) than in females (9.9+1.1mm). PSV and PI did not differ with age, gender or ethnicity. Conclusions: Mean portal vein diameter in this study is comparable with previous standards. Keywords: Peak systolic velocity, portal vein diameter, pulsatility index