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Browsing by Author "Pant, Pankaj"

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    Metabolic Syndrome among Stable Chronic Obstructive Pulmonary Disease Patients Visiting Outpatient Department of a Tertiary care centre: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2023) Baniya, Santosh; Shrestha, Tirtha Man; Pant, Pankaj; Aacharya, Ramesh Prasad
    Abstract Introduction: Metabolic syndrome; a constellation of obesity, hypertension, and disturbances of lipid and carbohydrate metabolism is a common phenomenon in chronic obstructive pulmonary disease. Systemic inflammation plays an important role in both conditions. The aim of this study was to find out the prevalence of metabolic syndrome among stable chronic obstructive pulmonary disease patients visiting the outpatient Department of a tertiary care centre. Methods: A descriptive cross-sectional study was done in the outpatient Department of Pulmonology and General Practice from 1 August 2019 to 31 December 2020. Ethical approval was obtained from Institutional Review Committee [Registration number: 5/(6-11)E2/076/077]. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 57 patients with stable chronic obstructive pulmonary disease, the prevalence of metabolic syndrome was 22 (38.59%) (27.48-49.70, 90% Confidence Interval). The prevalence of metabolic syndrome in patients with Global Initiative for Obstructive Lung Disease stages 1, 2, 3, and 4 were 6 (27.27%), 9 (40.90%), 6 (27.27%) and 1 (4.54%) respectively. Conclusions: The prevalence of metabolic syndrome was similar to the other studies done in similar settings. The screening of metabolic syndrome is necessary and stratification for cardiovascular disease risk is important for timely intervention to prevent and decrease morbidities and mortalities.
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    Plasma Fibrinogen Level in Chronic Obstructive Pulmonary Disease and Its Correlation with GOLD Severity Staging
    (Institute of Medicine, 2021) Gyawali, Achyut; Bam, Niraj; Pant, Pankaj; Das, Santa K
    ABSTRACT Introduction: Chronic obstructive pulmonary disease (COPD) has great implications on global health accounting for significant morbidity and mortality. It is a state of chronic inflammation of airways. The aim of this study was to measure the plasma fibrinogen level in patient with COPD and find the relationship between plasma fibrinogen levels and severity of airflow obstruction. Methods: This observational study was conducted from September 2017 to October 2018, where 80 eligible patients with the diagnosis of acute exacerbation of COPD (AECOPD) were included in the study and their plasma fibrinogen level was measured at the time of discharge. Clinical information was obtained and pulmonary function test (PFT) was done. Results: A total of 80 patients were enrolled. The mean age of the patient was 67.87±11.60 years. Plasma fibrinogen level was 159±12.72 mg/dl in mild COPD, 273.52±62.34 mg/dl in moderate COPD, 312.30±103.67 mg/dl in severe COPD, and 487±102.76 mg/dl in very severe COPD. The comparison between groups showed significant difference in plasma fibrinogen level (p<0.001). There was significant negative correlation between plasma fibrinogen level and forced expiratory volume in one second (FEV1%) predicted (r=-0.71, p=0.01). Conclusion: High plasma fibrinogen level on discharge was found in COPD patients with severe airflow obstruction, frequent exacerbations and severe level of dyspnoea during AECOPD. Keywords: Acute exacerbation, AECOPD, COPD, GOLD, plasma fibrinogen
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    Prevalence of Functional Limitation in COVID-19 Recovered Patients Using the Post COVID-19 Functional Status Scale
    (Nepal Medical Association, 2021) Pant, Pankaj; Joshi, Aishana; Basnet, Babin; Shrestha, Bibek Man; Bista, Navindra Raj; Bam, Niraj; Das, Santa Kumar
    Abstract: Introduction: COVID-19 is an emerging global health pandemic causing tremendous morbidity and mortality worldwide. Chronic symptoms progressing to poor functional status have been reported in a substantial proportion of COVID-19 patients worldwide. This study aimed to determine the prevalence of functional limitation in COVID-19 recovered patients using the post-COVID-19 functional status scale. Methods: A descriptive cross-sectional study was conducted at Tribhuvan University Teaching Hospital. COVID-19 recovered patients with reverse transcription-polymerase chain reaction negative status were included and assessed using the post-COVID-19 functional status scale. Data entry and analysis was done in Statistical Package for the Social Sciences version 20.0. Descriptive statistics were performed. Results: A total of 106 patients were included for the final analysis. More than half of the patients (56.6%) reported having no functional limitation (grade 0), while the prevalence of some degree of functional limitation was observed in 46 (43.4%) patients (grade 1 to 4). Conclusions: Some form of functional limitation should be anticipated after COVID-19 infection. Post-COVID-19 functional status scale can be a valuable tool in determining the prevalence of functional limitation in COVID-19 recovered patients in acute health care settings. It can potentially guide in planning rehabilitative measures in post-acute care management of COVID-19 survivors.
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    Serum Vitamin D Level in Chronic Obstructive Pulmonary Disease and its Relation with Severity: A Single Centre Study
    (Institute of Medicine, 2019) Pant, Pankaj; Thapa, Shovit; Das, Santa K; Bam, Niraj
    ABSTRACT Introduction Chronic obstructive pulmonary disease (COPD) is a public health problem of epidemic proportion. Several studies have shown low serum vitamin D levels in patients with COPD. The aim of this study was to compare serum vitamin D level in patients with Global Initiative for Chronic Obstructive Lung Diseases (GOLD) COPD stage II, III and IV with controls and correlate serum vitamin D level with severity of COPD. Methods A cross sectional study was conducted from June 2014 to November 2015 at Tribhuvan University Teaching Hospital (TUTH). A total of 154 subjects were enrolled for study that consisted of 77 cases of COPD and 77 controls for comparison. Participants were taken from medical wards and outpatient department. COPD staging was done as per GOLD guidelines and stage II, III and IV were labeled as advanced COPD cases. Both descriptive and inferential statistics were performed in SPSS version 20. ResultsStage II, III and IV COPD were 30%, 36% and 34% respectively. Mean serum vitamin D level was 15.16±7.19 ng/ml in COPD cases and 33.99±12.37 ng/ml in healthy controls showing statistically significant relation of low serum vitamin D in patients with advanced COPD (p <0.0001). Serum vitamin D was found to be in decreasing trend with increasing severity of COPD. Conclusion Patients with advanced COPD (GOLD stage II, III and IV) had low serum vitamin D levels compared to normal population and serum vitamin D level correlated with GOLD severity in Nepalese patients with COPD. Keywords: Chronic obstructive pulmonary disease; global initiative for chronic obstructive lung diseases; vitamin D
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    Survival in Critical Care Patients with COVID-19 Pneumonia: A Single Center Based Observational Study
    (Institute of Medicine, 2022) Bam, Niraj; Kuikel, Sandip; Sapkota, Dharmendra; Poudel, Sagar; Pant, Pankaj; Das, Santa K
    ABSTRACT Introduction: The severity of COVID-19 pneumonia ranges from asymptomatic to requiring mechanical support for survival. This observational study describes the demographic, management, vaccination status and outcome in Nepalese patients with COVID-19 who were admitted to critical care settings . Methods: Single center based cross sectional study was conducted. All the patients admitted to critical care of Tribhuvan University Teaching Hospital (TUTH) were eligible subjects for this study. Demographic, clinical details and vaccination status of respective patients was obtained from interview and chart review. Data was collected in Microsoft Excel 2016 and statistical analysis was performed using statistical software SPSS 21. Results: A total of 342 patients with mean age 53.95±15.6 years were included in the study. The mean duration of stay in critical care was 6.74±4.43 days. Fever and shortness of breath was the predominant symptom present in the studied patients with all patients having shortness of breath. Out of the 342 patients, 20.2% (n=69) were intubated at least once during their critical care stay, 57.89%(n=198) received only non-invasive ventilation and 21.9% (n=75) received oxygen via other means. The overall survival rate of patients admitted to critical care of TUTH was 60.53% with very low survival rate in intubated patients. Only 8.8% of the included patients had received at least one dose of vaccine. Conclusion: Our study suggest that the prognosis of critical care COVID-19 patients is poor with highest mortality in patients receiving mechanical ventilation. Delay in intubation may contribute to this worse outcome in intubated COVID-19 patients. Keywords: Corona virus, COVID-19, critical care, SARS, survival

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