Browsing by Author "Pant, V"
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Publication Anticoagulant Dependent Pseudothrombocytopenia: A Case Report(Institute of Medicine, 2017) Aryal, B; Adhikari, S; Aryal, N; Pant, VAbstract Pseudothrombocytopenia is a laboratory finding caused by in vitro autoaggregation of platelets (an irreversible change) resulting due to the presence of EDTA in containers. In contrast to serious and potential life-threatening causes of thrombocytopenia, EDTA-pseudothrombocytopenia (EDTA-PTCP) is solely an in vitro effect without any clinical relevance.We report a 24 year old patient from MCTVC hospitalwho presented with common flu. On blood examination there was low platelets count in EDTA anticoagulated sample but he was clinically otherwise normal and there were no symptoms of thrombocytopenia. On smear preparation, in EDTA and Trisodium citrate sample his all blood countparameters were within normal range. This case highlights the importance of slide preparation.Publication Dialysis adequacy in ESRD patients on maintenance hemodialysis in a tertiary care center(Institute of Medicine, 2017) Baral, S; Pant, V; Shah, DSAbstract Introduction: Assessment of the hemodialysis adequacy is one of the key factors for measurement of quality of life in end stage renal disease since it can predict the outcome of this disease. In this study, we aimed to evaluate hemodialysis adequacy in Institute of Medicine, Kathmandu. This would provide a good background for effective future planning by healthcare authorities. Methods: This is a cross-section observational study done in Hemodialysis Unit, Tribhuvan university teaching hospital, Kathmandu, a tertiary level referral hospital in Nepal. Hemodialysis sessions of 50 patients on maintenance hemodialysis were evaluated after written consent Demographic data along with length of hemodialysis, reuse of hemodialyzer, hemodialysis sessions per week and hemodialyzer membrane type were recorded for each patient. Urea reduction ratio (URR) and single pool kT/v (spKt/v) were calculated to determine hemodialysis adequacy. Results: Bicarbonate-based solutions and low-flux membranes was used in all patients. Length of each hemodialysis sessions was 240 minutes. Thirty-nine (78%) patients were male and eleven (22%) patients were female. The mean spKt/V and URR were found to be (1.15 ±40.3) and (60.35 ±9.26%) respectively. A spKt/V more than 12 and urea reduction rate more than 65% were found in 42% and 34% of the end stage renal disease patients respectively. Conclusions: This study showed hemodialysis inadequacy in more than half of the patients. Adequacy of hemodialysis can be obtained by increasing its frequency, avoiding multiple use of dialyzer and increasing blood flow rate. Keywords: End stage renal disease, Urea Reduction Ratio, Single-pool Ki/VPublication Does serum magnesium analysis need to be a part of routine dyselectrolytemia investigation?(Institute of Medicine, 2017) Tuladhar, ET; Pant, V; Aryal, B; Tumbapo, A; Ghimire, S; Sharma, VK; Bhattarai, A; Raut, M; Yadav, BKAbstract Introduction: The fourth most abundant cation in the body and the second most prevalent intracellular cation, magnesium (Mg) is a co-factor for over 300 enzymes. Though magnesium abnormalities frequently accompany other electrolytes abnormalities, during electrolyte investigation, magnesium estimation is often overlooked. This study aims to investigate the occurrence of magnesium abnormalities in serum samples sent, for routine electrolyte measurement like sodium, potassium, calcium and phosphorus, to the biochemistry laboratory of Tribhuvan University teaching hospital. Methods: Serum magnesium measurement was done in 799 serum samples ordered for various electrolyte estimation. Magnesium, Calcium and phosphorus present in sample was analyzed by BT 3500 machine spectrophotometrically. Sodium and potassium ions were analyzed by direct ion selective electrode method. Results: Only 14(1.75%) samples were requested by physician for magnesium estimation out of total 799 samples sent for various electrolyte estimation. When all 799 samples were analyzed for magnesium level, magnesium abnormalities were identified in 76(9.5%), out of which hypermagnesemia was found in 22 (2.75%) and hypomagnesemia in 54 (6.76%) samples. Conclusion: Since, significant numbers of patient's serum sample, sent for estimation of various electrolytes, are found to have magnesium abnormalities, we recommend routine measurement of this analyte along with other electrolytes. Keywords: Magnesium, Sodium, Potassium, Calcium, Phosphorus, DyselectrolytemiaPublication Langerhans Cell Histiocytosis, presenting as Central Diabetes Insipidus and Pneumothorax a Case Report(Institute of Medicine, 2017) Pant, V; Shrestha, A; Baral, S; Bhattarai, B; Bhatta, UAbstract Langerhans cell histiocytosis (LCH) is a proliferative disorder where pathologic Langerhans cell accumulate in a various organ. We report a case of 28 years’ male who was admitted in medical ward for initial evaluation of pneumothorax and increased thirst. Laboratory workup revealed central diabetes insipidus. After careful examination, a skin lesion was found from which biopsy and immunophenotyping was performed that lead to the diagnosis of Langerhans cell histiocytosis with multisystem involvement. Patient was managed as per LCH protocol and intranasal desmopressin was prescribed for Diabetes Insipidus. Keywords: Langerhans cell histiocytosis (LCH), Diabetes Insipidus, Pneumothorax