Browsing by Author "Pathak, S"
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Publication Clinical and Endoscopic Findings in Patients Presenting with Upper Gastrointestinal Bleeding at a Tertiary Care Hospital(Kathmandu University, 2024) Sharma, P; Sapkota, P; Pathak, S; Lamsal, A; Joshi, S; Parajuli, S; Rajak, S; Gautam, S; Tamang, AABSTRACT Background Upper gastrointestinal (UGI) bleeding is a severe medical condition that requires prompt evaluation and management. Understanding the clinical and endoscopic findings in patients presenting with upper gastrointestinal bleeding is essential for accurate diagnosis and effective treatment. Objective To investigate the age and sex composition, clinical presentations, and endoscopic findings of patients with upper gastrointestinal bleeding at a tertiary care hospital. Method A total of 561 patients with upper gastrointestinal bleeding were included in the study. Data on age, sex, and clinical presentation were collected for each patient. Endoscopic findings were recorded, and the relative frequency of various upper gastrointestinal lesions was analyzed. Result The age distribution of patients revealed that 40.82% were between 15 and 45 years, 32.98% were aged 46 to 65 years, and 26.20% were above 65 years. Among the patients, 73.08% were male and 26.92% were female. Hematemesis was observed in 248 cases, while melena was present in 136 cases, and both were present in 171 cases. Recent onset anemia with positive occult blood was reported in 6 patients. The most common endoscopic finding was varices (39.39%), followed by ulcers (15.51%). Mallory Weiss tear was noted in 5.53% of cases. Conclusion According to our findings, varices are the most common endoscopic finding in individuals with upper gastrointestinal bleeding rather than peptic ulcer disease. The considerable increase in varices emphasizes the critical importance of early identification and care in high-risk individuals, as well as contributing to a better understanding of upper gastrointestinal bleeding. KEY WORDS Bleeding, Endoscopy, Esophageal varices, Gastric varices, Gastrointestinal hemorrhage, Upper gastrointestinal tractPublication Clinical Characteristics and Outcomes of Anemia in Critically Ill Patients: A Cross-Sectional Observational Study from a Tertiary Intensive Care Unit in Nepal(Kathmandu University, 2025) Simkhada, N; Pathak, S; Thapa, N; Poudel, P; Dhakal, B; Upadhyay, G; Thapa, J; Regmi, A; Ojha, S; Adhikari, SABSTRACT Background Anemia is a common clinical problem among critically ill patients; however, its prognostic significance remains debatable. In low-resource settings, such as Nepal, data are limited. This study evaluated the clinical, laboratory, and outcome profiles of anemia in a tertiary Intensive Care Unit. Objective To assess the clinical characteristics, laboratory features, and outcomes of anemia in critically ill patients admitted to a tertiary Intensive Care Unit in Nepal. Method This retrospective observational study included 113 adult Intensive Care Unit patients with anemia admitted to Dhulikhel Hospital, Nepal, from October 2024 to March 2025 after obtaining ethical approval from the Institutional Review Committee, Kathmandu University School of Medical Sciences (IRC, KUSMS-156/25). Demographic data, anemia severity, laboratory markers, including peripheral blood smear (PBS), and outcomes, such as mortality and Intensive Care Unit stay, were analyzed using IBM SPSS Statistics version 25.0. Categorical variables were compared with Chi-square tests, continuous variables with independent t-test or Mann- Whitney U test, and correlations were assessed with Spearman’s rank method. Result The median hemoglobin level was 97 g/L (78-112g/L), and mild anemia was the most common (49.5%). Mortality correlated strongly with abnormal peripheral blood smear (p < 0.001, r = 0.52) and moderately with older age (p = 0.012, r = 0.35). Although anemia severity was not statistically significant (p = 0.423), its weak positive correlation (r = 0.15) indicates a potential trend. Conclusion Peripheral blood smear abnormalities and advanced age strongly predict mortality in critically ill patients, while anemia severity alone does not. Routine smear use in resource-limited ICUs may aid early risk stratification and improve care. KEY WORDS Anemia, Critical Illness, Intensive care unit, Nepal