Browsing by Author "Poudel, A"
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Publication Clinical profiling and use of loop-mediated isothermal amplification assay for rapid detection of Mycobacterium tuberculosis from sputum(Kathmandu University, 2009) Poudel, A; Pandey, BD; Lekhak, B; Rijal, B; Sapkota, BR; Suzuki, YNAPublication Evaluation of non-HDL-c and total cholesterol: HDL-c Ratio as Cumulative Marker of Cardiovascular Risk in Diabetes Mellitus(Kathmandu University, 2010) Aryal, M; Poudel, A; Satyal, B; Gyawali, P; Pokheral, BR; Raut, BK; Adhikari, RK; Koju, RABSTRACT Background Cardiovascular disease (CVD), is the primary cause of morbidity and mortality in patients with diabetes and have approximately - two to four times higher CVD rate than adult without diabetes. Low density lipoprotein cholesterol (LDL-C) is primarily used as the marker of cardiovascular risk in diabetes despite its several limitations. Although several newer markers of CVD are emerging, no marker has been established in Nepal. Objectives The study was designed to evaluate the non-high-density-lipoprotein- cholesterol(Non- HDL-C) and Total Cholesterol to High density lipoprotein cholesterol (TC:HDL-C ratio) as CVD risk marker in diabetes mellitus. Methods The study was conducted in the Department of Bbiochemistry, Kathmandu University School of Medical Sciences. The study comprised of 76 diabetic subjects and 60 non- diabetic subjects. The anthropometric and biochemical parameters were measured. The Non-HDL-C and TC:HDL-C ratio were also calculated employing their respective formula. Results Body mass index (BMI), waist circumference (WC), blood pressure and lipid parameters were significantly different between diabetic subjects and non-diabetic subjects. There was increased non-HDL-C and TC:HDL-C ratio in subjects with diabetes mellitus. Furthermore, statistically significant correlations of non-HDL-C and TC:HDL-C ratio were obtained with BMI, WC, total cholesterol, HDL-C and LDL-C in diabetic subjects. Conclusions The present study observation revealed that the Non-HDL-C and TC: HDL-C strongly correlate with established independent risk factors such as obesity(WC), elevated blood pressure, HDL-C and LDL-C in diabetes. Thus, the evaluation of Non-HDL-C and TC: HDL-C ratio can be used as the simple, cost-effective and cumulative marker of cardiovascular risk in diabetes mellitus. Key Words cardiovascular risk, diabetes mellitus, Hypertension, lipid profile, Obesity, Non-HDL- cholesterolPublication Irrational fixed dose combinations in Nepal: Need for intervention(Kathmandu University, 2008) Poudel, A; Palaian, S; Shankar, PR; Jayasekera, J; Izham, MIMAbstract A large proportion of drugs available are of little importance in terms of ful lling primary healthcare needs. Combination drugs increase the risk of side effects, lead to an ineffective dosage and liability to abuse and may also needlessly increase the cost. Drug combinations make it more dif cult to nd the causative agent responsible for the adverse reactions. In many cases their stability is doubtful, reducing the ef cacy of many preparations. The Fifteenth WHO model list of essential medicines (March 2007) contains only 25 approved xed dose combinations, whereas in Nepal, there are innumerable examples of irrational drug combinations, which are easily available and can be bought even without a prescription. A system of screening the drug combinations that are already licensed and available in the market is implemented in many developed and developing countries. Rational combinations can be of immense help to the health care system. These combinations may improve the quality of life for many and increase compliance. But irrational xed dose combination products can be equally harmful. Key words: Adverse drug reaction, Combination drugs, Fixed dose combination, Irrational drug use, NepalPublication Regarding the article “Irrational fixed dose combinations in Nepal: Need for intervention”(Kathmandu University, 2008) Poudel, A; Khanal, S; Alam, K; Palaian, SNAPublication Safety Profile and Patient Satisfaction of the Routine use of Propofol in Gastrointestinal Endoscopy(Kathmandu University, 2014) Gurung, RB; Purbe, B; Malla, B; Dhungel, A; Yogol, S; Poudel, A; Kunwor, K; Byanju, SABSTRACT Backgroud Routine use of sedation in upper gastrointestinal endoscopy is uncommon in Nepal. There is no study on use of propofol sedation in routine endoscopy examination in Nepal. This study was conducted in order to assess the patient satisfaction and safety profile in patient undergoing routine upper GI endoscopic examination on outpatients. Objective To study safety profile and patient satisfaction of use of propofol in patients undergoing upper GI endoscopy. Method A prospective, observational study was conducted in the endoscopy unit of Dhulikhel hospital, Kathmandu University Hospital from July 2011 to 2012 July. Patients who were referred to upper GI endoscopy were offered to sedation under propofol. Informed consent was taken after explaining side effects, advantages and risk-benefit to the clients. The propofol was administered by the endoscopy nurse under guidance and supervision of the endoscopy performing physician. Data were collected and analyzed using SPSS version 16.0 with 0.05 level of significance. Result Total of 203 patients included in the study. Among 203 patients, 21. 2% were males and 78.8% were females; 83.7% were of less than of 60 years age and 16.3% above 60 years of age. The mean total dose of propofol required was 136.08 ± 48.82 mg. Total of 29.1 % of cases required O2 administration during the procedure time due to transient drop in O2 saturation. Total of 4.4% of cases required fluid administration due to transient fall in blood pressure. Total of 68.0% of cases were completely sedated; 28.6% had minor restless and 3.4% showed agitation during induction period of propofol sedation. Total of 99.5% of patients reported pleasant experience while 0.5% reported unpleasant. Among 203 respondents, 98.5% responded they would prefer to do the procedure under propofol sedation in the future; 1.5% responded they did not want sedations in the future. Conclusion Upper GI endoscopy can safely be performed under propofol sedation administered by registered trained nurse under the supervision of endoscopist. KEY WORD Endoscopy, patient safety, patient satisfaction, propofol sedation