Browsing by Author "Poudel, Chandra Mani"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Publication Echocardiographic Findings in Patients with Atrial Fibrillation in a Tertiary Care Center of Nepal: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Shakya, Smriti; Gajurel, Ratna Mani; Poudel, Chandra Mani; Shrestha, Hemant; Devkota, Surya; Thapa, SanjeevAbstract: Introduction: Atrial fibrillation is the most prevalent supraventricular arrhythmia responsible for the large morbidity and mortality burden worldwide. There are various causes of atrial fibrillation that may affect the prognosis of patients. This study was intended to determine different echocardiographic findings in patients with atrial fibrillation in a tertiary care center. Methods: A descriptive cross-sectional study was conducted at Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, among 175 patients with atrial fibrillation admitted in the cardiology department from June 2017 to October 2018. It was approved by the Institutional Review Board of the Institute of Medicine (Ref.:411(6-11-E)2/073/074). Convenience sampling was used. Statistical analysis was done using Statistical Package for Social Sciences version 21.0. Results: A total of 175 patients with atrial fibrillation were enrolled where Rheumatic heart disease 68 (38.9%) was the leading cause in which 54 (79.4%) had mitral valve lesion, 1 (1.5%) had aortic valve lesion and rest had a combination of both. The mixed lesion of mitral stenosis and mitral regurgitation was the commonest. The left atrium size was larger in valvular atrial fibrillation (47.29±6.651mm). The left ventricular systolic dysfunction was seen more in non-valvular atrial fibrillation. The commonest site of thrombus formation was left atrium 7 (63.6%). Conclusions: Atrial fibrillation was common in rheumatic heart disease, especially mixed lesions of mitral stenosis and regurgitation. Valvular atrial fibrillation had a larger left atrium. The thrombus was seen in mitral stenosis and left ventricular systolic dysfunction. The left atrium size and left ventricular ejection fraction were associated with the occurrence of atrial fibrillation.Publication Emergency Heart Failure Mortality Risk Grade-7 Score Performance in Patients with Acute Heart Failure admitted at a Tertiary Care Center(Institute of Medicine, Tribhuvan University, 2024) Shrestha, Bikesh; Poudel, Chandra Mani; Gajurel,Ratna ManiAbstract: Introduction Heart failure is a major cause of morbidity and mortality worldwide with annual mortality of 8-9%. Acute heart failure patients require frequent Emergency Department visits and hospitalization.Emergency Heart Failure Mortality Risk Grade (EHMRG) score helps to risk stratify such patients. We aimed to study its performance at a tertiary care centre in Nepal. Methods This is an analytical, study involving 175 acute heart failure patients admitted at Emergency department over 1 year. The score was calculated for each patient and they were followed up for 30 days post discharge for readmission. The primary outcome studied was 7 day mortality. Results The median age was 66 years with 94 (53.7%) of the patients being male. Ischemic (38.3%) and dilated (25.1%) cardiomyopathies were the most common etiologies. Twenty seven (15.3%) of the patients required re-hospitalization within 1 month.There was statistically significant association (p<0.001) between 7-day mortality and high EHMRG scores (Class 5 and 4). No 7-day mortality was observed in the very low, low, and intermediate-risk groups. In the high-risk group (Class 4), 1 patient died while 15 survived. In the very high-risk group (Class 5), 29 patients died compared to 45 who survived. Conclusion Mortality within 7 days and readmission rates were higher in patients with high EHMRG scores. No mortalitites were encountered in patients with low scores. EHMRG can be a valuable tool to stratify acute heart failure patients as it can identify patients with high risk of 7 day mortality. It can help physician in deciding whether to discharge or admit the patients from Emergency rooms.Publication Occluded Coronary Artery among Non-ST Elevation Myocardial Infarction Patients in Department of Cardiology of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Sharma, Manju; Khanal, Raja Ram; Shah, Sangam; Gajurel, Ratna Mani; Poudel, Chandra Mani; Adhikari, Suman; Yadav, Vijay; Devkota, Surya; Thapa, ShovitAbstract Introduction: Non-ST elevation myocardial infarction is frequently thought to be caused by incomplete blockage of the culprit artery, whereas ST elevation myocardial infarction is frequently thought to be caused by total occlusion of the culprit artery. The objective of the study was to find out the prevalence of occluded coronary arteries among non-ST elevation myocardial infarction patients department of cardiology of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among non-ST elevation myocardial infarction patients in a tertiary care centre from 22 June 2020 to 21 June 2021 after taking ethical approval from the Institutional Review Committee [Reference number: 4271 (6-11) E2 076/077]. A total of 196 patients were included in the study by simple randomized sampling. Data on the patient’s clinical profile, angiographic findings, and in-hospital complications were recorded. Point estimate and 95% Confidence Interval were calculated. Results: Among 126 non-ST elevation myocardial infarction patients included in the study, the prevalence of occluded coronary artery was 41 (32.54%) (24.36-40.72, 95% Confidence Interval). Conclusions: The prevalence of occluded coronary arteries was similar to the studies done in similar settings.