Browsing by Author "Roka, Kumar"
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Publication Excessive Daytime Sleepiness among First to Fourth Year Undergraduate Students of a Medical College in Nepal: A Descriptive Cross-sectional Study(Nepal Medical Association, 2020) Roka, Kumar; Khadka, Sabina; Dahal, Sanju; Yadav, Meenakshi; Thapa, Puja; KC, RubinaAbstract: Introduction: Excessive Daytime Sleepiness is a significant health problem among medical students worldwide which can impair their cognitive and academic performances. Our study aims to determine the prevalence of Excessive Daytime Sleepiness among the first to fourth year undergraduate students of the Nepalese Army Institute of Health Sciences-College of Medicine. Methods: Following the ethical approval from the Institutional Review Committee with registration no. 317, a descriptive cross-sectional study was conducted among the first to fourth year medical students of the Nepalese Army Institute of Health Sciences-College of Medicine from 4" to 10" August 2020. Two hundred and thirty-two students were selected for the study using the stratified random sampling technique. Epworth Sleepiness Scale was used to obtain data on daytime sleepiness among the study participants. The data were entered into Google spreadsheets and later analyzed. Point estimate at 95% Confidence Interval was calculated along with the frequency and proportion for binary data. Results: The prevalence of Excessive Daytime Sleepiness among the first to fourth year undergraduate students of the Nepalese Army Institute of Health Sciences-College of Medicine is found to be 67 (31.02%) at 95% Confidence Interval (24.85-37.19). It was found to be highly prevalent among the fourth year undergraduate medical students 20 (35.09%) and least prevalent among the first year students 13 (26.00%). Excessive Daytime Sleepiness was found to be slightly higher among females 23 (34.85%) than males 44 (29.33%). Conclusions: Excessive Daytime Sleepinessis highly prevalent among medical students in our study as suggested by various international studies.Publication Home / Archives / Vol. 61 No. 265 (2023): JNMA: Published Monthly / Original Article Transaminitis among Patients with Dengue Fever Visiting a Tertiary Care Centre(Nepal Medical Association, 2023) Rayamajhi, Rabindra Jang; Thapa, Sangita; Rayamajhi, Prachi; Maharjan, Suman; Yadav, Roshan Kumar Ray; Roka, KumarAbstract Introduction: Transaminitis is a condition where serum aspartate transaminase and alanine transaminase increase indicating liver dysfunction. One such disease where liver involvement might be observed is dengue, which is a mosquito-borne viral infection. The aim of the study was to find out the prevalence of transaminitis among patients with dengue fever in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in a tertiary care centre from 1 November 2022 to 31 March 2023 after obtaining ethical approval from the Institutional Review Committee. Informed written consent was taken before collecting the data. A rapid immunochromatography test was used to confirm dengue infection. Serum aspartate transaminase and alanine transaminase were measured through routine Reitman and Frankel’s enzymatic method. Dengue-confirmed patients from the medical outpatient department, fever clinic, and medical ward of the centre were included in the study. Patients with known prior liver diseases or any other chronic diseases, pregnancy, and patients in the hospice unit were excluded. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 442 dengue infected patients, the prevalence of transaminitis was 188 (42.53%) (37.92-47.13, 95% Confidence Interval). The highest frequency of dengue positive was observed among the 18-35 years age group, which was 97 (51.59%) with male predominance 134 (71.27%). Conclusions: The prevalence of transaminitis among patients with dengue fever in a tertiary care centre was found to be lower than other studies done in similar settings.Publication Minimal Change Disease in an Adult: A Case Report(Nepal Medical Association, 2022) Neupane, Shashank; Pudasaini, Prasamsa; Sharma, Anupam; Sharma, Shriya; Adhikari, Aakriti; Roka, KumarAbstract: Minimal change disease is an important cause of nephrotic syndrome in children, however, few cases are seen among adults. There is very little literature regarding the occurrence of minimal change disease in adults. We reported a case of a 63-year-old male who presented with the complaint of swelling around the eyes mostly during the morning for 18 days and frothing of urine for 7 days. On examination, the patient was ill-looking and had edema around the eyes and over the ankles. After preliminary investigations, renal biopsy was performed and electron microscopy revealed diffuse effacement of foot processes of visceral epithelial cells suggesting minimal change disease (podocytopathy). The patient has been treated with tablet prednisolone 60 mg per oral once daily, tablet ramipril 2.5 mg per oral once daily, and tablet torsemide 20 mg per oral twice daily. Hence, minimal change disease should also be considered as a differential diagnosis in adults presenting with the features of nephrotic syndrome.Publication Minimal Change Disease in an Adult: A Case Report(Nepal Medical Association, 2022) Neupane, Shashank; Pudasaini, Prasamsa; Sharma, Anupam; Sharma, Shriya; Adhikari, Aakriti; Roka, KumarAbstract Minimal change disease is an important cause of nephrotic syndrome in children, however, few cases are seen among adults. There is very little literature regarding the occurrence of minimal change disease in adults. We reported a case of a 63-year-old male who presented with the complaint of swelling around the eyes mostly during the morning for 18 days and frothing of urine for 7 days. On examination, the patient was ill-looking and had edema around the eyes and over the ankles. After preliminary investigations, renal biopsy was performed and electron microscopy revealed diffuse effacement of foot processes of visceral epithelial cells suggesting minimal change disease (podocytopathy). The patient has been treated with tablet prednisolone 60 mg per oral once daily, tablet ramipril 2.5 mg per oral once daily, and tablet torsemide 20 mg per oral twice daily. Hence, minimal change disease should also be considered as a differential diagnosis in adults presenting with the features of nephrotic syndrome.Publication Portal Hypertension among Patients with Chronic Liver Disease Admitted to the Department of Internal Medicine of a Tertiary Care Centre(Nepal Medical Association, 2023) Khadka, Sabina; Aryal, Ananda; Karki, Sagun; Subedi, Pratik; Bogati, Kanchan; Baniya, Sunil; Khadka, Shrekshya; Roka, Kumar; Shahi, AshaAbstract Introduction: Portal hypertension is increased pressure within the portal vein. A portal pressure gradient of more than 10 mmHg is defined as "clinically significant portal hypertension" due to manifestations such as splenomegaly, gastroesophageal varices, ascites, hepatorenal syndrome, hepatopulmonary syndrome, hepatic encephalopathy, and spontaneous bacterial peritonitis. The aim of this study was to find out the prevalence of portal hypertension among patients with chronic liver disease admitted to the Department of Internal Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients with chronic liver disease in the Department of Internal Medicine of a tertiary care centre from 1 January 2021 to 31 December 2022 after obtaining ethical approval from the Institutional Review Committee. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 247 patients with chronic liver disease, the prevalence of portal hypertension was 38 (15.38%) (10.88-19.88, 95% Confidence Interval). A total of 16 (42.11%) patients were in the age group of 51-60 years and males were 36 (94.74%). Ascites as a complication were found in 4 (10.53%). Conclusions: The prevalence of portal hypertension among chronic liver disease inpatients in a tertiary care centre was found to be lower than other studies done in international settings.Publication Referrals from Paediatric Department with Respiratory Symptoms having Skin Lesions(Nepal Paediatric Society (JNPS), 2021) Jha, Sagar Mani; Budhathoki, Lee; Shakya, Nabin Bhakta; Shakya, Sunil; Roka, KumarAbstract: Introduction: Paediatric patients with respiratory symptoms having skin lesions are often referred from Paediatric to Dermatology Department. Knowledge about skin and respiratory manifestations will lead to early diagnosis and proper management by the doctors of both the specialties. These dermatological conditions may or may not be related to respiratory illness or may hence be part of total disease process or may be completely separate entity. The aim of this study was to find out skin manifestations of various respiratory diseases and analyse dermatological disorders in children referred from Paediatric Department having respiratory symptoms. Methods: An observational cross sectional hospital based study involving inpatients and outpatients referred from Paediatrics to Dermatology Department having respiratory illness and skin lesions was undertaken between January 2019 to December 2020. Details of skin disease were recorded. The descriptive statistical analysis was expressed in frequency and percentage and Chi square test was applied to determine significance among variables. Results: Total 437 patients were included in the study. The most common diagnosis made by Paediatric {160 (36.6%)} and Dermatology Departments {246 (56.2%) was viral exanthema followed by atopic dermatitis {77 (17.6%)}. Out of total 65 patients who suffered from bronchial asthma, 59 (90.7%) patients had atopic dermatitis. Conclusions: Significant paediatric patients with respiratory illnesses have concomitant skin lesions. There is very high percentage of patients having atopic dermatitis among those who had asthma and hence clearly depicts relation between the two diseases.