Browsing by Author "Sharma, U"
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Publication Comparative study in extracorporeal shock wave lithotripsy with and without the use of local anaesthetic (Lidocaine 1%) infiltration at the shock wave site(Kathmandu University, 2009) Nagendra, BKC; Sharma, UAbstract Background: Extracorporeal Shock Wave Lithotripsy (ESWL) is a simple and non-invasive technique in which renal and ureteric calculi are pulverised into small fragments by shockwaves and then allowed to pass spontaneously in small fragments along with urine. Effective ESWL requires a co-operative patient who will remain immobilize on the lithotripsy table comfortably for which different anaesthetic techniques are used. Occasionally discharge of patient is delayed due to persistent sedation, nausea and vomiting. Objective: The aim is to assess the use of local anaesthetic agent (20 ml Lidocaine 1% ) infiltration in 60 patients (Experiment Group ) and no infiltration in 60 patients ( Control Group ) on patients undergoing Extracorporeal shock wave lithotripsy (ESWL) procedure. Materials and methods: is a study done in 120 patients of ASA I and ASA II patients undergoing ESWL procedure. The infiltration technique is standardized so that the local anesthetic agent was infiltrated five minutes before the procedure along the line of shockwave site in Experiment Group. Result: In this study, the age, sex, weight, time of shockwave treatment was almost similar in both groups. The mean need of Ketamine and duration of stay after procedure was significantly more in control group than experiment group. Conclusion: In this study, it is concluded that the need of Ketamine and duration of stay after procedure is significantly more in control group. Key words: ESWL, infiltration, Ketamine, Lidocaine 1%Publication Digital Subtraction Angiography a Door Opener for Neurosurgical Residents who want to Perform Neurointerventional Procedures(Kathmandu University, 2021) Rajbhandari, P; Gurung, P; Rajbhandari, S; Shrestha, D; Acharya, S; Shrestha, R; Shrestha, P; Shrestha, J; Sharma, U; Mali, S; Rajbhandari, R; Neupane, A; Pant, BABSTRACT Digital subtraction angiography (DSA) has been a fluoroscopic golden investigative tool to know the vascular angiography of the brain and spinal cord. The technique in performing this procedure exposes residents in accessing the major vessels, branches of the arch of aorta, selective angiography and diagnosing different vascular anomalies of brain and spine. They are also exposed to the knowledge of different diagnostic catheters, its manipulation, use of dye and radiation exposure and safety. We would like to share our experience in training and disseminating the knowledge of digital subtraction angiography to the residents. KEY WORDS Digital subtraction angiography, Neurosurgical residents, NeurointerventionPublication Lipid Profile and Ultrasonographic Grading in Alcoholic and Non Alcoholic Fatty Liver Patients(Kathmandu University, 2021) Shahi, A; Gautam, N; Rawal, S; Sharma, U; Jayan, AABSTRACT Background Fatty liver disease (FLD) is a common and major chronic liver disease. It has been implicated that patients have disorders of lipid metabolism and are involved in the pathogenesis of fatty liver. Hence, it was designed to observe the association between lipid profile and fatty liver disease. Objective This study was undertaken to evaluate the association of lipid profile status, hemoglobin and albumin levels with fatty liver disease patients diagnosed based on ultrasonography (USG). Method This Cross-sectional study was undertaken in the Department of Internal Medicine with the collaboration of the Department of Radiology and Department of Biochemistry, Universal College of Medical Sciences-Teaching Hospital (UCMS-TH), Bhairahawa, Nepal from March 2019 to February 2020 in a total of 100 patients diagnosed with fatty liver disease by ultrasonography. The fasting blood was collected for lipid profile and carried out in the automated analyzer following standard protocol. Result In 100 cases, the male to female ratio was 1.8:1. Fifty six percent of the total cases presented with alcoholic fatty liver disease (AFLD) while the remaining 44% with nonalcoholic fatty liver disease (NAFLD). The spectrum of lipid abnormality was observed with increased total cholesterol (TC), Low Density Lipoprotein (LDL), increased triglycerides (TG), Very Low Density Lipoprotein (VLDL) in alcoholic fatty liver disease cases as compared to nonalcoholic fatty liver disease cases. However, it has been observed that TG/HDL and Non-HDL/HDL were higher in nonalcoholic fatty liver disease as compared to alcoholic fatty liver disease. Moreover, a statistically significant difference was observed in HDL between AFLG2 and NAFLG2 (p-value: 0.012). Conclusion Dyslipidemia and decreased HDL have been implicated in fatty liver diseases. USG in conjunction with Non-HDL/HDL, TG/HDL, hemoglobin, and albumin can be useful in early screening and monitoring of dyslipidemia in fatty liver patients. KEY WORDS Alcoholic fatty liver, Dyslipidemia, Non-alcoholic fatty liver