Browsing by Author "Thapa, Pradeep"
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Publication Clinical Profile of Patients Presenting with Low Back Pain to Out Patient Department of a Tertiary Level Hospital(Institute of Medicine, 2020) Thapa, Pradeep; Lakhey, Rajesh B; Shrestha, Binay LABSTRACT Introduction: Low back pain is experienced by most of the people at some point of life. In our setting, there are very limited data on low back pain. This study aims to elaborate demographic and clinical profile of patients presenting to outpatient department of Orthopedics, in Tribhuvan University Teaching Hospital with complaints of low back pain. Methods: A descriptive cross-sectional observational study was carried out in 150 patients who presented with complaints of lower back pain in outpatient department of Orthopedics of TU Teaching Hospital from May to November 2019. The demographics including age, gender, occupation, and clinical data- duration of symptoms, body mass index, VAS score and radiculopathy along with Body Mass Index of each patient were recorded in a proforma separately. Results: Out of total 150 patients, male: female ratio was 1:1.9. The average age of patients was 42.1 years The average height, weight and body mass index of patients were 157 cm, 61.81kg and 24.83kg/m2 respectively. The mean visual analogue score of patients was 5.41. Occupationally, predominant number of patients were housewives (41.3%). Seventy nine patients (52.7%) had low back pain alone. Seventy one patients (47.3%) had low back pain associated with radicular symptoms, out of which 74.6% had unilateral radiculopathy. Conclusion: Low back pain is most commonly seen in fourth decade of life. More females as compared to males are affected with low back pain. The radiculopathy associated with low backache is mostly unilateral. Keywords: Body mass index, low back pain, radiculopathy, visual analogue scorePublication Fasting Serum Magnesium Level and its Association with Type 2 Diabetes Mellitus and its Chronic Complications(Institute of Medicine, 2021) Lamsal, Manoj; Thapaliya, Sabin; Thapa, Pradeep; Bhandari, Roshan; Sangroula, Raj K; Sayami, Matina; Shrestha, Pradeep KABSTRACT Introduction: Diabetes mellitus is one of the most common metabolic disorders. Hypomagnesemia is a common feature in patients with type 2 diabetes mellitus (T2DM). This study aims to assess the serum magnesium level and its association with chronic complications in patients with T2DM. Methods: A total of 173 T2DM patients at Tribhuvan University Teaching Hospital were evaluated from July 2016 to August 2017. Patients were investigated for fasting serum magnesium level, fasting plasma glucose (FPG), postprandial plasma glucose (PPG), Glycosylated haemoglobin (HbA1c) and also target organ evaluation for diabetes. Data was analyzed using Statistical Package for the Social Sciences (SPSS) version 20. Results: Hypomagnesemia was found in 86 patients out of the 173 enrolled patients. Observations revealed significant association between hypomagnesemia and various microvascular complications viz. retinopathy (p=0.001), neuropathy (p<0.001) and nephropathy (p<0.001). There was also a significant association between hypomagnesemia and FPG (p=0.008) and HbA1c (p=0.009). The overall prevalence of hypomagnesemia among T2DM patients was 49.7% and the prevalence of hypomagnesemia was significantly higher (74%) among diabetic patients with microvascular complications (p=0.001) compared to diabetics with no microvascular complications. Conclusion: There was a high prevalence of hypomagnesemia among T2DM patients. A significant association was seen between hypomagnesemia and various microvascular complications like retinopathy, neuropathy and nephropathy. Routine surveillance and timely treatment of hypomagnesemia is advisable for patients with T2DM. Keywords: Diabetic retinopathy; glycosylated haemoglobin; hypomagnesemia; type 2 diabetes mellitusPublication Incidence of Contrast Induced Acute Kidney Injury, Its Risk Factors and In-Hospital Outcomes in Patients Undergoing Coronary Angiography and Angioplasty(Institute of Medicine, 2020) Upadhaya, Prashun; Thapa, Pradeep; Gajurel, Ratna M; Sigdel, Mahesh RABSTRACT Introduction: Contrast-induced acute kidney injury (CI-AKI) is a serious complication of angiographic procedures with significant morbidity and mortality. We aimed to find the incidence, risk factors and outcomes of CI-AKI in patients who have undergone coronary angiography/angioplasty in a referral hospital in Nepal. Methods: It was a descriptive observational study of consenting consecutive patients above 18 years undergoing coronary angiography/angioplasty at Manmohan Cardiothoracic Vascular and Transplant Centre, Nepal from July 2015 to September 2017. CI AKI was defined as an elevation of serum creatinine of >25% or ≥0.5 mg/dl (44 μmol/L) from baseline within 48 hour of exposure to contrast. Statistical analysis was performed using SPSS 18 software. Statistical analysis was completed using Student’s t-test, chi-square test and multivariable logistic regression analysis. Results: Out of 240 patients, 156 (65%) were male, mean age was 60.36±11.29 years. Eighteen patients (7.5%) developed CI-AKI. Incidence of CI-AKI was 20% in patients with chronic kidney disease (CKD), 5.4% in diabetics, 13.6% in patients >70 years, 12.79 % in patients with anaemia and 12.3% in patients with prior contrast exposure. Multivariate logistic regression analysis found smoking and history of prior contrast exposure to be independent predictors for development of CI-AKI. Among patients with CI-AKI, one (5.88%) required dialysis and one (5.88%) died. Conclusion: Incidence of CI-AKI after coronary angiography/angioplasty was 7.5%. Patients with prior contrast exposure and smoking were at significantly increased risk of CI-AKI; higher trend of CI-AKI was seen in patients with CKD, diabetes, elderly and anaemia. Keywords: Angiography, angioplasty, contrast induce acute kidney injury, contrast media,, contrast nephropathy