Browsing by Author "Thapa, Suman"
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Publication DECAF Score in Predicting Outcomes of Acute Exacerbation of Chronic Obstructive Pulmonary Disease: An Observational Study(Nepal Medical Association, 2025) Prajapati, Amit; Sharma, Yuba Raj; Thapa, Suman; Devkota, SadinaAbstract Introduction: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can often lead to hospital admission and has the potential to be fatal. Lack of prognostic research in exacerbation requiring hospitalization that can accurately predict inhospital mortality is a challenge. This study aims to assess value of the DECAF (Dyspnea, Eosinopenia, Consolidation, Acidemia and Atrial fibrillation) score as a clinical prediction tool for inhospital mortality, need of intensive care unit (ICU) stay and risk stratification in patients with Acute exacerbation of chronic obstructive pulmonary disease. Methods: This is an observational cross-section, hospital based study conducted from April 2022 to February 2023 at a tertiary care centre. The patients admitted with the diagnosis of acute exacerbation of chronic obstructive pulmonary disease were included in the study and their DECAF score were calculated. Patients were followed up during hospital stay and their outcome were recorded. The prognostic value of DECAF score was assessed by area under receiver operator characterstics curve. Results: There were 83 patients enrolled in the study out of which 13 (15.66%) died in the hospital and 20 (24.09%) required ICU stay. The area under receiver operator characteristic curve value for mortality owas 0.89 and that for intensive care unit stay was 0.84. Conclusions: This study shows that DECAF score is a good predictor of inhospital mortality and ICU admission.Publication Gallstone among Patients Presenting to the Department of Surgery in a Tertiary Care Center: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Pahari, Soumya; Basukala, Sunil; Piya, Utsav; Khand, Yugant; Thapa, Baivavi; Thapa, Ojas; Thapa, SumanAbstract Introduction: Gallstone is the most common biliary pathology. Once thought of as a disease of the western world, the incidence and burden of cholelithiasis are increasing in Asia. Its literature from Nepal is however still primitive. The study aimed to find out the prevalence of gallstone among patients presenting to the Department of Surgery in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients presenting to the Department of Surgery after receiving ethical approval from the Institutional Review Committee (Registration number: 625). The study was conducted from 1 June 2022 to 1 November 2022. Patients with age more than 18 years were included and patients less than 18 years of age, having common bile duct stones, suffering from biliary malignancy or having an immunocompromised state were excluded. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 1700 patients, gallstone was seen in 200 (11.76%) (10.23-13.29, 95% Confidence Interval). Among the 200 patients, 133 of them (66.50%) were females. Multiple gallstones were present in 118 (59%) cases whereas 82 (41%) cases had a single stone. Conclusions: The prevalence of gallstone was found to be similar as compared to other reported literature.Publication Spontaneous Bacterial Peritonitis among Chronic Liver Disease Patients with Ascites Admitted to the Department of Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Mahato, Tarkeshwor; Sharma, Yubaraj; Thapa, SumanAbstract Introduction: Chronic liver disease is a common problem worldwide. Spontaneous bacterial peritonitis is a dreaded complication and has high in-hospital mortality. Few studies have been done about the prevalence of spontaneous bacterial peritonitis and associated clinical and biochemical features in a hospital-based population. The aim of this study was to find out the prevalence of spontaneous bacterial peritonitis in chronic liver disease patients with ascites admitted to Department of Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was done among patients with chronic liver disease with ascites admitted to the Department of Medicine of a tertiary care centre between 18 March 2021 to 28 February 2022 after receiving ethical approval from the Institutional Review Committee (Reference number: PMM2103161493). Convenience sampling method was used. Diagnostic paracentesis was done in every such patient. Point estimate and 95% Confidence Interval were calculated. Results: Among 157 patients, the prevalence of spontaneous bacterial peritonitis was 46 (29.29%) (22.17-36.41, 95% Confidence Interval). The most common presenting symptom was pain abdomen seen in 29 (63.04%). Conclusions: The prevalence of spontaneous bacterial peritonitis in chronic liver disease patients with ascites was similar to studies done in similar settings. Clinicians should be aware that it can present with or without abdominal pain.