NepMed Repository :: Browsing by Author "Tiwari, Sanjeeb"

Browsing by Author "Tiwari, Sanjeeb"

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Admission Rate of Patients Visiting Emergency Department in a Tertiary Care Center in Kathmandu: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2024) Tiwari, Sanjeeb; Tiwari, Jyotshna Sharma; Jha, Jay Bhushan; Regmi, Sushant; Yadav, Dhirendra; Kafle, Ravi; Khanal, Inesh; Shrestha, Aakripa Rani; Shrestha, Shubham; Shakya, Yagya Laxmi; Maharjan, Ramesh Kumar; Gupta, Sanjaya Kumar
Abstract Introduction: Emergency departments serve as the initial point of contact for patients with a wide range of conditions. Not all patients visiting get admitted to the hospital. The admission rate varies from 20% in the United States to 40.83% in Nepal. Given the variability in these results across different regions, there is a need to better understand the admission rates from the Emergency Department. Methods: A descriptive cross-sectional study was conducted after obtaining ethical approval( Reference Number: 58 (6-11)E2 081/082) in the Emergency Department of a tertiary health care center. Retrospective data was collected from the data register. The data from April 2023 to April 2024 was collected. A sample size of 222 was calculated and convenience sampling was done. Demographic details like age, sex, and data regarding admission status were collected. Data was collected in MS Excel and was analyzed using JASP software. Results: Out of 222 patients that presented to the emergency department, 53 (23.87%)(18.26-29.47,95 % Confidence Interval) were admitted to the ward or intensive care unit of the hospital, whereas 167 (75.23) got discharged, 1 (0.45%) was brought dead and 1 (0.45%) expired. The median age of patients was 43 (IQR: 26-62). The admission rate of females was 20 (17.24%), whereas for males it was 33 (31.13%). Conclusions: The prevalence of admission of patients visiting the emergency department was higher than similar US based studies. There was a higher percentage of female patients presenting to theemergency department, while those being admitted were mostly males.
Hyponatremia in Patients Admitted to Intensive Care Unit of a Tertiary Center: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Parajuli, Suraj; Tiwari, Sanjeeb; Gupta, Sanjay Kumar; Shakya, Yogendra Man; Shakya, Yagya Laxmi
Abstract Introduction: Hyponatremia is one of the common electrolyte abnormalities in intensive care unit settings. Hyponatremia may lead to an increased hospital stay, morbidity and mortality. Hyponatremia can occur due to a variety of iatrogenic as well as part of complex disease processes during hospital admission. The objective of this study was to find the prevalence of hyponatremia in patients admitted to the intensive care unit of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the intensive care unit of a tertiary care centre for a duration of six months from 12 August 2015 to 11 January 2016. Ethical approval was taken from the Institutional Review Committee (Reference number: 124/6-11-E/072/073). Data was collected from hospital records. Patients with abnormal serum sodium levels after admission to the intensive care unit were included in the study. Hyponatremia was defined as a serum sodium level less than 135 mEq/L. Convenience sampling methods were used. Point estimate and 95% Confidence Interval were calculated. Results: Among 102 patients, the prevalence of hyponatremia was found to be 21 (20.59%) (12.74-28.44, 95% Confidence Interval). Conclusions: The prevalence of hyponatremia in patients admitted to the intensive care unit was higher than in other studies conducted in similar settings.
Hypovitaminosis D among Adult Patients Visiting for General Health Check-up in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2024) Tiwari, Sanjeeb; GC, Saroj; Shrees, Vijay; Maharjan, Sujata; Sherpali, Aakash; Bhandari, Khagendra; Oli, Suman
Abstract Introduction: Vitamin D deficiency presents a notable public health concern, with reported prevalence rising in hospital and community settings. It's linked to various chronic health issues and most often remains undiagnosed in developing nations. This study aimed to determine the prevalence of hypovitaminosis D among adults attending general health check-ups at a tertiary care hospital. Methods: This descriptive cross-sectional study was conducted among adult patients visiting for general health checkups in a tertiary care centre. The patients' data from 16 April 2023 to 24 November 2023 was retrieved from the hospital record. Serum 25(OH)D was measured by using the chemiluminescence micro particles immunoassay technique and classified as deficient, insufficient, and sufficient with values <20 ng/ml, 20–29 ng/ml, and 30–100 ng/ml, respectively. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of 357 adult patients, 291 (81.51%; 95% CI: 77.49%-85.54%) Confidence Interval) had hypovitaminosis D. Among them 124 (42.61%) were categorised as vitamin D insufficient and 167 (57.39%) as deficient. The mean age of patients was 43.25±12.99 years, with 205 (70.45%) female and 86 (29.55%) male. A total of 169 (58.08%) individuals were classified as obese. Dyslipidemia was observed in 249 (85.57%) patients, with 94 (32.30%) exhibiting hypercholesterolemia. Conclusions: The prevalence of hypovitaminosis D was higher than other studies done in similar settings. This higher prevalence necessitates public awareness of vitamin D's importance, urging proactive screening and management by physicians and implementation of cost-effective guidelines by policymakers.
Thyroid Disorders in Patients with Polycystic Ovarian Syndrome in a Tertiary Care Center: An Observational study
(Nepal Medical Association, 2024) Sharma, Jyotshna; Mahat, Bimita; Tiwari, Sanjeeb; Singh, Niraj Kumar; Thapa, Durga; Yadav, Ranjana
Abstract Introduction: Polycystic ovarian syndrome is the most common endocrine and metabolic disorder in women of childbearing age, affecting 3–15% of women worldwide, leading to reproductive, metabolic, and psychological issues. Patients with polycystic ovarian syndrome require rigorous thyroid function detection, monitoring, and correction over time. In this study, we aimed to evaluate the clinical presentations and thyroid dysfunction in patients with polycystic ovarian syndrome. Methods: An observational study was done in patients with polycystic ovarian disease presenting to a tertiary care centre over six months, from December 2023 to May 2024 Total population sampling was done. All the women during the study period diagnosed with polycystic ovarian disease based on Rotterdam criteria were included in the study after getting ethical approval from the institutional review board. (Reference number: 20102023/03). Results: The mean age of women in the study was 24.74±5.01 years. A total of 28 (31.46%) patients of polycystic ovarian disease had hyperthyriodism, hypothyroidism was found in 13 (14.60%) and subclinical hypothyroidism was found in 6 (6.74%) patients. All the women had menstrual irregularities. Regarding androgenic characteristics, 53 (59.55%) of patients presented with hirsutism, 43 (48.51%) presented with acne, 13 (14.61%) women had alopecia, and 4 (4.49%) women had acanthosis. Conclusions: Hyperthyroidism, hypothyroidism and subclinical hypothyroidism were prevalent in polycystic ovarian disease patients, emphasizing the need for thorough thyroid evaluation in polycystic ovarian disease patients due to its impact on metabolic and reproductive health. High rates of menstrual irregularities, androgenic symptoms like hirsutism and acne, and fertility challenges were also prevalent, aligning with findings from similar studies.
Vaginal Microflora in High Vaginal Swab in Prelabour Rupture of Membrane: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2024) Sharma, Jyotshna; Tiwari, Sanjeeb; Thapa, Durga; Yadav, Ranjana
Abstract Introduction: Premature rupture of membrane (PROM) refers to the disruption of the fetal membrane before the beginning of labor, resulting in spontaneous leakage of amniotic fluid. Cervicovaginal infection is an important risk factor of PROM and can lead to complications to mother and the child. This study aimed to delineate the bacterial patterns found in PROM so that the ideal appropriate responsive antibiotics can be chosen. Methods: A descriptive cross-sectional was done during the period of 6 months from December of 2023 to May 2023, to characterize the microorganisms in the vaginal fluid found in antenatal women presenting with premature rupture of membraneafter obtaining ethical approval (IRC number: 20102023/02). A total of 117 antenatal women diagnosed with premature rupture of membrane were included in the study. High vaginal swabs were collected for microbial culture and sensitivity. Data were entered using Microsoft Excel 2000 (v9.0) and Statistical Package for the Social Sciences (SPSS) software version 26.0 was used for analysis. Results: Out of 117 samples, culture growth was present in the culture of high vaginal swabs of 23 (19.66%) women. The high vaginal swab cultures from the samples collected in women presenting with PROM reported 9 different types of pathogens E. coli in 12 (52.17%), Klebsiella in 4 (17.39%) and Pseudomonas in 2 (8.70%) cultures. Conclusions: This study reveals diverse microorganisms in premature rupture of membrane cases, with E. coli being the most common. Identifying these bacterial patterns is essential for selecting effective antibiotics, improving maternal and neonatal outcomes, and reducing morbidity and mortality by early detection and treatment of vaginal infections.

Browsing by Author "Tiwari, Sanjeeb"

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