Browsing by Author "Yadav, Devesh Kumar"
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Publication Diagnostic Yield of Bronchoalveolar Lavage in Nepalese Patients Presenting with Chronic Cough with Normal Radiological Imaging in Tertiary Care Hospital(Nepalese Respiratory Society, 2022) Shahi, Rejina; Bhatta, Narendra; Mishra, Deebya Raj; Verma, Avatar; Upreti, Augraj; Aryal, Prakash; Yadav, Devesh Kumar; Regmi, GunjanAbstract: Background: Cough is one of the most common symptoms that lead patients to seek medical attention. The diagnosis of chronic cough is complex and challenging. In our setting, a large proportion of patients with cough are treated empirically without a definite diagnosis. Despite investigation and treatment, fiberoptic bronchoscope with bronchoalveolar lavage (BAL) has been shown to be a useful technique in a selected group of patients with unexplained chronic persistent cough. The aim of the study was to determine the diagnostic yield of bronchoalveolar lavage in Nepalese patients presenting with chronic cough with normal radiological imaging. Methods: This was a hospital based cross sectional study. The patients presenting with chronic cough (>8 weeks) with normal radiological imaging were enrolled in the study. Results: 1 patient (2.6%) sputum sample for AFB was negative however BAL sample of the same patient sent for Gene xpert came positive for Mycobacterium Tuberculosis, 5 patients (12.8%) had positive BAL culture, 29 patients (74.4%) had normal cellular pattern in BAL Cytology. Conclusion: Diagnostic yield of BAL was very low for chronic cough in our study. Patient presenting with eosinophilic pattern in BAL had cough variant asthma suffer from non-productive cough in the absence of other asthma symptoms such as dyspnea and wheezing. Thus, though fiberoptic bronchoscope with BAL is indicated in chronic cough of unknown etiology, its diagnostic yield is lowPublication Metabolic Signature and Obstructive Sleep Apnea in Nepalese Patients(Nepalese Respiratory Society, 2023) Verma, Avatar; Bhatta, Narendra; Mishra, Deebya Raj; Shahi, Rejina; Uprety, Augraj; Aryal, Prakash; Yadav, Devesh Kumar; Lama, UrmilaAbstract: Introduction: Untreated Obstructive Sleep Apnea (OSA) causes sleep related symptoms and also causes increased incidence of RTA, cardiovascular diseases and all cause mortality. Currently OSA has been recognized as the consequence of number of interrelated metabolic and oxidative pathologies. As there are limited data of association of OSA with metabolic stress and its correlation with severity of OSA, study of metabolic profile of these patients in view of defining the Metabolic signature of OSA was carried out in eastern Nepal. Objectives: To study metabolic profile of OSA and its association with clinical severity. Methods: Hospital based descriptive cross sectional study. Biochemical profile results related to metabolic –oxidative pathway of the OSA patients were obtained. Quantitative and qualitative data were obtained. Quantitative data were compared using Mann–Whitney test while qualitative variables compared using Pearson χ2. Correlation was carried out using Pearson and Spearman’s test. P-value<0.05 considered significant. Results: 33 patients of OSA were enrolled. Majority of patients had deranged metabolic and oxidative parameters despite mild OSA. Among metabolic stress parameters, most commonly deranged were decreased high density lipoprotein (HDL), increased mean arterial pressure (MAP), waist circumference (WC) and raised fasting blood sugar (FBS). Increased MAP and increased WC was significantly corelated with severity. Conclusion: Besides symptom complex, OSA is also harbinger of metabolic stress that can lead to various cardiometabolic diseases and premature mortality thus early recognition and treatment can mitigate these consequences.