Browsing by Author "Yadav, Dipendra"
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Publication Anthropometric and Nutritional status of Chronic Obstructive Pulmonary Disease presenting in Acute Exacerbation in Tertiary care Hospital in Eastern Nepal(Nepalese Respiratory Society, 2024) Uprety, Augraj; Pantha, Srijan; Gurung, Kum Bahadur; Aryal, Prakash; Timsina, Anup; Mandal, Dipesh; Hamal, Sangita; Chaudhary, Sabnam; Thakur, Aanad Lohar; Yadav, Krishna Chandra; Shah, Nensi; Yadav, Dipendra; Pandey, Prajwal; Dahal, Sweta; Shahi, Rejina; Mishra, Deebya Raj; Bhatta, NarendraAbstract: Background: There is scarcity of data regarding the nutritional status of COPD patients presenting in exacerbation in our setup, thus this observational study was conducted. Methods: We performed an observational study of patients with acute exacerbation of COPD, who were admitted in the Department of Pulmonary, Critical care and Sleep Medicine in tertiary hospital in eastern Nepal from April 2023 to June 2023. Results: During the study period, a total of 154 patients of COPD with exacerbations were admitted in our department. The baseline anthropometric parameters, lab parameters as well as the malnutrition scores were determined. The mean BMI was 21.82 ± 3.92 kg/m2 and only 29% had BMI < 18.5 kg/m2.The mean hemoglobin, mean cell volume, serum protein, serum albumin, serum calcium, phosphorus and vitamin D level were 12.43 ± 2.32 g/dL, 84.4 ± 9.41 fL, 6.42 ± 1.74 g/ dL, 3.32 ± 0.34 g/dL, 8.98 ± 0.63 mg/dL, 3.02 ± 0.42 mg/dL, 18.48 ± 8.22 pg/mL and 40%, 12%, 28%, 41%, 31%, 42% and 49% of these values were below the lower normal limit respectively. The nutritional status tool used NRS-2002, MUST and MNAS-F screened malnutrition in about 68%, 51% and 54% respectively. There shows a discrepancy between the evaluation of the malnutrition assessed by BMI with that of nutritional assessment score. Conclusion: COPD who present in exacerbations are malnourished, but use of sole BMI to rule out malnutrition in such group of patients can cause false negative result.Publication Potential Drug-drug Interactions among Hospital Discharge Prescriptions in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study Authors(Nepal Medical Association, 2022) Bhandari, Bijay; Lamichhane, Pratik; Yadav, Dipendra; Bajracharya, Sangha RatnaAbstract: Introduction: In our setup, potential drug-drug interactions are overlooked in routine clinical practice. In general, most of the discharges are handwritten in the developing world, and the discharge prescriptions are not checked with the database for potential drug-drug interactions checker. This study aimed to determine the prevalence of potential drug-drug interactions in the prescribed drugs in clinical practice in a tertiary care centre of Nepal. Methods: A descriptive cross-sectional study was conducted in a tertiary care center from October 2019 to December 2019. Ethical approval was taken from the Institutional Review Committee (Reference number: 394(6-11)E2/075/76). Through simple random sampling, the data about drug prescription was collected from the patient discharge records of the Department of Internal Medicine. The potential drug interactions were checked by using Lexicomp® drug interactions. Data was analysed using Statistical Package for the Social Sciences version 20.0. Point estimate at 95% Confidence Interval was calculated along with frequency, percentage, mean, standard deviation and mode. Results: Among 382 discharge prescriptions, the prevalence of potential drug-drug interactions was 299 (78.3%) (74.1-82.4 at 95% Confidence Interval). A total of 1519 drug interactions with a mean of 5.08±3.89 drug interactions per prescription was identified. The major, moderate and minor drug-drug interactions according to the severity were found to be 163 (10.7%), 1162 (76.5%), and 178 (11.7%) respectively. Conclusions: The prevalence of potential drug-drug interactions is high among the patients on discharge compared to similar studies. Use of drug-drug interactions checker databases before discharge with computer-based discharge prescriptions is recommended.Publication Varicella Pneumonia in Young Adult Male: A Case Report(Nepalese Respiratory Society, 2024) Uprety, Augraj; Pantha, Srijan; Gurung, Kum Bahadur; Aryal, Prakash; Timsina, Anup; Mandal, Dipesh; Yadav, Krishna Chandra; Shah, Nensi; Yadav, Dipendra; Pandey, Prajwal; Dahal, Sweta; Shahi, Rejina; Mishra, Deebya Raj; Bhatta, NarendraAbstract: Varicella infection is a common disease in pediatric age group but is uncommon in adult. Varicella pneumonia is the dreaded complication in these patients leading to mortality, which is more pronounced in adult patients. This is a case report of a young adult male, presenting with Varicella pneumonia in severe hypoxic respiratory failure, which was successfully managed with oxygen therapy, acyclovir, and steroids.