Browsing by Author "Yadava, SK"
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Publication Measurement of Right Atrial Volume and Diameters in Healthy Nepalese with Normal Echocardiogram(Kathmandu University, 2014) Karki, DB; Pant, S; Yadava, SK; Vaidya, A; Neupane, DK; Joshi, SABSTRACT Background The size of right atrium is expected to be different in diverse healthy ethnic groups. It is important to know the normal size of right atrium in our healthy population. Objective The study aimed to find out the normal values of right atrial volume, right atrial short axis diameter and right atrial long axis diameter in healthy Nepalese population with normal echocardiographic findings. It also looked at correlations between right atrial dimensions and the right atrial volume. Method Verbal consent was taken from all the participants. One hundred participants between the age of 18 and 60 years with normal echocardiographic findings and without any chronic disease were included in this study. Right atrial volume was measured by using area length method. Right atrial short axis diameter and Right atrial long axis diameter were measured in the four chamber view. Result The mean right atrial volume was 23.64±5.36 ml (range 11.30 - 40.00 ml).The range of right atrial short axis diameter and right atrial long axis diameter were 1.34-3.80 cm and 2.4-4.7 cm respectively. Conclusion The size of right atrium in the Nepalese population is smaller compared to western population. Male right atrial volume size is greater than female in Nepalese population similar to western population. The findings of normal value of right atrial volume and right atrial diameter in Nepalese population will help the physician to assess patients with various conditions affecting the right atrium. KEY WORDS Nepalese population, right atrial short axis diameter, right atrial long axis diameter, right atrial volume.Publication Prevalence of Diastolic Dysfunction in Type 2 Diabetes Mellitus(Kathmandu University, 2017) Yadava, SK; Dolma, N; Lamichhane, G; Poudel, N; Barakoti, M; Karki, DBABSTRACT Background Diastolic dysfunction is an inability of the ventricle to fill to a normal end-diastolic volume, both during exercise as well as at rest. Diabetes mellitus increases the risk of heart failure even in the absence of other co-morbidities. Objective To find the prevalence of diastolic dysfunction in patients with type 2 diabetes mellitus and its association with age, gender, duration, glycosylated hemoglobin levels, dyslipidemia, tobacco smoking and alcohol consumption. Method Ninety patients with type 2 diabetes mellitus of both genders, aged 30 to 60 years, were included in this study. Doppler echocardiography was performed to evaluate diastolic dysfunction. Result The mean age of the study population was 46.21 ± 9.20 yrs. The overall prevalence of diastolic dysfunction in the study population was 47.8%. The prevalence of diastolic dysfunction increases with age: 23.1% in patients of age 30 – 39 yrs to 65.8% in patients of age 50 – 60 yrs (adjusted OR 0.16, 95% CI 0.04 - 0.64, P = 0.010) and with the duration of diabetes: 32.8% in patients with diabetes for <5 yrs to 75% in patients with diabetes for >10 yrs (adjusted OR 0.31, 95% CI 0.08 - 1.00, P = 0.05). There was no significant association between diastolic dysfunction and dyslipidaemia, BMI, tobacco smoking, alcohol consumption, HbA1c and gender. Conclusion Prevalence of diastolic dysfunction in type 2 diabetes mellitus was 47.8% in our study. A rising trend of prevalence of diastolic dysfunction with the duration of diabetes and increasing age of patients was observed. KEY WORDS Diastolic dysfunction, Prevalence, Type 2 diabetes mellitusPublication Prevalence of Sensory Neuropathy in Type 2 Diabetes Mellitus and Its Correlation with Duration of Disease(Kathmandu University, 2016) Karki, DB; Yadava, SK; Pant, S; Thusa, N; Dangol, E; Ghimire, SABSTRACT Background Peripheral neuropathy is one of the most common and distressing late complication of diabetes mellitus. Ignorance of the complications may develop foot ulcers and gangrene requiring amputation. Objective The main objective of this study is to find out the prevalence of sensory neuropathy in type 2 diabetes mellitus and to compare it with the duration of disease. Method Two hundred seventy one patients with type 2 diabetes mellitus of both gender age 30 years and above willing to participate were included in this study. Patients having hypothyroidism, rheumatoid arthritis, B12 deficiency, cerebrovascular disease, chronic musculoskeletal disease, Parkinson’s disease, alcohol abuse, chronic renal or liver failure and cancer were excluded from the study. Touch, pin prick and vibration sensation were tested. Vibration perception threshold was recorded from six different sites of the sole of each foot using Biothesiometer. Result Two hundreds seventy one type 2 diabetic outpatients were studied. The mean age was 59.81±22.85 years. The overall prevalence of diabetic sensory neuropathy in the study population was 58.70%. A rising trend of diabetic sensory neuropathy with increasing age and duration of diabetes was observed. Neuropathy was found more in patients having urinary microalbuminuria. Burning and pins and needles sensation were most common symptoms. Conclusion The overall prevalence of diabetic sensory neuropathy in the study population was 58.70% (mean age 59.81±22.85 yrs), and its prevalence increased with duration of diabetes and increasing age. Its prevalence was found more in patients having microalbuminuria. KEY WORDS Biothesiometer, sensory neuropathy, type 2 diabetes mellitusPublication Relation between Serum Intact Parathyroid Hormone Level and Hematocrit in Chronic Kidney Disease Patients(Kathmandu University, 2015) Adhikary, LP; Pokhrel, A; Yadava, SK; Khadka, D; Thakur, RABSTRACT Background Anemia is a common complication of chronic kidney disease. There are various causes of anemia in chronic kidney disease patients on hemodialysis. Secondary hyperparathyroidism is one of the less recognized causes of anemia in chronic kidney disease patients. Objectives The main objective of the study is to find the correlation between intact parathyroid hormone and hematocrit level in chronic kidney disease (CKD) patients undergoing hemodialysis. Method Verbal consent was taken from all the participants. Eighty participants between the age of 29 and 70 years with chronic kidney disease having indication of hemodialysis were included in this study. Hematocrit was measured by bioelectrical impedance method and serum intact parathyroid hormone was by using Chemi Luminescence Immuno Assay (CLIA) method. Result A weak reverse correlation was found between serum intact parathyroid level and hematocrit (r= -0.33). Conclusion In chronic kidney disease patient, there is reverse correlation between level of serum intact parathyroid and hematocrit level. This association may have clinical relevance in assessing the cause of unexplained low hemoglobin level in CKD patients. KEY WORDS Anemia, chronic kidney disease, hematocrit, intact parathyroid hormone, secondary hyperparathyroidism.