Journal Issue: Volume: 22, No 3, Issue 87 (JULY-SEPTEMBER) 2024
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Volume
Number
Issue Date
2024
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Co-infection of COVID-19 with Malaria and Dengue -A Hospital based Study in Kathmandu, Nepal
(Kathmandu University, 2024) Bajracharya, B; Shrestha, P; Shrestha, D; Karna, AK; Mahato, RK; Shrestha, S; Baral,B; Bhandari, P; Sah, P; Bastola, A; Pandey, BD
ABSTRACT
Background
In tropical countries like Nepal, the COVID-19 pandemic unfolded within a population
already grappling with various tropical infectious diseases. Co-infection with malaria
and dengue holds clinical significance when managing COVID-19 patients in regions
endemic to these diseases.
Objective
To identify malaria and dengue infections in febrile or symptomatic patients suspected
of COVID-19 at the Sukraraj Tropical and Infectious Disease Hospital, Kathmandu.
Method
Over two months, a prospective study was conducted on febrile or symptomatic
patients suspected of COVID-19 visiting Sukraraj Tropical and Infectious Disease
Hospital, Kathmandu. One hundred and twenty-three patients suspected of
COVID-19 were tested for SARS-CoV-2 through RT-PCR as well as for malaria and
dengue infection using rapid diagnostic test kits.
Result
Out of 123 patients suspected of COVID-19, 64 were confirmed to have COVID-19. No
evidence of SARS-CoV-2 and malaria co-infection was found among the 123 tested
patients. However, two patients admitted for COVID-19 tested positive for dengue
virus infection. The patients with co-infections with dengue or scrub typhus were
likely to have a longer hospital stays (OR 2.5; 95% CI: 0.22-29.26), though lacking a
significant association.
Conclusion
The two patients diagnosed with dengue virus and SARS-CoV-2 were identified
during their hospital visit and both recovered after receiving treatment. Given that
COVID-19 patients manifest symptoms resembling many tropical infectious diseases,
the study underscores the clinical importance of testing for multiple circulating
infections in patients from endemic areas. This approach ensures appropriate and
timely management reducing the risk of severity or mortality.
KEY WORDS
Co-infection, COVID-19, Dengue, Malaria, Nepal
Correlation between Computed Tomography and Ultrasonography Findings in Patients with Fatty Liver
(Kathmandu University, 2024) Kayastha, P; Paudel, S; Chapagain, P; Shingh, SS; Adhikari, B; Joshi, S; Katwal, S
ABSTRACT
Background
Fatty liver disease, linked to obesity, alcohol consumption, and insulin resistance,
is characterized by pathological fat deposition exceeding 5%. Its rising global
prevalence, particularly in Southeast Asia, highlights the need for effective diagnostic
modalities.
Objective
To find the correlation between computed tomography and ultrasonography findings
in patients with fatty liver.
Method
A prospective cross-sectional study was conducted on 211 patients from December
2016 to October 2017. Patients referred for computed tomography chest and
abdomen were included, excluding those with diffuse or focal liver disease other
than fatty liver. Computed tomography attenuation values were measured using non-
contrast sequences, with participants showing mean hepatic attenuation less than
+48 Hounsfield units subjected to further ultrasound and shear wave elastography
examinations. Data were analyzed using Microsoft Excel and SPSS, with associations
examined through Pearson correlation, ANOVA and Shapiro-Wilk test.
Result
The study included 100 males and 111 females, aged 21 to 65 years. The mean
computed tomography attenuation was +40.31 Hounsfield units. A moderately
strong negative correlation was found between Computed Tomography attenuation
and ultrasound grades of fatty liver (Spearman’s coefficient = -0.775, p = 0.005). No
significant correlation was observed between computed tomography attenuation and
shear wave elastography values, nor between patient age and hepatic attenuation.
Conclusion
This study demonstrates a significant correlation between computed tomography
attenuation and ultrasound grades of fatty liver, highlighting their complementary
roles in diagnosing fatty liver disease. However, no significant correlation was found
between computed tomography attenuation and shear wave elastography values.
KEY WORDS
Attenuation, Computed tomography, Elastography, Fatty liver, Ultrasound
Root Canal Morphology of Mandibular Premolars in a Nepalese Population: A Cone-Beam Computed Tomographic Study
(Kathmandu University, 2024) Chakradhar, A; Nepal, M; Pradhan, SP; Bali, H; Napit, R
ABSTRACT
Background
Mandibular premolars are the most challenging teeth to treat endodontically
because of their variability in morphological and internal anatomical features. The
knowledge of root canal morphology and its variation is crucial for the endodontic
success.
Objective
To evaluate the root and canal morphology of mandibular premolars in a Nepalese
population by using Cone Beam Computed Tomography.
Method
A total of 1924 mandibular first and second premolar teeth from 481 patients
were evaluated. The number of roots and canal configuration were identified and
categorized according to Vertucci’s classification. An association between number
of roots and root canal configuration with gender and ethnic group was evaluated.
Also, the bilateral symmetrical occurrence of root and canal configuration were
investigated.
Result
Majority of mandibular first premolars (86.7%) and second premolars (98.7%) were
single rooted with type I root canal configuration followed by type V (8.6%) in first
premolars and type III (0.6%) in second premolars while 3.8% of first premolars
and 0.6% of second premolars were two rooted. In first premolars, there was an
association between gender with number of roots (p-value = 0.007) and root canal
configuration (p-value < 0.001). High degree of bilateral symmetry was seen in both
first (85.4%) and second premolars (96.9%) in terms of the number of roots and canal
configuration.
Conclusion
Most of the mandibular premolars were single rooted with Type I canal configuration.
However, clinicians should be aware of the variations that may be encountered
during routine endodontics which may influence the success behind treatment.
KEY WORDS
Cone-beam computed tomography, Mandibular premolars, Root canal configuration
Development of a Model One Stop Approach to Post-COVID-19 and other Rehabilitation Conditions
(Kathmandu University, 2024) Adhikari, P; Tamrakar, D; Thakur, C; Shakya, R; Vaidya, N; Acharya, R; Shrestha, J; Byanju Shrestha, I
ABSTRACT
Background
Post-COVID-19 cases can cause severe disabling symptoms and functional disabilities.
WHO recognizes the severity of the condition and publishes a standardised Case
Report Form to inform clinical management and public health response.
Objective
To determine the post-COVID-19 case load. A multidisciplinary team including a
diverse team were composed and priority intervention areas were identified through
a transdisciplinary approach eventually developing a Model One Stop Approach to
post-COVID-19 and other Rehabilitation Conditions.
Method
The COVID-19 cases recorded at Dhulikhel Hospital were monitored through phone
calls to post-COVID-19 complications. Patients were then invited for additional
clinical assessments. A diverse team conducted these assessments to identify the
needs for expanding a post-COVID-19 clinic and devised rehabilitation services based
on predefined criteria.
Result
A total of 550 respondents were included in the study. The proportion of males
(51.7%) was slightly higher than females (48.3%) with the majority of them being
Brahmin/Chettri. The primary comorbidities identified were diabetes (10.55%) and
hypertension (11.4%). Of the participants, about 50.73% experienced persistent
symptoms. About 17.8% reported lasting muscle-related problems, 12.1% had
persistent joint pain, and 33% faced temporary cardiac issues. Less than 10%
experienced enduring health problems related to vision, hearing, and sleep patterns.
Conclusion
After COVID-19, patients experienced cardiac and muscle-related issues, increasing
morbidity, financial burdens, and pressure on healthcare systems. With the need of
sustainable rehabilitation training package, Dhulikhel Hospital serves as a model for
a One-Stop Approach to post-COVID-19 and other rehabilitation conditions.
KEY WORDS
Model, Persistent, Post-COVID-19, Rehabilitation, Symptoms