Journal Issue: Volume: 19, No 4, Issue 76, OCT.-DEC, 2021
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Volume
Number
Issue Date
2021
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Angiographic Severity of Coronary Artery Disease in Diabetic and Non-diabetic Acute STEMI Patients in a Tertiary Care Centre of Nepal
(Kathmandu University, 2021) Pathak, SR; Gajurel, RM; Poudel, CM; Shrestha, H; Thapa, S; Thapa, S; Koirala, P
ABSTRACT
Background
Patients with diabetes mellitus have a higher prevalence of atherosclerotic heart
disease and a higher incidence of myocardial infarction than the general population.
Definitive diagnosis and precise assessment of anatomic severity of Coronary Artery
Disease requires invasive diagnostic modality like coronary angiography.
Objective
To study angiographic characteristics and severity involving coronary arteries in
patients with acute ST segment elevation Myocardial infarction and to compare the
same in diabetics and non-diabetics.
Method
Among 150 patients with acute coronary syndrome, 75 diabetics and 75 non-
diabetics admitted in Manmohan Cardiothoracic vascular and transplant Centre were
selected randomly during a period of one year formed the study group. Random
Blood Sugar, Fasting Blood Sugar was done in all 150 patients, HbA1c in all diabetics.
All subjects with acute ST Elevation Myocardial Infarction were taken up for coronary
angiography intended for primary PCI.
Result
In our study, 35 (46.7%) out of 75 diabetic patients had triple or multi-vessel
disease compared to 10 (13.4%) out of 75 non diabetics. Non-diabetic patients
had significantly higher single vessel disease (65.3%). There was a statistically
significant association of duration of DM with vessels involved. The occurrence of
Triple Vessel Disease/Multivessel Disease was significantly higher in the patients
with DM duration > 10 years compared to patients with DM duration < 10 years
(64.7% vs. 35.3%, P < 0.001), however there was no significant difference in type of
vessel involved. Similarly, a significantly higher proportion of Triple vessel disease
was observed in patients with poor glycemic control (HbA1c > 8.5%). 72.2% of the
patients with HbA1c > 8.5% had Triple vessel disease/Multi vessel disease, whereas
patients with good glycemic control (HbA1c < 7.0%) had predominantly Single vessel
disease (90.0%), with no occurrence of Triple vessel disease/Multi vessel disease
Conclusion
Diabetic patients presenting with ST Elevation Myocardial Infarction are likely to have
triple/multiple vessel disease compared to non-diabetic patients. The occurrence of
Triple Vessel Disease/Multivessel Disease was significantly higher in the patients with
DM duration > 10 years compared to patients with DM duration <10 years.
KEY WORDS
Diabetes mellitus, Acute coronary syndrome, STEMI, Coronary angiography
Biochemical Parameters in Confirmed Covid-19 Patients: A Hospital Based Study from Eastern Nepal
(Kathmandu University, 2021) Niraula, A; Gelal, B; Lamsal, M; Karki, D; Chhetri, R
ABSTRACT
Background
COVID-19 has posed a global threat to almost every part of the world. The disease
has varied form of presentation and the modern medicine has still not been able to
provide definite treatment for the disease.
Objective
To assess the biochemical parameters in confirmed patients of COVID-19 admitted at
B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal.
Method
This is a retrospective hospital based cross-sectional study conducted in the
Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Dharan from
October to December, 2020. Convenient sampling technique was used to enroll the
data of the patients for whom the biochemical parameters were requested by the
clinicians. Routine biochemical tests were performed in Cobas c311 autoanalyzer.
Result
A total of 202 patients with confirmed COVID-19 infections and admitted at COVID
Hospital, BPKIHS were enrolled. The findings depict an elevated liver enzyme (alanine
aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma
glutamyl transpeptidase and cardiac enzymes (creatine kinase-total and creatine
kinase- MB) in the study population. Increased serum ferritin (1026.08±220.53), hs
CRP (41.52±5.22) and lactate dehydrogenase 360 [303.50-526.75] was found in the
patients. Also, majority of the patients (> 50%) had abnormal biochemical findings.
Conclusion
Biomarkers like C-reactive protein, lactate dehydrogenase and ferritin have shown
significant clinical implications in effective management, monitoring, and assessment
of the severity of disease in COVID- 19 patients. Simple and cost-effective markers
like CRP, LDH, HbA1c could be used for monitoring the severity of COVID-19 infection.
KEY WORDS
Biomarkers, COVID-19, Ferritin, hs-CRP, Inflammation
Correlation of Pelvic Parameters with Isthmic Spondylolisthesis
(Kathmandu University, 2021) Shrestha, S; Lakhey, RB; Paudel, S; Kafle, D; Pokharel, R
ABSTRACT
Background
Spondylolisthesis is one of the major causes of low back pain. The anterior shift of
the vertebra is mostly at L4 and L5 levels. Several types have been described, most
common being the isthmic type. Pelvic parameters are said to be associated with
development and progression of listhesis, and should be evaluated while treating it.
Objective
To study the correlation of Pelvic parameters with isthmic spondylolisthesis.
Method
It was a cross sectional case control study. In 68 cases with Isthmic Spondylolisthesis
and of 34 cases with low back pain without listhesis (control), the spinopelvic
parameters like lumbar lordosis, pelvic incidence, pelvic tilt and sacral slopes were
measured together with degree of slip with lateral radiographs. Findings were
analyzed and compared with control group.
Result
In control group, the pelvic incidence was 50.44±4.78o, the sacral slope was
34.38±6.79o, the pelvic tilt was 15.97±5.31o, and the lumbar lordosis was 46.76±6.78o.
In Isthmic Spondylolisthesis group, the pelvic incidence was 60.85±6.79o, the sacral
slope was 40.40±6.91o, the pelvic tilt was 20.63±7.51o, and the lumbar lordosis was
57.31±7.11o. The difference in spinopelvic parameters amongst control and Isthmic
Spondylolisthesis group was statistically significant (p < 0.001). The degree of slip was
directly proportional to the pelvic incidence angle (grade I=52o, II =62o and III 72.5o).
Conclusion
Spino-pelvic parameters are higher in isthmic spondylolisthesis group and is
significantly associated with severity of the slip.
KEY WORDS
Isthmic spondylolisthesis, Lumbar lordosis, Pelvic incidence, Pelvic tilt, Sacral slope
Study of Echocardiographic Measurements to Estimate the Physiological Cardiac Efficiency in Apparently Healthy Patients Visiting University Hospital for Cardiac Evaluation
(Kathmandu University, 2021) Nepal, O; Humagain, S; Koju, RP
ABSTRACT
Background
Healthy cardiac function is evaluated by echocardiography in the non-invasive
cardiology department. Cardiac functional and structural evaluation is assessed by
cardiologists based on a physiologically defined normal range. We want to compute
the physiological value of variables in the healthy population.
Objective
To compute and compare the recorded echocardiographic parameters among
apparently healthy patients.
Method
This is a retrospective study and a total of 544 subjects whose standard reference
range was within the normal limit are included for computational study. 268 males
(52.8%) and 240 females (47.2%) were studied for the size of the aortic root, size of
the left atrium, left ventricular internal diameter during diastole (LVIDd) and systole
(LVIDs), interventricular septum during diastole and systole (IVSd and IVSs), left
ventricular posterior wall during diastole (LVPWd) and systole (LVPWs) and ejection
fraction (EF).
Result
Ejection fraction (EF) is not significantly different (p=0.14) between genders,
Mean±SD; 70.45±6.7 for females and Mean±SD; 68.34±7.18 for males. The mean
age of examined female patients is Mean±SD; 36.88±12.6 which is not significantly
different with male patients age Mean±SD; 38.28±12.5. Males have larger left
ventricular internal diameter in diastole, Mean±SD; 43.90±6.4 than females
Mean±SD; 41.37±8.08. Ejection fraction for females is Mean±SD; 70.45±6.7, for
males is Mean±SD; 68.34±7.18 with p=0.14.
Conclusion
Absolute echocardiographic measurements vary physiologically between apparently
healthy genders yet the ejection fraction is not significantly different between both
the genders in the examined Nepali population.
KEY WORDS
Diastole, Echocardiography, Ejection fraction, Systole, Ventricular