Advances in internal medicine最新文献

{"title":"Risk factors and incidence of contrast-induced acute kidney injury associated with diagnostic or interventional coronary angiography","authors":"A. Maskey, R. Kafle, Sudip Lamsal","doi":"10.3126/jaim.v9i1.29162","DOIUrl":"https://doi.org/10.3126/jaim.v9i1.29162","url":null,"abstract":"Background and Aims: Coronary angiography/ interventions depend on iodinated contrast media (CM) and consequently pose risk of contrast-induced acute kidney injury (CI-AKI). This is an important complication that accounts for a significant number of cases of hospital-acquired kidney injury, with adverse effects on prognosis and health care. This study aimed to assess incidence and evaluate risk factor CI-AKI associated with diagnostic or interventional coronary angiography. Methods: A prospective cross sectional observational hospital based study was conducted. All patients undergoing percutaneous coronary angiography in Manipal Teaching Hospital from May 1, 2019 to April 31, 2020 were included in this study. Appropriate statistical tests were used to analyse results and P <0.05 was considered statistically significant. Results: We evaluated a total of 155 patients. Among them, 90 (58%) were male and 65 (42%) female. The mean age of patients was 62.74 ± 13.9 years. Overall incidence of contrast induced acute kidney injury was 15.48%. CI-AKI was observed to be more common in patient with advance age and diabetes. Apart from advance age and diabetes, none of the other conventional risk factors such as hypertension, anaemia, volume of contrast, baseline chronic kidney disease found to have a significant association with incidence of CI-AKI. None of the patients in our study required renal replacement therapy, and there was no mortality. Conclusion: The overall incidence of CI-AKI after coronary intervention in this study is high. Patients with advance age and diabetes were at high risk of CI-AKI. Abhishek Maskey1*, Ram Chandra Kafle1, Sudip Lamsal2","PeriodicalId":75443,"journal":{"name":"Advances in internal medicine","volume":"9 1","pages":"21-24"},"PeriodicalIF":0.0,"publicationDate":"2020-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/jaim.v9i1.29162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47711742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A young female with double mechanical prosthetic heart valves presenting with coronary embolism-a rare case report","authors":"S. Adhikari, R. Gajurel, Chandra Mani Paudel, S. Devkota, S. Shakya, S. Thapa, V. Yadav, Manju Sharma","doi":"10.3126/jaim.v9i1.29167","DOIUrl":"https://doi.org/10.3126/jaim.v9i1.29167","url":null,"abstract":"Coronary embolism is a very uncommon cause of acute coronary syndrome and it can have multiple etiologies. The common etiologies include infective endocarditis,atrial fibrillation,prosthetic heart valve thrombosis.There are other less common causes such as iatrogenically induced emboli,atrial myxoma,malignancies.1The incidence of coronary embolism is around 0.06%.2-3 As per literatures,coronary embolism can occur even with normally functioning prosthetic valves when associated with suboptimal anticoagulation.4 The left anterior descending artery (LAD) is the most common artery to be involved.1 Coronary embolism is responsible for acute coronary syndrome in about 2.9 % of cases.5","PeriodicalId":75443,"journal":{"name":"Advances in internal medicine","volume":"9 1","pages":"37-39"},"PeriodicalIF":0.0,"publicationDate":"2020-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/jaim.v9i1.29167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44285081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noninvasive assessment of liver fibrosis in Nonalcoholic Fatty Liver Disease in Nepal","authors":"M. Sah, B. Basnet, N. Poudyal, N. Karki, R. Shrestha","doi":"10.3126/jaim.v9i1.29163","DOIUrl":"https://doi.org/10.3126/jaim.v9i1.29163","url":null,"abstract":"NAFLD is the most common form of liver disease and a leading cause of morbidity and mortality in both developed and developing countries.2 NAFLD progresses to liver fibrosis and ultimately cirrhosis and its complication. So early diagnosis and timely treatment of fibrosis is important to prevent cirrhosis related complications, mortality and healthcare cost. Cardiovascular disease is the leading cause of death in people with NAFLD.1 Abstract Background and Aims: Nonalcoholic Fatty Liver Disease (NAFLD) progresses to liver fibrosis and ultimately cirrhosis and its complications. Grading of liver fibrosis 2D SWE (Shear Wave Elastography) is a noninvasive study of liver fibrosis and stiffness. We compared different fibrosis scores (NAFLD fibrosis score, FIB 4 score, APRI score) and ultra-sonogram identified fatty liver with 2 d shear wave elastography score. Methods: A hospital based prospective observational study was conducted from May 2019 for ten months period in the Gastroenterology and Liver Unit, NAMS, Nepal. Seventy patients with known fatty liver and its severity were identified by Ultrasonogram criteria were enrolled, who met the exclusion criteria. All patients underwent 2D shear wave elastography. Patients were evaluated for effects of obesity, diabetes mellitus, thyroid related disease and dyslipidemias on NAFLD. Tests were done to calculate different fibrosis scores (NAFLD Fibrosis, FIB4, APRI, AST/ALT ratio) and compared with 2d shear wave score. Results: Baseline Characteristics among 70 patients 39(55.7%) were male and 31(44.3%) were female with mean age of the patients 44.3 years. Most of the patients were overweight with mean BMI of 28.2, kg/m2among them 51(72.9%) patients were more than 25.kg/m2Most of the patients 41.4% had diabetes mellitus, 77.1% had hypertension, 30% had hypothyroidism and were 25.9% had metabolic syndrome. Majority of patients on ultrasound gradings were mild 64.28%, 25.72% were moderate and only 10 % were in severe groups. In comparison ultra-sonogram with 2 d shear wave elastography, mild grade mean fibrosis 7.07 kpa, for moderate grade mean fibrosis 8.22 kpa and for severe grade mean fibrosis was 18.16 kpa. Conclusion: In patients with NAFLD, measurement of liver stiffness by 2d shear wave elastography has positively correlated with fib-4 score and non-inferior to NAFLD fibrosis score. The mean value of elastography increases significantly with the severity of steatosis on ultrasonography. . Manoj Kumar Sah*, Bhupenndra Kumar Basnet, Nandu Silwal Poudyal, Niyanta Karki, Roshan Shrestha","PeriodicalId":75443,"journal":{"name":"Advances in internal medicine","volume":"9 1","pages":"25-28"},"PeriodicalIF":0.0,"publicationDate":"2020-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/jaim.v9i1.29163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48250694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19: a global pandemic causing local threat in Nepal","authors":"J. Koirala, S. Basnet","doi":"10.3126/jaim.v9i1.29154","DOIUrl":"https://doi.org/10.3126/jaim.v9i1.29154","url":null,"abstract":"Coronavirus, first described in 1966, is known to cause mild respiratory illnesses in humans. However, more virulent form of coronaviruses causing serious respiratory illnesses were identified in the past 2 decades. SARS-CoV (coronavirus) caused outbreaks of severe acute respiratory syndrome (SARS) in 29 countries between 2002-2004. MERS-CoV, which was first identified in 2012, caused Middle East respiratory syndrome (MERS) with high mortality. The current pandemic Coronavirus Disease 2019 (COVID-19) was identified in December 2019 after a cluster of patients with pneumonia of unknown etiology leading to ARDS (Acute Respiratory Distress Syndrome) were admitted in Hubei Province of China. It was subsequently linked to the seafood and wet animal market of Wuhan, China.1,2","PeriodicalId":75443,"journal":{"name":"Advances in internal medicine","volume":"9 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2020-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46521654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Extraction of CBD Stone: single centre experience in tertiary care centre","authors":"Arun Gnawali, R. Pathak, R. Pandey, P. Khadga, Sashi Sharma, A. Jha, R. Hamal, D. Koirala","doi":"10.3126/jaim.v9i1.29164","DOIUrl":"https://doi.org/10.3126/jaim.v9i1.29164","url":null,"abstract":"Introduction Cholelithiasis is an endemic condition in both Western and Eastern countries, affecting upto 20% of the general population.1 11 to 21% of patients with cholelithiasis also have concomitant common bile duct(CBD) stones.2-4 Studies regarding the natural history of choledocholithiasis indicate that 21% to 34% CBD stones will spontaneously migrate and migrating stones pose a moderate risk of pancreatitis (25% to 36%)5, 6 or cholangitis if they obstruct the distal bile duct. ERCP with endoscopic sphincterotomy (ES) Abstract","PeriodicalId":75443,"journal":{"name":"Advances in internal medicine","volume":"9 1","pages":"29-33"},"PeriodicalIF":0.0,"publicationDate":"2020-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/jaim.v9i1.29164","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41632183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on community health: A systematic review of a population of 82 million","authors":"B. Sathian, M. Asim, Ahammed A Mekkodathil, E. V. Teijlingen, S. Subramanya, P. Simkhada, S. Marahatta, U. Shrestha","doi":"10.3126/jaim.v9i1.29159","DOIUrl":"https://doi.org/10.3126/jaim.v9i1.29159","url":null,"abstract":"The novel coronavirus disease 2019 (COVID-19) outbreak, caused by the pathogenic severe acute respiratory syndrome-2 (SARS-CoV-2) virus, is exponentially spreading across the globe. As there is paucity of published literature, the influence of COVID-19 on community health remains unclear. Therefore, we aimed to conduct a systematic review of the literature on the impact of COVID-19 on community health. The current systematic review was performed utilizing electronic databases, i.e., PubMed, MEDLINE, and EMBASE. We searched for the keywords \"COVID-19\" AND \"community health\" between January 1, 2020, until May 10, 2020. Although, limited evidence is available regarding quarantine to prevent COVID‐19, most studies considered quarantine as an essential public health measure to minimize rate of infection and mortality. Under these circumstances, people should focus on maintaining personal hygiene, proper nutrition, and extreme social distancing to reduce the risk of COVID-19. Besides, that there is a need to provide professional psychological support to reduce mental ill-health. We have highlighted two different public health approaches in South Asian countries, namely Nepal and India.","PeriodicalId":75443,"journal":{"name":"Advances in internal medicine","volume":"9 1","pages":"4-11"},"PeriodicalIF":0.0,"publicationDate":"2020-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/jaim.v9i1.29159","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45944289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report on Scalp edema in a case of HSP in a young adult","authors":"S. Thapaliya, M. Nepal, B. Nepal, R. Pathak","doi":"10.3126/jaim.v8i2.28006","DOIUrl":"https://doi.org/10.3126/jaim.v8i2.28006","url":null,"abstract":"case report: an eighteen year old boy presented to tUtH (tribhuvan University teaching Hospital) er (emergency room) with 4 days epigastric pain that increased with food intake, and passage of black tarry stool for 2 days. a day prior to his presentation, he developed skin rashes over the extensor surfaces of his legs and his buttocks. He also complained of progressive fatigue, joint pain over the lower limbs, loss of appetite, fever and shortness of breath on exertion.","PeriodicalId":75443,"journal":{"name":"Advances in internal medicine","volume":"8 1","pages":"35-37"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/jaim.v8i2.28006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43652569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications and predictors of diagnostic yield of endobronchial forceps biopsy in visible lesions","authors":"Bishow Kumar Shrestha, S. Adhikari, B. Thakur, D. Kadaria, Kishor Kumar Tamrakar, M. Devkota","doi":"10.3126/jaim.v8i2.28002","DOIUrl":"https://doi.org/10.3126/jaim.v8i2.28002","url":null,"abstract":"Background: Fiberoptic bronchoscopy is an important and relatively safe procedure for evaluation of various pulmonary diseases. endobronchial forceps biopsy is commonly performed sampling technique for visible lesions in tracheobronchial tree. Diagnostic yield of biopsy depends upon lesion type and the number of biopsy samples taken. this study aimed to evaluate the complications and diagnostic yield of endobronchial forceps biopsy in visible lesions and correlate the number of biopsy samples taken with the yield.","PeriodicalId":75443,"journal":{"name":"Advances in internal medicine","volume":"8 1","pages":"21-25"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/jaim.v8i2.28002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42400387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-demographic and Clinical Characteristics of Patients with Ulcerative Colitis at a Tertiary Care Centre in Nepal","authors":"R. Pathak, T. Sherpa, A. Jha, R. Hamal, Sabin Thapallya","doi":"10.3126/jaim.v8i2.28003","DOIUrl":"https://doi.org/10.3126/jaim.v8i2.28003","url":null,"abstract":"introduction PoUlcerative colitis (Uc), a chronic inflammatory disease of unknown etiology involving the colonic mucosa, has been increasing in asian countries over the last few decades. epidemiological studies from Japan and Korea have shown that the temporal trend in the incidences of iBD in these regions is related to lifestyle changes and other environmental factors due to rapid urbanization and industrialization.1,2 a population based study among indian migrants to the United States found a high prevalence of ulcerative colitis, which also support the role of lifestyle and environmental factors.3 in india, a population based study in Punjab reported a crude incidence rate of 6.02 cases abstract","PeriodicalId":75443,"journal":{"name":"Advances in internal medicine","volume":"8 1","pages":"26-29"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/jaim.v8i2.28003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41672183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic resection of a giant symptomatic Brunner’s gland hamartoma of duodenal bulb","authors":"U. Shrestha, G. Aryal","doi":"10.3126/jaim.v8i2.28004","DOIUrl":"https://doi.org/10.3126/jaim.v8i2.28004","url":null,"abstract":"Brunner›s gland hamartoma is a very rare benign tumor arising from the Brunner’s gland of duodenum and is usually asymptomatic, but may present with the symptom of duodenal obstruction or upper gastrointestinal bleeding due to ulceration from the tumor, requiring endoscopic or surgical resection. in our study, we report the case of a 57 year-old male who presented with pain over epigastrium, recurrent vomiting, black stool and dizziness with a lowering of hemoglobin up to 7.5 gm/dl. the blood transfusion was done to raise the hemoglobin. the upper gastrointestinal endoscopy revealed a giant submucosal polypoidal mass with a thick short stalk in duodenal bulb causing almost complete obstruction of the lumen of duodenum and there was a superficial ulceration on the under-surface of the mass. the endoscopic ultrasound revealed a submucosal lesion arising from the echo layer three. the computed tomography of abdomen showed that the polypoidal mass was confined to the duodenal lumen with no significant lumphadenopathy and normal biliary and pancreas. the endoscopic polypectomy was attempted, but the lesion was too large to grab the polyp as a whole with the conventional snare. Hence, the repeated partial snare polypectomies were done, followed by submucosal dissection to ensure the complete removal of the mass. there were no complications after the procedure. the histopathology examination of the duodenal mass confirmed the diagnosis of Brunner’s gland hamartoma and showed the presence of Helicobacter pylori as well. the endoscopic treatment of giant Brunner’s gland hamartoma avoided the need of unnecessary more invasive surgical procedure. Umid Kumar Shrestha, gopi aryal","PeriodicalId":75443,"journal":{"name":"Advances in internal medicine","volume":"8 1","pages":"30-32"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/jaim.v8i2.28004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46663976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}