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Status of Serum Vitamin B12 in Type 2 Diabetes Mellitus Patients under Metformin Therapy

Sah, Sanjay Kumar ; Gupta, Suprita ; Jha, Amit Chandra ; [et al.]

Nepal Journals Online (JOL) ; 2022

In: Nepal Journal of Health Sciences Vol. 2, No. 2 ( 2022-12-31), p. 9-14

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In: Nepal Journal of Health Sciences, Nepal Journals Online (JOL), Vol. 2, No. 2 ( 2022-12-31), p. 9-14

Abstract: Introduction: Type 2 diabetes mellitus, a prevalent global health problem, is a major cause of morbidity and mortality. Metformin, the most widely used hypoglycemic agent can lead to a deficiency of vitamin B12. Very less information is available regarding the relationship between metformin therapy and vitamin B12 deficiency in the Nepalese population. Objectives: The study aims to evaluate the level of vitamin B12 in cases of diabetes mellitus under metformin therapy and to access the relationship of serum vitamin B12 level with the duration of metformin therapy. Methods: A hospital-based cross-sectional study with 300 diagnosed diabetes mellitus cases under metformin therapy were enrolled in the study after the consent was taken. The prior ethical clearance was taken and the duration of the study was from December 2021 to June 2022. Results: The study showed 78% (n=234) of the total diabetic cases under metformin therapy had lower vitamin B12. In 50-60 years, age group, 91% of them were vitamin B12 deficient. Vitamin B12 deficient cases were more with the increase in duration and dose of metformin therapy. All the diabetics who were under medication for 16-20 years had lower vitamin levels. About 94% (n=200) of the diabetics taking more than 1000 mg/day were vitamin B12 deficient whereas only 39% (n=34) of diabetics taking less than 1000mg/day were found to be deficient. Conclusions: Vitamin B12 is deficient in diabetics under long-term and higher doses of metformin therapy. Diabetic patients who are undergoing metformin treatment should monitor their vitamin B12 status as they are more prone to vitamin B12 deficiency.

Type of Medium: Online Resource

ISSN: 2795-1812 , 2795-1618

URL: Article

DOI: 10.3126/njhs.v2i2.56784

Language: Unknown

Publisher: Nepal Journals Online (JOL)

Publication Date: 2022

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Prevalence of Iron Deficiency Anemia in Anemic Patients: A Hospital Based Study

Mishra, Satyendra Kumar ; Marasini, Surendra ; Gupta, Badri Kumar ; [et al.]

Nepal Journals Online (JOL) ; 2018

In: Journal of Universal College of Medical Sciences Vol. 6, No. 2 ( 2018-12-03), p. 41-45

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In: Journal of Universal College of Medical Sciences, Nepal Journals Online (JOL), Vol. 6, No. 2 ( 2018-12-03), p. 41-45

Abstract: Introduction: In developing countries like Nepal, iron deficiency anemia (IDA) is one of the major concern. The high rate incidence has been related to insufficient iron intake, accompanied by chronic intestinal blood loss due to parasitic and malarial infections. Therefore, a study was conducted to evaluate the prevalence of IDA in anemic patients of Universal College of Medical Sciences-Teaching Hospital (UCMS-TH), South Western region, Nepal. Material and Method It was a hospital based cross sectional study comprised of 100 anemic patients. Their detailed medical history and lab investigations, focusing on hematological parameters were documented. Peripheral smear examination and serum ferritin estimation were done to observe red cell morphology and iron status respectively. Results: This study revealed that out of 100 anemic patients, 35% were that of IDA. The most affected age group was 21-40 years with frequency 42.55%. IDA was more common in females (42.85%) than in male (21.62%). Out of 100 anemic patients, microcytic hypochromic anemia was predominant in 47% followed by macrocytic anemia (31%) and then normocytic normochromic anemia (22%). Out of 47 microcytic hypochromic anemic patients, 12 had normal serum ferritin. There was a statistical significant difference in Hb (p=0.011), MCV (p=0.0001), MCH (p=0.0001), MCHC (p=0.0001) and serum ferritin (p=0.0001) among all types of anemia. There was a statistical significant positive correlation of ferritin with Hemoglobin (0.257, p= 0.01), MCV (0.772, p= 0.0001), MCH (0.741, p=0.0001) and MCHC (0.494, p=0.0001). Conclusion: The peripheral smear in conjunction with serum ferritin estimation needs to be included for susceptible individuals to screen the IDA and other types of anemia.

Type of Medium: Online Resource

ISSN: 2350-8582 , 2091-2846

URL: Article

DOI: 10.3126/jucms.v6i2.22494

Language: Unknown

Publisher: Nepal Journals Online (JOL)

Publication Date: 2018

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Evaluation of fungicides to control potato late blight ( Phytophthora infestans ) in the plains of Nepal

Khadka, Ram Bahadur ; Chaulagain, Bhim ; Subedi, Surendra ; [et al.]

Wiley ; 2020

In: Journal of Phytopathology Vol. 168, No. 5 ( 2020-05), p. 245-253

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In: Journal of Phytopathology, Wiley, Vol. 168, No. 5 ( 2020-05), p. 245-253

Abstract: Fungicide application is an effective management option to control late blight of potato (caused by Phytophthora infestans ). Field experiments were conducted to evaluate the efficacy of recently introduced and previously used fungicides on late blight management and potato yields in the western plains of Nepal in 2015 and 2016 crop seasons. Fungicides and a non‐treated control (NTC) were replicated three times in a randomized block design planted with late blight susceptible cultivar Cardinal. Chlorothalonil, copper oxychloride, dimethomorph, fenamidone + mancozeb, mancozeb and metalaxyl were sprayed in 2015. In 2016, carbendazim was used instead of chlorothalonil. The area under disease progress curve (AUDPC) was consistently reduced in years by dimethomorph (90% and 65% in 2015 and 2016, respectively), fenamidone + mancozeb (68% and 62%) and mancozeb (40% and 47%) compared with the NTC. Similarly, tuber yield was increased with the application of dimethomorph (266% and 146% in 2015 and 2016, respectively), fenamidone + mancozeb (211% and 155%) and mancozeb (136% and 116%) compared with the NTC. Chlorothalonil reduced AUDPC by 43% and increased tuber yield by 170% in 2015. Other fungicides either had inconsistent results or did not reduce late blight severity and consequent effects on potato yield. The overall benefit–cost ratio was highest for dimethomorph in both years. These results show efficacy of dimethomorph, fenamidone + mancozeb and mancozeb in reducing late blight severity and increasing potato tuber yield in the plains of Nepal.

Type of Medium: Online Resource

ISSN: 0931-1785 , 1439-0434

URL: Issue

URL: Article

DOI: 10.1111/jph.v168.5

DOI: 10.1111/jph.12886

Language: English

Publisher: Wiley

Publication Date: 2020

detail.hit.zdb_id: 2020539-9

SSG: 12

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Transmission of Leishmania donovani in the Hills of Eastern Nepal, an Outbreak Investigation in Okhaldhunga and Bhojpur Districts

Ostyn, Bart ; Uranw, Surendra ; Bhattarai, Narayan Raj ; [et al.]

Public Library of Science (PLoS) ; 2015

In: PLOS Neglected Tropical Diseases Vol. 9, No. 8 ( 2015-8-7), p. e0003966-

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In: PLOS Neglected Tropical Diseases, Public Library of Science (PLoS), Vol. 9, No. 8 ( 2015-8-7), p. e0003966-

Type of Medium: Online Resource

ISSN: 1935-2735

URL: Article

DOI: 10.1371/journal.pntd.0003966

DOI: 10.1371/journal.pntd.0003966.g001

DOI: 10.1371/journal.pntd.0003966.g002

DOI: 10.1371/journal.pntd.0003966.g003

DOI: 10.1371/journal.pntd.0003966.t001

DOI: 10.1371/journal.pntd.0003966.t002

DOI: 10.1371/journal.pntd.0003966.t003

DOI: 10.1371/journal.pntd.0003966.s001

DOI: 10.1371/journal.pntd.0003966.s002

DOI: 10.1371/journal.pntd.0003966.s003

DOI: 10.1371/journal.pntd.0003966.s004

DOI: 10.1371/journal.pntd.0003966.s005

DOI: 10.1371/journal.pntd.0003966.s006

Language: English

Publisher: Public Library of Science (PLoS)

Publication Date: 2015

detail.hit.zdb_id: 2429704-5

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Pattern of Liver Function Test in Scrub Typhus Cases: A Hospital Based Observational Study in a Tertiary Care Center in Nepal

Sah, Sanjay Kumar ; Sah, Navin Kumar ; Singh, Alok Kumar ; [et al.]

Sciencedomain International ; 2023

In: Asian Journal of Research in Infectious Diseases Vol. 14, No. 1 ( 2023-06-30), p. 1-7

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In: Asian Journal of Research in Infectious Diseases, Sciencedomain International, Vol. 14, No. 1 ( 2023-06-30), p. 1-7

Abstract: Background and Aim: Scrub typhus, a potentially severe but treatable infection is a major cause of acute non-malarial febrile illness in children in the rural tropics. The present study aims to explore the association between the liver function tests in the cases of scrub typhus and correlate the levels of these parameters with the severity of the scrub typhus infections, their clinical risk characteristics that may be used to forecast disease severity under routine clinical practice. Methodology: This prospective observational study, conducted at National Medical College Teaching Hospital, a tertiary care referral teaching hospital situated in province two of Nepal over a period of 7 months (November, 2021- May 2022) enrolled 75 scrub typhus cases and their liver function tests were done following standard guidelines. Results:There were deranged liver function tests in the participants. The mean Aspartate Transaminase, Alanine Transaminase, Total Bilirubin and Albumin were425.48 ± 505.56 U/L, 368.54 ± 402.22 U/L, 3.8 ± 3.1 mg/dL and 3.10 ± 0.8 g/dL, respectively. Most of the cases presented with hypoalbuminemia (66.7%), cardiac dysfunction (64%), acute kidney injury (61%) and hepatitis (60%). About 9 % of the subjects presented as multiorgan dysfunction syndrome (MODS). Conclusion: Scrub typhus cases presents with deranged liver function tests results and the values can be helpful in assessment of the disease severity and outcome.

Type of Medium: Online Resource

ISSN: 2582-3221

URL: Article

DOI: 10.9734/ajrid/2023/v14i1276

Language: Unknown

Publisher: Sciencedomain International

Publication Date: 2023

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Thyroid Peroxidase Autoantibody in Subclinical and Overt Hypothyroidism: A Hospital Based Retrospective Study

Marasini, Surendra ; Sah, Sanjay Kumar ; Gupta, Suprita ; [et al.]

Nepal Journals Online (JOL) ; 2023

In: Med Phoenix Vol. 7, No. 2 ( 2023-01-06), p. 34-38

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In: Med Phoenix, Nepal Journals Online (JOL), Vol. 7, No. 2 ( 2023-01-06), p. 34-38

Abstract: Introduction:Thyroid peroxidase (TPO) is a key enzyme of thyroid hormone biosynthesis as it catalyzes the iodination and the coupling steps. Subclinical hypothyroidism is the condition of increased Thyroid Stimulating Hormone (TSH) and normal levels of serum free thyroxine (ft4) and free triiodothyronine (ft3) levels. Subclinical hypothyroidism can be progressed to overt hypothyroidism in which ft3 and ft4 levels are decreased along with an increment of TSH levels. Materials and methods: This was the hospital-based retrospective study conducted on the patients who had undergone thyroid function test measurements along with thyroid peroxidase autoantibody level in serum. The study duration was eight months (January 2022 to August 2022). All the data were entered in Microsoft Excel version 10 and analyzed in SPSS version 22 accordingly. Results: In the study among 424 patients, 73.8% were female and 26.2% were male. Firstly, our study revealed subclinical hypothyroidism was predominant (41.7%), followed by euthyroidism (34.7%) overt hypothyroidism (20.3%), and overt hyperthyroidism (3.3%). Secondly, there was no statistically significant difference in age (P value: 0.26) and gender (0.64) between subclinical and overt hypothyroidism. There was no statistically significant difference in serum anti-TPO antibodies level between subclinical (median 6.25) and overt hypothyroidism (median 6.12) (P value: 0.92) when median and interquartile ranges were compared. Correlation analysis revealed a significant positive correlation of TPO antibodies with TSH (0.27, 0.00) and no significant negative correlation with fT4 (-0.02, 0.46) and fT3 (-0.05, 0.37). Conclusion: The current study revealed the elevation of thyroid peroxidase autoantibodies in both subclinical and overt hypothyroid patients though subclinical hypothyroidism was predominant.

Type of Medium: Online Resource

ISSN: 2631-1992 , 2392-425X

URL: Article

DOI: 10.3126/medphoenix.v7i2.49408

Language: Unknown

Publisher: Nepal Journals Online (JOL)

Publication Date: 2023

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Study of Hemoglobin and Calcium Phosphorus Product in Patients with Chronic Kidney Disease

Gupta, Suprita ; Gupta, Sunita Kumari ; Marasini, Surendra ; [et al.]

Nepal Journals Online (JOL) ; 2023

In: Med Phoenix Vol. 8, No. 1 ( 2023-07-30), p. 74-78

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In: Med Phoenix, Nepal Journals Online (JOL), Vol. 8, No. 1 ( 2023-07-30), p. 74-78

Abstract: Introduction: Kidneys play a vital role in the metabolism of minerals such as calcium and phosphorous. Moreover, kidney is involved in the production of erythropoietin hormone.The bone marrow suppression may occur in Chronic Kidney Disease (CKD) patients. Reduced hemoglobin and increased calcium phosphorous product concentration is also common in CKD patients.The current study is aimed to find out the impact of CKD in calcium phosphorous product and hemoglobin level in Nepalese population. Materials And Methods: One hundred consecutive diagnosed cases of CKDpatients were enrolled retrospectively for the study. Calcium, phosphorous, urea, creatinine and other biochemical parameters were measured in fully automated biochemistry analyzer and hemoglobin was measured using hematology analyzer (Beckman Coulter DxH500 Automated Hematology analyzer). Results: The current study revealed the hemoglobin and calcium phosphorous product in CKD patients.The Calcium Phosphorous Product (CaP) of 69 subjects were having less than 〈 40mg2/dL2 and remaining 31 were having ≥ 40mg2/dL2. The negative correlation of calcium phosphorous product was seen with calcium (r= -0.478, p-value = 0.000) and sodium (r=-0.309, p-value=0.002) whereas positive correlation of calcium phosphorous product was seen with urea (r= 0.559, p-value=0.000) andCreatinine (r=0.353, p-value = 0.000). The creatinine was negatively correlated with the hemoglobin concentration (r= -0.320, p-value = 0.001). Conclusion: Calcium phosphate product can be fluctuated in chronic kidney disease patients along with the decrement of hemoglobin concentration. The serum calcium phosphorous product measurement can assist to rule out the severity of chronic kidney disease.

Type of Medium: Online Resource

ISSN: 2631-1992 , 2392-425X

URL: Article

DOI: 10.3126/medphoenix.v8i1.56928

Language: Unknown

Publisher: Nepal Journals Online (JOL)

Publication Date: 2023

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Cleidocranial dysplasia—A case report of incidentally found and lately diagnosed disorder

Adhikari, Aayush ; Shrestha, Suraj ; Bhattarai, Prabin ; [et al.]

Wiley ; 2022

In: Clinical Case Reports Vol. 10, No. 10 ( 2022-10)

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In: Clinical Case Reports, Wiley, Vol. 10, No. 10 ( 2022-10)

Type of Medium: Online Resource

ISSN: 2050-0904 , 2050-0904

URL: Issue

URL: Article

DOI: 10.1002/ccr3.v10.10

DOI: 10.1002/ccr3.6440

Language: English

Publisher: Wiley

Publication Date: 2022

detail.hit.zdb_id: 2740234-4

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Aspergillus Coinfection in a Hydatid Cyst Cavity of Lung in an Immunocompetent Host: A Case Report and Review of Literature

Adhikari, Aayush ; Khanal, Surendra ; Magar, Sagar Rana ; [et al.]

Hindawi Limited ; 2023

In: Case Reports in Infectious Diseases Vol. 2023 ( 2023-7-14), p. 1-9

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In: Case Reports in Infectious Diseases, Hindawi Limited, Vol. 2023 ( 2023-7-14), p. 1-9

Abstract: Aspergilloma (a saprophytic infection) typically colonizes lung cavities due to underlying diseases such as tuberculosis, bronchiectasis, cavitary lung cancer, sarcoidosis, and pulmonary infarctions. Rarely, aspergilloma has been noted within a hydatid cyst. Even if this was the case, it is more common to find the coexistence of aspergilloma and pulmonary echinococcal cysts in immunocompromised individuals. It is, however, very uncommon to find this coinfection in normal immune status individuals. Here, we report on the successfully treated case of a 30-year-old immunocompetent female from Western Nepal with histologically proven coinfection by these two pathogens. She had a prolonged history of exposure to domesticated dogs. She suffered from hemoptysis from time to time for 3 years with increased frequency in the last 30 days. She was misdiagnosed clinically during a past medical visit at a local health center. Her computed tomography (CT) scans showed well-defined nonenhancing cystic lesions in the anterior basal segment of the right lower lobe adjacent to the major fissure. She underwent enucleation of the cyst via right posterolateral thoracotomy. On further histopathological evaluation, laminated membranes of the ectocyst along with fungal elements were found, and periodic acid-Schiff (PAS) staining revealed Aspergillus in the form of septate hyphae and acute angle branching. Owing to patient’s economic constraints and unavailability in our center, DNA testing and molecular characterization could not be performed which further highlights the essence of diagnosing and managing such cases in resource poor settings. Eventually, we reviewed 12 confirmed cases of this coinfection in immunocompetent individuals during a period of 7 years (2015–2022) comparing them to a systematic review of 22 confirmed cases of the same coinfection from 1995 to 2014.

Type of Medium: Online Resource

ISSN: 2090-6633 , 2090-6625

URL: Article

DOI: 10.1155/2023/6975041

Language: English

Publisher: Hindawi Limited

Publication Date: 2023

detail.hit.zdb_id: 2627642-2

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Non-Thyroidal Illness Syndrome: A Pattern of Thyroid Dysfunction Seen in Intensive Care Unit Patients of a Tertiary Care Centre

Sah, Sanjay Kumar ; Gupta, Suprita ; Marasini, Surendra ; [et al.]

Nepal Journals Online (JOL) ; 2022

In: Med Phoenix Vol. 7, No. 1 ( 2022-08-19), p. 51-56

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In: Med Phoenix, Nepal Journals Online (JOL), Vol. 7, No. 1 ( 2022-08-19), p. 51-56

Abstract: Introduction: The response to the endocrine mechanism including thyroid gland hormones to critical illness is a complex phenomenon.1 There is a marked and distinct changes in the levels of thyroid hormones in critical illness.2 The magnitude of the decrease in circulating tri-iodothyronine (fT3) levels (also known as non-thyroidal illness) during the first 24 hour after the onset of acute illness reflects the severity of illness and correlates with mortality. The study aims to evaluate the thyroid function test (TFT) of critically ill patients. The results of the study will be helpful in determining the thyroid picture of the critically ill patients in our setting and definitely help in assessing the outcome of the patient admitted in ICU or ward. Materials and Methods: This is a hospital based cross sectional study. A total of 150 cases with the critical illness assessed as per Acute Physiology and Chronic Health Evaluation II (APACHE II) score were enrolled in the study from 12th December 2021 to 15th June, 2022. Informed written consent and ethical approval were taken. Results: The majority of the cases (52%) were of geriatric age group with the mean age of 57 years. Majority of the study participants (42%) in APACHE II were from 20–24 across all participants, and both sexes. Fifty‑one percent of the patients had reduced fT3 levels. There was an increase in percentage of patients with decreased fT3 levels with increasing APACHE II score, compared to normal fT3 levels at similar APACHE II score and the distribution was found to be statistically significant (p = 0.0233). Of the 68 patients expired, 52 of them had low fT3 levels whereas only 16 cases expired were with the normal fT3 level, making it a strong predictor of severity and outcome. Conclusion: Decrease in the levels of fT3, a condition of non-thyroidal illness, is a crucial prognostic indicator in critically ill patients which in coordination APACHE Score II can be helpful in clinical settings to predict the severity and outcome of such patients.

Type of Medium: Online Resource

ISSN: 2631-1992 , 2392-425X

URL: Article

DOI: 10.3126/medphoenix.v7i1.47404

Language: Unknown

Publisher: Nepal Journals Online (JOL)

Publication Date: 2022

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