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Biomedical subjects

D B Karki

Publications and source records attributed to D B Karki.

25 records · Page 2Linked to original sources
PubMedDate not supplied

Injection drug use and tricuspid valve endocarditis.

Tricuspid valve endocarditis is more common in injection drug users. Pulmonary valve and Eustachian valve endocarditis have been reported but are very rare. Earlier reports of endocarditis in injection drug users emphasized the dominance of right sided involvement. In a series of 105 patients 86 % were right sided and 14 % had left sided involvement. We report a case of isolated tricuspid valve endocarditis in an injection drug user affecting a structurally normal heart and review of the literature on this subject. Key Words: injection drug use, tricuspid valve endocarditis.

Adult↗
PubMedDate not supplied

Correlation between serum-ascites albumin concentration gradient and endoscopic parameters of portal hypertension.

OBJECTIVE: We sought to determine the correlation between the level of serum-ascites albumin concentration gradient (SAAG) and the complications of portal hypertension (PHTN), manifested by the presence and grade of esophageal varices (EV). MATERIAL AND METHODS: Our study included 32 patients with ascites, demonstrated by ultrasonography, who had measurement of the SAAG. All had upper gastrointestinal endoscopy with assessment of the presence and size of EV. High SAAG was considered to be present when SAAG was >=1.1 g/dl and Low SAAG when it measured < 1.1 g/dl. RESULTS: We found that 25 of 32 (78.13%) patients had High SAAG and 7 of 32 (21.87%) had Low SAAG. Esophageal varices were present in 18 of 25 (72%) patients with High SAAG and in none of 7 (0%) patients with Low SAAG (p =<0.001). Among patients with High SAAG, EV were present in four of 8 patients (50%) with SAAG values of 1.10-1.49g/dl; in four of seven patients (57.1%) with SAAG values of 1.50-1.99g/dl; and in ten of ten (100%) with SAAG values of >=2.0g/dl (p = 0.037). The size of the esophageal varices had no association with the level of SAAG in patients with High SAAG (p = 0.426). CONCLUSIONS: In patients with ascites the presence of esophageal varices is associated only with patients with High SAAG. The presence of EV in patients with ascites and High SAAG is directly related to the degree of SAAG. The size of the EV in patients with ascites and High SAAG is not associated with the degree of SAAG.

Adult↗
PubMedDate not supplied

Effectiveness of nicotinic acid and bezafibrate alone and in combination for reducing serum triglyceride level.

OBJECTIVE: To study the effectiveness of nicotinic acid and Bezafibrate alone and in combination for reducing triglyceride level. DESIGN: It was a randomised, prospective, longitudinal study. SETTING: Patients attending a private clinic, and medical department of Kathmandu Medical College, Sinamangal. METHODS: This study included 83 consecutive patients, 19 females and 64 males with hypertriglyceridaemia (defined as serum triglyceride >200mg/dl) attending the department of medicine, Kathmandu Medical College, Sinamangal and private clinic. MAIN OUTCOME MEASURES: Statistically significant reduction of serum triglyceride level. RESULT: 51 out of 83 patients completed the study in which Nicotinic acid alone reduced the serum trygleceride level from 320.62 +/- 104.23 to 182.55 +/- 46.21, which is a reduction of 138.07 +/- 85.69 (P. value = 001). Bezafibrate when given alone also reduced triglyceride level significantly from 345.25 +/- 181.03 to 203.30+/-93.59 which is a reduction of 141.95 +/- 121.130 (P value= .001). When a combination of both drugs was given the reduction of 472.73+/-247.53 (P value =.002) was achieved. CONCLUSIONS: Nicotinic acid is a very effective drug in reducing serum triglyceride level and its effectiveness is similar to Bezafibrate. There is no added benefit of giving a combination of nicotinic acid and Bezafibrate in reducing serum triglyceride level.

Bezafibrate↗
PubMedDate not supplied

Study of accuracy of commonly used fetal parameters for estimation of gestational age.

Estimation of the gestational age by sonographic measurements of fetal parameters is usually done by measuring mean sac diameter (MSD), Crown-rump length (CRL), biparietal diameter (BPD), head circumference (HC), femoral length (FL) and abdominal circumference (AC) depending on the trimester of pregnancy. This is a prospective study to see the correlation of different fetal parameters in estimating the gestational age. A total of 71 normal women were taken and ultrasonogram was done to take MSD and CRL in 1st trimester and BPD, HC, FL and AC in 2nd and 3rd trimester. Gestational age was calculated by MSD using Rempen normogram and Hadlock normograms were used for the rest of fetal parameters. Gestational age by LMP was also calculated at the same time. Correlation of different fetal parameters in estimating gestational age in different trimesters was done by Pearson correlation. Pearson correlation showed that the CRL was the best fetal parameter (correlation coefficient of 0.909) in the first trimester. The correlation of MSD and average gestational age by MSD and CRL was with correlation coefficients of 0.778 and 0.888 respectively. Thus the averaging of gestational age in 1st trimester decreases the accuracy in the gestational age estimation. Correlation of gestational age by BPD, HC, FL and AC and their average in 2nd trimester showed that the best correlation was by AC and the least correlation by BPD in this study. It is in contrary to other studies which could be due to chance finding or bias because of prospective study. Pearson correlation calculated in 3rd trimester showed HC and FL were better parameters than BPD and AC. Average gestational age by simple averaging of BPD, HC, FL and AC gives more accurate estimation of gestational age in both 2nd and 3rd trimester.

Anthropometry↗