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1.
JNMA J Nepal Med Assoc ; 59(235): 243-247, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-34506437

RESUMO

INTRODUCTION: D-dimer is currently the best available marker for COVID-19 associated hemostatic abnormalities. This study aims to find out the prevelance of elevated D-dimer levels in confirmed COVID-19 cases in intensive care unit of a tertiary care hospital of western Nepal. METHODS: This descriptive cross-sectional study was conducted among 95 patients admitted to COVID Intensive Care Unit of a teriary care centre from August 2020 to January 2021 after taking ethical clearence from Institutional Review Committee in order to determine the D-dimer levels in confirmed COVID-19 cases. D-dimer value was measured at the admission and the highest D-dimer value was recorded during the course of hospital stay with the risk of mortality in confirmed COVID-19 cases. The normal range of D-dimer was taken as <0.35 mg/dl as per our hospital laboratory standards. Convenience sampling method was used. Data entry and descriptive analysis were done in Statistical Package for the Social Sciences version 25.0, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Out of total 95 cases of COVID-19 included in this study, 25 (89.3%) patients with age ≥ 65 years and 42 (62.69%) patients aged <65 years had elevated D-dimer on admission. Data showed that 29 (67.4%) patients having elevated D-dimer at admission had mortality. CONCLUSIONS: Elevated D-dimer levels was frequently seen in patients admitted in Intensive Care Unit with COVID-19. Our study suggested that measurement of D-dimer may guide in clinical decision making.


Assuntos
COVID-19 , Idoso , Estudos Transversais , Produtos de Degradação da Fibrina e do Fibrinogênio , Humanos , Unidades de Terapia Intensiva , Nepal/epidemiologia , Prevalência , SARS-CoV-2 , Centros de Atenção Terciária
2.
JNMA J Nepal Med Assoc ; 59(240): 783-786, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34508474

RESUMO

INTRODUCTION: Thyroid hormones have a major influence on synthesis, mobilization and metabolism of lipids. Hypothyroidism accounts for a notable cause of secondary dyslipidemia. This can increase the risk for cardiovascular morbidity and mortality. This study was performed to find out the prevalence of lipid profile abnormalities in newly diagnosed primary hypothyroid states. METHODS: This descriptive cross-sectional study was conducted among 71 patients in the context of newly diagnosed primary hypothyroidism patients visiting outpatient department of internal medicine from 9th December 2018 to 30th June 2020 after taking ethical clearance from Institutional Review Committee. Case screening for lipid profile changes was performed at the time of diagnosis of primary hypothyroidism. A convenience sampling method was used. Data entry and descriptive analysis were done in Statistical Package for the Social Sciences version 16.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: In this study including 71 cases of newly diagnosed primary hypothyroidism, 49 (69.0%) (95% Confidence Interval= 58.24-79.76) had abnormal lipid profiles. Among them, 5 (38.5%) out of 13 (18.3%) cases of subclinical hypothyroidism and 44 (75.9%) out of 58 (81.7%) cases of overt hypothyroidism had abnormal lipid profiles. CONCLUSIONS: The prevalence of abnormal lipid profile parameters was similar to the study done in various studies in similar settings except for high-density lipid which showed both similarity and dissimilarity with other studies. Our study suggested that all newly diagnosed cases of primary hypothyroidism are to be investigated for dyslipidemia thus ensuring early treatment and prevention of complications.


Assuntos
Hipotireoidismo , Estudos Transversais , Humanos , Hipotireoidismo/diagnóstico , Hipotireoidismo/epidemiologia , Lipídeos , Nepal/epidemiologia , Centros de Atenção Terciária
3.
Case Reports Hepatol ; 2021: 6653266, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33777462

RESUMO

The liver function test (LFT) is a commonly performed test in clinical practice in order to assess well-being of the liver; however, derangement in liver enzymes, however, may not necessarily imply an underlying liver pathology. The standard liver function test measures alanine aminotransferase (ALT), aspartate aminotransferase (AST), alanine phosphatase (ALP), bilirubin levels (total, direct, and indirect), proteins (total protein and albumin), and PT-INR (prothrombin time and international normalized ratio). In addition to common causes, liver enzyme levels can also be elevated due to extrahepatic causes, such as muscular injury can elevate transaminases levels. Here in, we present a case of an asymptomatic healthy male who was doing vigorous exercise and presented with reports of elevated transaminase levels. During evaluation of the case, most of his reports came to be within normal range. Additionally, when reevaluated after discontinuation of vigorous exercise, 3 weeks later and then a month later, his liver enzyme levels were observed to be within normal range. Hence, we suspect that muscle damage-induced transaminitis might not have been considered in the differential diagnosis during the evaluation of a patient with raised transaminases levels and also suggest that it should be kept as a differential in the given scenario.

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