M. Bhattarai, R. Shah, N. K. Sainju, B. Bhandari, S. Keshari, D. Karki
Background and Aims: High-income countries have reported common causes of heart failure as ischaemic heart diseases, hypertension, valvular heart diseases, and cardiomyopathies. There are limited data available about epidemiology of heart failure in low-income countries like Nepal. The main objective of this study is to explore etiological spectrum of heart failure in Nepal. Methods: This cross-sectional study was conducted at the cardiology department of Kathmandu Medical College from April 15, 2019, to July 15, 2019. Data were collected from patients diagnosed as heart failure following the European Society of Cardiology criteria and having left ventricular ejection fraction less than 50% and classified into Heart failure with midrange or reduced ejection fraction. Diastolic heart failure, Cor-pulmonale, and stroke were excluded. The data were entered and analyzed in Statistical Package for Social Sciences 20.0 using descriptive and inferential statistics. Results: Among 132 heart failure patients (mean age: 63.9±13.9 years), around two-thirds (65.2%) had heart failure with reduced ejection fraction (ejection fraction of less than 40%) and one third (34.8%) had heart failure with mid-range ejection fraction (40 to 49%). Dilated cardiomyopathy was the leading cause of heart failure among nearly half (47.7%) of study participants, followed by valvular heart disease (19.7%), hypertensive heart disease (14.4%) and ischaemic heart disease (13.6%). Almost half of the study participants with dilated cardiomyopathy had severe left ventricular systolic dysfunction. (p<0.05). Conclusion: Dilated cardiomyopathy was the most prevalent cause of heart failure, followed by valvular heart disease in our study.
{"title":"Etiological spectrum of Heart Failure in a tertiary health care facility of Central Nepal","authors":"M. Bhattarai, R. Shah, N. K. Sainju, B. Bhandari, S. Keshari, D. Karki","doi":"10.3126/njh.v16i2.26313","DOIUrl":"https://doi.org/10.3126/njh.v16i2.26313","url":null,"abstract":"Background and Aims: High-income countries have reported common causes of heart failure as ischaemic heart diseases, hypertension, valvular heart diseases, and cardiomyopathies. There are limited data available about epidemiology of heart failure in low-income countries like Nepal. The main objective of this study is to explore etiological spectrum of heart failure in Nepal. \u0000Methods: This cross-sectional study was conducted at the cardiology department of Kathmandu Medical College from April 15, 2019, to July 15, 2019. Data were collected from patients diagnosed as heart failure following the European Society of Cardiology criteria and having left ventricular ejection fraction less than 50% and classified into Heart failure with midrange or reduced ejection fraction. Diastolic heart failure, Cor-pulmonale, and stroke were excluded. The data were entered and analyzed in Statistical Package for Social Sciences 20.0 using descriptive and inferential statistics. \u0000Results: Among 132 heart failure patients (mean age: 63.9±13.9 years), around two-thirds (65.2%) had heart failure with reduced ejection fraction (ejection fraction of less than 40%) and one third (34.8%) had heart failure with mid-range ejection fraction (40 to 49%). Dilated cardiomyopathy was the leading cause of heart failure among nearly half (47.7%) of study participants, followed by valvular heart disease (19.7%), hypertensive heart disease (14.4%) and ischaemic heart disease (13.6%). Almost half of the study participants with dilated cardiomyopathy had severe left ventricular systolic dysfunction. (p<0.05). \u0000Conclusion: Dilated cardiomyopathy was the most prevalent cause of heart failure, followed by valvular heart disease in our study.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/njh.v16i2.26313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45697226","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}
S. Thapa, R. Gajurel, C. Poudel, H. Shrestha, S. Thapa, S. Devkota, P. Koirala, S. Pathak
Background and Aims: Although pacemaker implantation has been done regularly in Nepal for the last 20 years, there is no large scale published data of pacemaker implantations. Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC) have been providing uninterrupted permanent pacemaker implantation services since its inception. This led us an opportunity to report the data regarding permanent pacemaker implantations in MCVTC. Methods: Hospital records of all patients who had undergone PPI at MCVTC between Shrawan 2070 – Ashad 2075/ July 2013- June 2018 (5 years) were searched for and all available data were retrospectively analyzed. Results: A total of 277 cases underwent PPI at MCVTC in 5 years. Out of these 165 (59.5%) were male with male to female ratio of 1.47. The mean age was 65.82±16.10 years with 3 (1.1%) cases of <20 years of age and almost 70% of cases aged >60 years. Dual chamber units were implanted in 49 (17.7%) cases. Only 13 women (11.6%) received dual chamber pacemaker compared with 36 men (21.8%) (P = 0.029). The most common indication for PPI was complete atrioventricular block 165 (59.6%) followed by sick sinus syndrome 65 (23.5%). Hypertension 84 (30.3%) was the most common co morbidity present. Complication occurred in 5.4% of cases with wound infection as commonest complication and single mortality due to postoperative complications post-RV repair. Conclusion: Single chamber pacemaker was the most commonly used pacemaker. Dual chamber pacemaker was more common in younger patients. Complete heart block was the most common indication. Permanent pacemaker insertion was effective and relatively safe procedure in MCVTC with few complications.
{"title":"Study of clinical profile and indications of Permanent Pacemaker Insertion in Nepali population presenting to tertiary care centre in Nepal","authors":"S. Thapa, R. Gajurel, C. Poudel, H. Shrestha, S. Thapa, S. Devkota, P. Koirala, S. Pathak","doi":"10.3126/njh.v16i2.26317","DOIUrl":"https://doi.org/10.3126/njh.v16i2.26317","url":null,"abstract":"Background and Aims: Although pacemaker implantation has been done regularly in Nepal for the last 20 years, there is no large scale published data of pacemaker implantations. Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC) have been providing uninterrupted permanent pacemaker implantation services since its inception. This led us an opportunity to report the data regarding permanent pacemaker implantations in MCVTC. \u0000Methods: Hospital records of all patients who had undergone PPI at MCVTC between Shrawan 2070 – Ashad 2075/ July 2013- June 2018 (5 years) were searched for and all available data were retrospectively analyzed. \u0000Results: A total of 277 cases underwent PPI at MCVTC in 5 years. Out of these 165 (59.5%) were male with male to female ratio of 1.47. The mean age was 65.82±16.10 years with 3 (1.1%) cases of <20 years of age and almost 70% of cases aged >60 years. Dual chamber units were implanted in 49 (17.7%) cases. Only 13 women (11.6%) received dual chamber pacemaker compared with 36 men (21.8%) (P = 0.029). The most common indication for PPI was complete atrioventricular block 165 (59.6%) followed by sick sinus syndrome 65 (23.5%). Hypertension 84 (30.3%) was the most common co morbidity present. Complication occurred in 5.4% of cases with wound infection as commonest complication and single mortality due to postoperative complications post-RV repair. \u0000Conclusion: Single chamber pacemaker was the most commonly used pacemaker. Dual chamber pacemaker was more common in younger patients. Complete heart block was the most common indication. Permanent pacemaker insertion was effective and relatively safe procedure in MCVTC with few complications.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/njh.v16i2.26317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44341795","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}
N. Paudel, A. Maskey, D. Karki, Sushant Katwal, Namrata Thapa
Background and Aims: Microalbuminuria (MA) (urinary albumin excretion of 30-299 mg/d in a 24 hours collection or 30-299 μg/mg creatinine in a spot collection) is well accepted marker of micro and macrovascular damage in patients with diabetes mellitus and is considered as a surrogate marker for endothelial dysfunction in diabetic and non-diabetic patients. This study has been undertaken to investigate the prevalence of microalbuminuria among non-diabetic Acute Coronary Syndrome (ACS) patients. Methods: A hospital based cross-sectional study of 100 consecutive non-diabetic ACS patients was done. Traditional risk factors (like smoking, hypertension, dyslipidemia, obesity) of coronary artery disease were studied for the association with microalbuminuria in study subjects. Investigations were carried out in all the cases as per proforma and entered in the SPSS software for analysis. Results: The prevalence of microalbuminuria in non-diabetic ACS patients in the study was 73% which was statistically significant (p=0.04). A statistically significant higher prevalence of microalbuminuria was seen with different presentations of ACS; being highest (81.96%) in NSTEMI followed by STEMI (63.15%) and Unstable Angina (55%). It was found to be significant with the history of smoking (81.25%, p=0.013) and hypertension (82.25%, p=0.013). No significant association was found with age, body mass index (BMI) and dyslipidemia. A statistically significant higher prevalence of microalbuminuria was seen with increasing number of risk factors. Conclusion: There is increased prevalence of microalbuminuria in ACS patents. MA was associated with statistically higher number of cases with history of smoking and hypertension and presence of increasing number of risk factors.
{"title":"Profile of Non-Diabetic patients with Microalbuminuria in Acute Coronary Syndrome: A hospital based study","authors":"N. Paudel, A. Maskey, D. Karki, Sushant Katwal, Namrata Thapa","doi":"10.3126/njh.v16i2.26320","DOIUrl":"https://doi.org/10.3126/njh.v16i2.26320","url":null,"abstract":"Background and Aims: Microalbuminuria (MA) (urinary albumin excretion of 30-299 mg/d in a 24 hours collection or 30-299 μg/mg creatinine in a spot collection) is well accepted marker of micro and macrovascular damage in patients with diabetes mellitus and is considered as a surrogate marker for endothelial dysfunction in diabetic and non-diabetic patients. This study has been undertaken to investigate the prevalence of microalbuminuria among non-diabetic Acute Coronary Syndrome (ACS) patients. \u0000Methods: A hospital based cross-sectional study of 100 consecutive non-diabetic ACS patients was done. Traditional risk factors (like smoking, hypertension, dyslipidemia, obesity) of coronary artery disease were studied for the association with microalbuminuria in study subjects. Investigations were carried out in all the cases as per proforma and entered in the SPSS software for analysis. \u0000Results: The prevalence of microalbuminuria in non-diabetic ACS patients in the study was 73% which was statistically significant (p=0.04). A statistically significant higher prevalence of microalbuminuria was seen with different presentations of ACS; being highest (81.96%) in NSTEMI followed by STEMI (63.15%) and Unstable Angina (55%). It was found to be significant with the history of smoking (81.25%, p=0.013) and hypertension (82.25%, p=0.013). No significant association was found with age, body mass index (BMI) and dyslipidemia. A statistically significant higher prevalence of microalbuminuria was seen with increasing number of risk factors. \u0000Conclusion: There is increased prevalence of microalbuminuria in ACS patents. MA was associated with statistically higher number of cases with history of smoking and hypertension and presence of increasing number of risk factors.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/njh.v16i2.26320","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42992230","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}
R. Raut, M. Kc, S. Rajbhandari, Murari Dhungana, Mukunda Sharma, S. Joshi, P. Bajracharya
Background and Aims: Cardiac resynchronization therapy (CRT) has become an established treatment modality for patients with advanced heart failure. CRT abbreviates the dysynchronus heart failure mainly by correcting left ventricular dysynchrony. In the last three years, CRT has been regularly done in Shahid Gangalal National Heart Center(SGNHC) which has provided us the platform to report the outcome of CRT, for the first time in Nepal. The aim of this study is to review the recent clinical experience and outcome of CRT in our centre. Methods: All consecutive patients who underwent CRT at SGNHC from July, 2016 to July, 2019 were reviewed retrospectively. Results: Altogether 42 patients underwent CRT. Mean age was 65±11 years (range 43 to 84). Coronary sinus cannulation was successful in 41 patients. In one patient, LV lead delivery was unsuccessful. Thus, procedural success was obtained in 95% (40 out of 42) patients. LV lead dislodgement occurred in three patients (7%). Coronary sinus dissection occurred in two patients (5%). Biventricular (BiV) paced QRS was significantly narrower compared to baseline QRS (127ms Vs 162ms, p<0.01). During mean follow up of 12±10 months (range 1 to 30 months), there was significant improvement in the clinical outcomes: NYHA class (1.8 Vs 2.9, p<0.01), LVEF (22.3 Vs 27.5, p<0.01), left ventricle internal diameter in systole (LVIDs), (57 Vs 60.5 mm, p<0.01). The CRT responder rate was 86%. Super-responder was observed in 12% of patients. Conclusion: In SGNHC, Cardiac resynchronization therapy is emerging as a routine treatment strategy with a reasonable efficacy and safety outcome.
背景和目的：心脏再同步治疗（CRT）已成为晚期心力衰竭患者的一种既定治疗模式。CRT主要通过纠正左心室不同步来缩短不同步性心力衰竭。在过去的三年里，Shahid Gangalal国家心脏中心（SGNHC）定期进行CRT，这为我们提供了报告CRT结果的平台，这在尼泊尔是第一次。本研究的目的是回顾我们中心最近CRT的临床经验和结果。方法：回顾性分析2016年7月至2019年7月在SGNHC接受CRT治疗的所有连续患者。结果：共有42例患者接受了CRT治疗。平均年龄为65±11岁（43至84岁）。41例患者冠状窦插管成功。在一名患者中，左心室导线输送不成功。因此，95%（42名患者中有40名）的患者获得了手术成功。三名患者（7%）发生左心室导线移位。两名患者（5%）发生冠状窦夹层。双心室（BiV）起搏QRS明显窄于基线QRS（127ms Vs 162ms，p<0.01）。在平均12±10个月（1至30个月）的随访中，临床结果有显著改善：NYHA分级（1.8 Vs 2.9，p<0.01）、LVEF（22.3 Vs 27.5，p<0.01），CRT应答率为86%。在12%的患者中观察到超级反应。结论：在SGNHC中，心脏再同步治疗正在成为一种常规治疗策略，具有合理的疗效和安全性。
{"title":"Cardiac Resynchronization Therapy- Single center experience in Nepal","authors":"R. Raut, M. Kc, S. Rajbhandari, Murari Dhungana, Mukunda Sharma, S. Joshi, P. Bajracharya","doi":"10.3126/njh.v16i2.26308","DOIUrl":"https://doi.org/10.3126/njh.v16i2.26308","url":null,"abstract":"Background and Aims: Cardiac resynchronization therapy (CRT) has become an established treatment modality for patients with advanced heart failure. CRT abbreviates the dysynchronus heart failure mainly by correcting left ventricular dysynchrony. In the last three years, CRT has been regularly done in Shahid Gangalal National Heart Center(SGNHC) which has provided us the platform to report the outcome of CRT, for the first time in Nepal. The aim of this study is to review the recent clinical experience and outcome of CRT in our centre. \u0000Methods: All consecutive patients who underwent CRT at SGNHC from July, 2016 to July, 2019 were reviewed retrospectively. \u0000Results: Altogether 42 patients underwent CRT. Mean age was 65±11 years (range 43 to 84). Coronary sinus cannulation was successful in 41 patients. In one patient, LV lead delivery was unsuccessful. Thus, procedural success was obtained in 95% (40 out of 42) patients. LV lead dislodgement occurred in three patients (7%). Coronary sinus dissection occurred in two patients (5%). Biventricular (BiV) paced QRS was significantly narrower compared to baseline QRS (127ms Vs 162ms, p<0.01). During mean follow up of 12±10 months (range 1 to 30 months), there was significant improvement in the clinical outcomes: NYHA class (1.8 Vs 2.9, p<0.01), LVEF (22.3 Vs 27.5, p<0.01), left ventricle internal diameter in systole (LVIDs), (57 Vs 60.5 mm, p<0.01). The CRT responder rate was 86%. Super-responder was observed in 12% of patients. \u0000Conclusion: In SGNHC, Cardiac resynchronization therapy is emerging as a routine treatment strategy with a reasonable efficacy and safety outcome.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/njh.v16i2.26308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47772912","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}
Objective: The aim of this study is to identify the relationship between carotid intima-media thickness (c-imt) and non-alcoholic fatty liver disease (NAFLD), and to determine whether NAFLD is an independent predictor for the progression of atherosclerosis. Method: This is a prospective randomized controlled study. 103 NAFLD patients who have hepatosteatosis with grade II and above were enrolled in this study. Patients were divided into NAFLD with metabolic syndrome (MS) and NAFLD without MS groups and compared with 50 healthy people. Basal demographic characteristics and C-imt of all patients and control group were measured. Results: C-imt and carotid cross sectional area rates in the NAFLD groups were significantly higher than those in the control group. The mean and max. c-imt levels were significantly higher in the NAFLD group with metabolic syndrome (p<0,001). Homeostatic Model of Assessment-Insulin Resistance (HOMA-IR) levels were increased in the group with metabolic syndrome than those in the group without metabolic syndrome, with statistical significance (p<0.001). There was no difference in c-imt levels between HOMA-IR positive and negative groups (p=0.254) in patients with NAFLD and without metabolic syndrome. There was only a mild positive corelation between c-imt levels and high sensitive C-Reactive protein (hs-CRP) levels in metabolic syndrome positive group (p=0.026 r=0.30). Conclusion: NAFLD was a significant predictor to determine the increased risk of carotid atherosclerosis.
{"title":"Non alcoholic fatty liver disease is a predictor of subclinical Carotid Atherosclerosis in the presence of Metabolic Syndrome","authors":"C. Kemaloğlu, Melek Didem Kemaloğlu","doi":"10.3126/NJH.V16I1.23898","DOIUrl":"https://doi.org/10.3126/NJH.V16I1.23898","url":null,"abstract":"Objective: The aim of this study is to identify the relationship between carotid intima-media thickness (c-imt) and non-alcoholic fatty liver disease (NAFLD), and to determine whether NAFLD is an independent predictor for the progression of atherosclerosis. \u0000Method: This is a prospective randomized controlled study. 103 NAFLD patients who have hepatosteatosis with grade II and above were enrolled in this study. Patients were divided into NAFLD with metabolic syndrome (MS) and NAFLD without MS groups and compared with 50 healthy people. Basal demographic characteristics and C-imt of all patients and control group were measured. \u0000Results: C-imt and carotid cross sectional area rates in the NAFLD groups were significantly higher than those in the control group. The mean and max. c-imt levels were significantly higher in the NAFLD group with metabolic syndrome (p<0,001). Homeostatic Model of Assessment-Insulin Resistance (HOMA-IR) levels were increased in the group with metabolic syndrome than those in the group without metabolic syndrome, with statistical significance (p<0.001). There was no difference in c-imt levels between HOMA-IR positive and negative groups (p=0.254) in patients with NAFLD and without metabolic syndrome. There was only a mild positive corelation between c-imt levels and high sensitive C-Reactive protein (hs-CRP) levels in metabolic syndrome positive group (p=0.026 r=0.30). \u0000Conclusion: NAFLD was a significant predictor to determine the increased risk of carotid atherosclerosis. ","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V16I1.23898","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44953081","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}
Coronary arteries arising from single coronary sinus is a rare congenital anomaly. We report a 30-year-old male who presented with atypical chest pain and computed tomography coronary angiography revealed a solitary coronary artery originating from a single ostium in the right sinus of Valsalva.
{"title":"Solitary coronary artery: An unusual cause of atypical chest pain","authors":"L. Dubey, Ridhi Adhikari, S. Deep","doi":"10.3126/NJH.V16I1.23903","DOIUrl":"https://doi.org/10.3126/NJH.V16I1.23903","url":null,"abstract":"Coronary arteries arising from single coronary sinus is a rare congenital anomaly. We report a 30-year-old male who presented with atypical chest pain and computed tomography coronary angiography revealed a solitary coronary artery originating from a single ostium in the right sinus of Valsalva. ","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V16I1.23903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43876470","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}
Background and Aims: Awareness raising is an important component of primary prevention of RHD. Data are lacking on primary prevention activities for rheumatic heart disease (RHD) prevention in Nepal. The aim of this study is to assess the effectiveness of various awareness raising activities on increasing knowledge about throat infection (TI), acute rheumatic fever (ARF) and RHD and their impact on RHD prevention. Methods: Fourteen randomly selected government health facilities in Lalitpur were enrolled in this study. A baseline study conducted in early 2015 analyzed the level of knowledge about RHD among care seekers attending health facilities in Lalitpur. An expansive public awareness raising activities on RHD were performed for 2.5 years starting from February 2015. Data were collected using structured interviews, and review of health facility records. Data were analyzed to compare the postintervention status with the baseline status. Results: The mean knowledge about ARF and RHD increased by over 71% (1.82 to 3.12) and 124% (0.37 to 0.83) respectively in post intervention group. There was significant difference in knowledge about TI, ARF and RHD among baseline and post intervention group (p-value<0.0001). The number of throat infection cases presented at health facilities increased by 30.39% from fiscal year (FY) 2071/72 to FY 2072/073 and by 4.69% in the next FY. Conclusions: Awareness raising interventions are effective in increasing knowledge about TI, ARF and RHD which further can produce positive impact in the primary prevention of ARF and RHD.
{"title":"Effectiveness of awareness raising interventions on knowledge about Rheumatic Heart Disease and change in care seeking behavior for throat infection in Lalitpur, Nepal","authors":"P. Regmi, K. Sanjel","doi":"10.3126/NJH.V16I1.23893","DOIUrl":"https://doi.org/10.3126/NJH.V16I1.23893","url":null,"abstract":"Background and Aims: Awareness raising is an important component of primary prevention of RHD. Data are lacking on primary prevention activities for rheumatic heart disease (RHD) prevention in Nepal. The aim of this study is to assess the effectiveness of various awareness raising activities on increasing knowledge about throat infection (TI), acute rheumatic fever (ARF) and RHD and their impact on RHD prevention. \u0000Methods: Fourteen randomly selected government health facilities in Lalitpur were enrolled in this study. A baseline study conducted in early 2015 analyzed the level of knowledge about RHD among care seekers attending health facilities in Lalitpur. An expansive public awareness raising activities on RHD were performed for 2.5 years starting from February 2015. Data were collected using structured interviews, and review of health facility records. Data were analyzed to compare the postintervention status with the baseline status. \u0000Results: The mean knowledge about ARF and RHD increased by over 71% (1.82 to 3.12) and 124% (0.37 to 0.83) respectively in post intervention group. There was significant difference in knowledge about TI, ARF and RHD among baseline and post intervention group (p-value<0.0001). The number of throat infection cases presented at health facilities increased by 30.39% from fiscal year (FY) 2071/72 to FY 2072/073 and by 4.69% in the next FY. \u0000Conclusions: Awareness raising interventions are effective in increasing knowledge about TI, ARF and RHD which further can produce positive impact in the primary prevention of ARF and RHD.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V16I1.23893","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41618752","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}
C. Adhikari, M. Shrestha, A. Bogati, S. Dhungel, K. Acharya, U. Shakya, Poonam Sharma, Shilpa Aryal, J. Adhikari, R. Malla
Background and Aims: Atrial septal defect (ASD) device closure has been accepted worldwide as an alternative to surgical closure with the excellent results. This interventional, non-surgical technique plays an important role in the treatment of ASD. This audit aims to report our experience of ASD device closure in our centre. Methods: This cross sectional study was conducted at Shahid Gangalal National Heart Centre, Kathmandu, Nepal. All patients who were attempted for ASD device closure from February 2016 to January 2018 were included. ASD size, device size, procedural approach, and device implantation success rates were retrospectively analyzed from our hospital records. Result: During the study period, 566 cases were attempted for device closure. Among them device was successfully implanted in 557(98.4% of cases). In nine cases ASD device could not be implanted. Among the 557 successful cases, 401 (71.9%) were female. Age ranged from 5 to 72 years with the mean of 30.9 years. In five patients, transcatheter closure cases, was done under general anesthesia with the guidance of transesophgeal echocardiogram. In all other patients, device closure was done in local anesthesia under transthoracic echocardiography guidance. ASD size ranged from 7mm to 37mm with the mean of 20.8mm. ASD device ranged from 8 to 42mm with the mean of 26.5mm. Four different devices were used with the Amplatzer septal occluder used in 527 (94.6%) patients, hyperion( Comed) device in 10 (1.7%) patients, Memopart (Lepu) device in 19 (3.4%) patients and Cera (Life tech) device in 1(0.1%) patients. Discussion: ASD device closure is a safe and effective procedure.
{"title":"Recent experience on atrial septal defect device closure at Shahid Gangalal National Heart Centre, Kathmandu, Nepal","authors":"C. Adhikari, M. Shrestha, A. Bogati, S. Dhungel, K. Acharya, U. Shakya, Poonam Sharma, Shilpa Aryal, J. Adhikari, R. Malla","doi":"10.3126/NJH.V16I1.23891","DOIUrl":"https://doi.org/10.3126/NJH.V16I1.23891","url":null,"abstract":" \u0000 Background and Aims: Atrial septal defect (ASD) device closure has been accepted worldwide as an alternative to surgical closure with the excellent results. This interventional, non-surgical technique plays an important role in the treatment of ASD. This audit aims to report our experience of ASD device closure in our centre. \u0000Methods: This cross sectional study was conducted at Shahid Gangalal National Heart Centre, Kathmandu, Nepal. All patients who were attempted for ASD device closure from February 2016 to January 2018 were included. ASD size, device size, procedural approach, and device implantation success rates were retrospectively analyzed from our hospital records. \u0000Result: During the study period, 566 cases were attempted for device closure. Among them device was successfully implanted in 557(98.4% of cases). In nine cases ASD device could not be implanted. Among the 557 successful cases, 401 (71.9%) were female. Age ranged from 5 to 72 years with the mean of 30.9 years. In five patients, transcatheter closure cases, was done under general anesthesia with the guidance of transesophgeal echocardiogram. In all other patients, device closure was done in local anesthesia under transthoracic echocardiography guidance. ASD size ranged from 7mm to 37mm with the mean of 20.8mm. ASD device ranged from 8 to 42mm with the mean of 26.5mm. Four different devices were used with the Amplatzer septal occluder used in 527 (94.6%) patients, hyperion( Comed) device in 10 (1.7%) patients, Memopart (Lepu) device in 19 (3.4%) patients and Cera (Life tech) device in 1(0.1%) patients. \u0000Discussion: ASD device closure is a safe and effective procedure.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V16I1.23891","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43649284","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}
A. Shakya, S. Jha, R. Gajurel, C. Poudel, Ravi Sahi, H. Shrestha, S. Devkota, S. Thapa
Background and Aims: Acute coronary syndrome (ACS) refers to a group of clinical symptoms consistent with new onset or worsening ischemic symptoms. ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA) are the three types of ACS. The objectives were to study the risk factors prevalence, angiographic distribution and severity of coronary artery stenosis in ACS among patients admitted in Cardiology Department of Manmohan Cardiothoracic Vascular and Transplant Center (MCVTC). Methods: This is a restrospective study of 419 ACS patients admitted and treated in MCVTC from November 2017 to October 2018. Patients were divided into STEMI, NSTEMI and UA then analyzed for various risk factors, angiographic patterns and severity of coronary artery disease. Results: Mean age of presentation was 59.3Å}12.8 years. Majority were male 317(75.7%). Most patients had STEMI 252 (60.1%) followed by NSTEMI 98 (23.4%) and UA 69 (16.5 %). Risk factors: smoking was present in 241 (57.5%), hypertension in 212 (50.6%), diabetes in 144 (34.4%), dyslipidemia in 58 (13.8%). Single-vessel disease was present in 34.6 % patients, double- vessel disease was present in 27.44 % patients and triple vessel disease was present in 26.3 % patients, left main disease in 1.4 % patients. Normal coronaries were present in 6.4% patients and minor coronary artery disease in 3.8 % patients. Conclusions: STEMI was the most common presentation. Three quarters of ACS were male patients. Smoking was most prevalent risk factor. Single vessel involvement was the most common CAG finding in all spectrum of ACS. Diabetic patients had more multivessel disease.
{"title":"Clinical characteristics, risk factors and angiographic profile of acute coronary syndrome patients in a tertiary care center of Nepal.","authors":"A. Shakya, S. Jha, R. Gajurel, C. Poudel, Ravi Sahi, H. Shrestha, S. Devkota, S. Thapa","doi":"10.3126/NJH.V16I1.23895","DOIUrl":"https://doi.org/10.3126/NJH.V16I1.23895","url":null,"abstract":"Background and Aims: Acute coronary syndrome (ACS) refers to a group of clinical symptoms consistent with new onset or worsening ischemic symptoms. ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA) are the three types of ACS. The objectives were to study the risk factors prevalence, angiographic distribution and severity of coronary artery stenosis in ACS among patients admitted in Cardiology Department of Manmohan Cardiothoracic Vascular and Transplant Center (MCVTC). \u0000Methods: This is a restrospective study of 419 ACS patients admitted and treated in MCVTC from November 2017 to October 2018. Patients were divided into STEMI, NSTEMI and UA then analyzed for various risk factors, angiographic patterns and severity of coronary artery disease. \u0000Results: Mean age of presentation was 59.3Å}12.8 years. Majority were male 317(75.7%). Most patients had STEMI 252 (60.1%) followed by NSTEMI 98 (23.4%) and UA 69 (16.5 %). Risk factors: smoking was present in 241 (57.5%), hypertension in 212 (50.6%), diabetes in 144 (34.4%), dyslipidemia in 58 (13.8%). Single-vessel disease was present in 34.6 % patients, double- vessel disease was present in 27.44 % patients and triple vessel disease was present in 26.3 % patients, left main disease in 1.4 % patients. Normal coronaries were present in 6.4% patients and minor coronary artery disease in 3.8 % patients. \u0000Conclusions: STEMI was the most common presentation. Three quarters of ACS were male patients. Smoking was most prevalent risk factor. Single vessel involvement was the most common CAG finding in all spectrum of ACS. Diabetic patients had more multivessel disease.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V16I1.23895","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45736331","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}
K. Acharya, C. Adhikari, Aarjan Khanal, S. Dhungel, A. Bogati, M. Shrestha, D. Sharma
Only few cases of Device closure of atrial septal defect in dextrocardia with situs inversus totalis has been reported previously. We present a case of a 36 years old male, who had secundum type of atrial septal defect in dextrocardia with situs inversus totalis. ASD device closure was successfully done. However, we encountered few technical difficulties in this case which are discussed in this case review.
{"title":"Transcatheter device closure of atrial septal defect in dextrocardia with situs inversus totalis","authors":"K. Acharya, C. Adhikari, Aarjan Khanal, S. Dhungel, A. Bogati, M. Shrestha, D. Sharma","doi":"10.3126/NJH.V16I1.23901","DOIUrl":"https://doi.org/10.3126/NJH.V16I1.23901","url":null,"abstract":"Only few cases of Device closure of atrial septal defect in dextrocardia with situs inversus totalis has been reported previously. We present a case of a 36 years old male, who had secundum type of atrial septal defect in dextrocardia with situs inversus totalis. ASD device closure was successfully done. However, we encountered few technical difficulties in this case which are discussed in this case review.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJH.V16I1.23901","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46390883","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}
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