Background Non-alcoholic fatty liver disease (NAFLD) is emerging as the most common chronic condition. Approximately 70% of type 2 diabetes mellitus (T2DM) patients have a liver; progression to non-alcoholic steatohepatitis (NASH) dramatically increases risks cirrhosis and hepatocellular carcinoma. The aim our study was assess profile enzymes in subjects with T2DM NAFLD. Method This cross-sectional clinic-based T2DM. An ultrasonography abdomen done all order examine presence liver. Body mass...

Background Hepatic encephalopathy (HE) is a common cause of hospital admission in patients with liver cirrhosis (LC). The aims this study were to evaluate the precipitant factors and analyze treatment outcomes HE LC. Methods All LC admitted between February 2017 January 2018 for overt analyzed precipitating outcomes. Treatments compared among three groups: receiving lactulose, lactulose plus L-ornithine L-aspartate (LOLA), rifaximin. primary endpoints mortality stay. chi-square test was used...

Background Non-alcoholic fatty liver disease (NAFLD) is the deposition of fat inside cells in absence secondary causes. It considered as a hepatic complication metabolic syndrome. The syndrome consists dyslipidemia, hypertension, diabetes, and obesity. This study aims to determine prevalence Nepalese patients with NAFLD from mid-Western part Nepal. Method was descriptive cross-sectional study. Three different sites were chosen around Butwal sub-metropolitan city Rupandehi district, A one-day...

Helicobacter pylori (H. pylori) is one of the most common human infections worldwide particularly in developing countries. We aimed to study an association H. Pylori infection with endoscopic and histological findings Nepalese population.We conducted a between Oct 2014 Jan 2015 after meeting inclusion exclusion criteria. Institutional Review Board approval was obtained from National Academy Medical Sciences. Endoscopic histopathological diagnosis were documented data analysed.A total 113...

Introduction. Myocardial infarction in the setting of anaphylaxis may result from itself or epinephrine used to treat anaphylaxis. While cases myocardial due large doses intravenous have previously been reported, after therapeutic intramuscular is rarely reported. Case Report. A 23-year-old male presented with sudden onset difficulty swallowing and speech eating takeout food. He was treated for presumed angioedema following which he immediately developed chest tightness associated ST...

Refractory alcohol withdrawal delirium is uncommon in day-to-day clinical practice. This case report presents a rare of tremens unusually long duration that was complicated by the difficulty tapering down benzodiazepines despite adding midazolam drip as well phenobarbitone to management regimen and excluding other possible diagnoses.

Background We compared the in-hospital complications, outcomes, cost, and length of stay (LOS) between angiography-guided percutaneous coronary intervention (PCI) intravascular ultrasound (IVUS)-guided PCI in patients with ST-elevation myocardial infarction (STEMI) USA.Methods A nationwide inpatient database was queried to identify >18 years STEMI who underwent IVUS-guided from January 2016 December 2016. mortality, LOS two groups.Results identified 100,485 5,460 PCI. In-hospital mortality...

Background Contrast-induced nephropathy (CIN) is one of the leading causes morbidity and mortality including increased financial burden in high risk patients undergoing percutaneous coronary intervention (PCI). Methods This an observational prospective study. We aimed to study incidence CIN Nepalese populations compare outcome international reprinted values with artery disease (CAD) PCI. All consecutive CAD PCI between February 2010 July were enrolled Results One hundred fifty-two during six...

Acute variceal bleeding in liver cirrhosis is an immediate life-threatening condition and amajor complication of portal hypertension associated with higher morbidity, mortality hospital costs than any other causes UGI bleeding. Therefore, early stratification initiation therapy based on several factors can reduce it. We aimed to study the predictors acute LC.An observational prospective was conducted Gastroenterology Hepatology units Bir Hospital, Kathmandu, Nepal from April 1, 2016 May 30,...

Although atrial fibrillation (AF) has been correlated with hyponatremia, it not described in association the correction of chronic hypernatremia previous studies. Here, we describe three elderly patients who had on presentation, most likely secondary to dehydration. Their electrocardiogram (EKG) presentation was normal, and they no known history AF but developed transient during course correction. Similar occurrences have reported previously though there studies showing relation between...

Renal and neurological involvements are frequently seen in thrombotic thrombocytopenic purpura (TTP). Cardiac involvement, however, has been rarely reported. In this article, we present 2 cases of myocardial infarction patients with TTP. the first case, a young man presented non–ST-segment elevation that resolved promptly plasmapheresis. The second patient developed ST-segment early course disease died before plasmapheresis could be initiated. Hence, high degree suspicion prompt diagnosis...

Ventriculoperitoneal (VP) shunt placement is one of the more common procedures in neurosurgery and has a variety indications. However, can be associated with multiple complications, which proximal distal migration. There have been reported cases migration end VP from intraperitoneal cavity into different organs resulting complications. Most are result spontaneous catheter could iatrogenic as well. We present case intragastric patient following percutaneous endoscopic gastrostomy tube.

Ecstasy or 3,4-methylenedioxymethamphetamine (MDMA) is an illicit recreational drug. Effects include euphoria, increased sensory awareness, and central stimulation. Although various arrhythmias, as well dilated cardiomyopathy, have been previously noted to occur with chronic use, cardiac toxicities are seldom reported in acute setting. Herein, we present a 28-year-old female patient no prior medical condition that presented the Emergency Department chest pain following intake of MDMA....

An isolated descending colonic stricture is an unlikely complication of acute pancreatitis, with the nonspecific symptoms making overall diagnosis difficult. Crohn’s disease (CD) and tuberculosis (TB) are two common etiologies may present similarly to related pancreatitis. Unfortunately, colonoscopy biopsy often cannot determine etiology, surgical resection be needed provide both symptomatic relief confirm diagnosis. As a result, produce diagnostic dilemma CD TB as all 3 conditions...

Percutaneous endoscopic gastrostomy (PEG) feeding is a common and widely performed procedure appropriate for long-term enteral nutrition in patients with multiple indications. We present the case of 59-year-old woman PEG tube placed owing to complication following thyroid surgery approximately 20 years ago, representing most extended duration without any significant chronic mechanical dysphagia. This highlights importance feeding, where this route can be used indefinitely an clinical setting...

Dronedarone is a class III antiarrhythmic agent and potent blocker of multiple intracardiac ion channels with many electrophysical properties common amiodarone. Oral dronedarone, 400 mg twice daily, approved for the maintenance normal sinus rhythm in patients history atrial fibrillation (AF) or flutter. It primarily used paroxysmal persistent AF relatively new therapeutic which non-iodinated congener amiodarone hypothesized to have far lesser side effects. Photosensitivity an uncommon effect...

Background: Liver cirrhosis is one of the major causes morbidity and mortality. The threatening complication variceal bleeding. Early diagnosis initiation therapy can reduce mortality associated with This study designed to predict esophageal varices by non-invasive method using aspartate aminotransferase platelet count ratio index (APRI).Methods: A total 100 patients were studied between March 2016 February 2017 admitted at Bir Hospital fulfilling inclusion exclusion criteria. Ethical...

Liver cirrhosis is one of the major causes morbidity and mortality. The threatening complication variceal bleeding. Early diagnosis initiation therapy can reduce mortality associated with This study designed to predict esophageal varices by non-invasive method using aspartate aminotransferase platelet count ratio index (APRI).A total 100 patients were studied between March 2016 February 2017 admitted at Bir Hospital fulfilling inclusion exclusion criteria. Ethical approval was obtained from...

Gastrointestinal (GI) angioectasia is an important cause of acute GI bleed, particularly in the elderly; however, uncommon upper bleeding related to cirrhosis. With increasing incidence liver cirrhosis and recent improvements treatment advanced cirrhosis, this condition may become more common should be considered a differential diagnosis patients with who present occult or overt blood loss. We case 66-year-old man admitted that was found have antral duodenal during esophagogastroduodenoscopy...

Chronic obstructive pulmonary disease (COPD) is associated with systemic inflammation. Weight loss seen in patients COPD a consequence of this We hypothesized that higher grades are greater degree weight loss.In cross-sectional study, we assessed the body mass index (BMI) 34 proven by handheld spirometer. The difference BMI among various was compared.BMI found to be inversely related our study (P = 0.001). No significant regards age and duration symptoms before presentation.Advanced loss.