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  • 1
    Online Resource
    Online Resource
    Challenges in Managing Acute ST Myocardial Infarction in Community Heart Hospital
    Nepal Journals Online (JOL) ; 2023
    In:  Journal of National Heart and Lung Society Nepal Vol. 2, No. 1 ( 2023-06-30), p. 9-13
    Details
    In: Journal of National Heart and Lung Society Nepal, Nepal Journals Online (JOL), Vol. 2, No. 1 ( 2023-06-30), p. 9-13
    Abstract: Background:The financial issue can cause pre-hospital delay, choosing reperfu-sion therapy and delay in door to balloon or door to needle time during early management of STMI. The objective of this research is to study the in-hospital cost for STMI patients in community hospital. Methods: This cross sectional observational study was done for two years from September 2019 to August 2021. Total in hospital host (in Nepalese rupees) dur-ing managing STMI was calculated. Results: The mean in-hospital cost of managing STMI (intervention or medical management) was 78,585±71167. For Intervention the total mean cost was 1,73,884±137551 of which PPCI with one stent 1,80,972±25547 and Percutane-ous old balloon angioplasty (POBA) 1,37,551 ±34824. For medical manage-ment, the total mean cost was 32,001 ±19442 of which thrombolysis 36069±24188 while conservative management was 31488±18765. Conclusion: The in hospital cost was more for intervention management com-pared to medical therapy. The mortality was more for the medical therapy com-pared to intervention. Cost of life saving procedures like reperfusion therapy in STMI need to be make more affordable. Patient education for early use of nearby available cardiac facilities including Cath lab need to be promoted.
    Type of Medium: Online Resource
    ISSN: 2976-1468
    URL: Article
    DOI: 10.3126/jnhls.v2i1.56162
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2023
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  • 2
    Online Resource
    Online Resource
    Door-to-balloon time and the determining factors in a tertiary cardiac center in Nepal
    Elsevier BV ; 2018
    In:  Indian Heart Journal Vol. 70 ( 2018-12), p. S309-S312
    Details
    In: Indian Heart Journal, Elsevier BV, Vol. 70 ( 2018-12), p. S309-S312
    Type of Medium: Online Resource
    ISSN: 0019-4832
    URL: Article
    DOI: 10.1016/j.ihj.2018.07.011
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2018
    detail.hit.zdb_id: 2085051-7
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  • 3
    Online Resource
    Online Resource
    In Hospital Complications of Atrial Septal Defect Device Closure at Shahid Gangalal National Heart Centre, Kathmandu, Nepal
    Nepal Health Research Council ; 2020
    In:  Journal of Nepal Health Research Council Vol. 17, No. 4 ( 2020-01-21), p. 474-478
    Details
    In: Journal of Nepal Health Research Council, Nepal Health Research Council, Vol. 17, No. 4 ( 2020-01-21), p. 474-478
    Abstract: Background: Atrial deptal defect device closure has become the preferred method in the treatment of atrial septal defect. We aim to study the in-hospital complications of atrial septal defect device closure procedure.Methods: It was a single center, retrospective study conducted from Febuary 2016 to January 2019. Cardiac catheterization laboratory records of all consecutive patients who underwent atrial septal defect device closure was included and the in-hospital complications were been retrospectively reviewed.Results: During the study period, a total of 566 patients were attempted for device closure. In 557 (98.4%) of cases device was implanted. Among the 557 patient in which device was implanted 401(71.9%) were female. Age ranged from 5 years to 72 years with the mean of 30.9 years. Transient ST segment elevation 15 (2.6 %)was the commonest complication followed by pericardial tamponade 4 (0.7%), and cardiac arrhythmias 3 (0.5%). Conclusions: Atrial deptal defect device closure can be done safely with a high success rate and a low complication rate.Keywords: Amplatzer duct occluder; atrial septal defects; in hospital complications; transcatheter device closure.
    Type of Medium: Online Resource
    ISSN: 1999-6217 , 1727-5482
    URL: Issue
    URL: Article
    DOI: 10.33314/jnhrc.v17i4
    DOI: 10.33314/jnhrc.v17i4.1957
    Language: Unknown
    Publisher: Nepal Health Research Council
    Publication Date: 2020
    detail.hit.zdb_id: 2551251-1
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  • 4
    Online Resource
    Online Resource
    Pseudocoarctation of Aorta with Aneurysmal Dilatation with Acute Coronary Syndrome
    Symbiosis Group ; 2017
    In:  American Journal of Cardiovascular and Thoracic Surgery Vol. 2, No. 4 ( 2017-7-14), p. 1-3
    Details
    In: American Journal of Cardiovascular and Thoracic Surgery, Symbiosis Group, Vol. 2, No. 4 ( 2017-7-14), p. 1-3
    Type of Medium: Online Resource
    ISSN: 2573-864X
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.15226/2573-864X/2/4/
    DOI: 10.15226/2573-864X
    DOI: 10.15226/2573-864X/2/4/00123
    Language: Unknown
    Publisher: Symbiosis Group
    Publication Date: 2017
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  • 5
    Online Resource
    Online Resource
    Radial pseudoaneurysm following diagnostic coronary angiography
    Nepal Journals Online (JOL) ; 2015
    In:  Journal of College of Medical Sciences-Nepal Vol. 10, No. 3 ( 2015-06-17), p. 48-50
    Details
    In: Journal of College of Medical Sciences-Nepal, Nepal Journals Online (JOL), Vol. 10, No. 3 ( 2015-06-17), p. 48-50
    Abstract: The radial artery access has gained popularity as a method of diagnostic coronary catheterization compared to femoral artery puncture in terms of vascular complications and early ambulation. However, very rare complication like radial artery pseudoaneurysm may occur following cardiac catheterization which may give rise to serious consequences. Here, we report a patient with radial pseudoaneurysm following diagnostic coronary angiography. Adequate and correct methodology of compression of radial artery following puncture for maintaining hemostasis is the key to prevention.DOI: http://dx.doi.org/10.3126/jcmsn.v10i3.12776 Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 48-50
    Type of Medium: Online Resource
    ISSN: 2091-0673 , 2091-0657
    URL: Article
    DOI: 10.3126/jcmsn.v10i3.12776
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2015
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  • 6
    Online Resource
    Online Resource
    Risk factors for ST- Elevation Myocardial Infarction in a tertiary hospital in central Nepal
    Nepal Journals Online (JOL) ; 2017
    In:  Journal of College of Medical Sciences-Nepal Vol. 13, No. 4 ( 2017-12-20), p. 416-419
    Details
    In: Journal of College of Medical Sciences-Nepal, Nepal Journals Online (JOL), Vol. 13, No. 4 ( 2017-12-20), p. 416-419
    Abstract: Background & Objectives: Coronary artery disease is the common cardiac disease in Nepal. The objective of the study is to explore different risk factors for coronary artery disease.Materials & Methods: This was cross sectional  hospital based study studying the baseline clinical and angiographic characters in ST Myocardial infarction who had Primary Percutaneous coronary intervention (PPCI) in College of Medical Science Teaching Hospital (CMSTH).Results: There were 95 cases with male 77 (82.1%)   and female 18 (17.9%). The mean age overall was 60.05 ± 12.2. The mean age of male was 59.9 ± 12.5 and of female was 60.5 ± 11.2 years. Apart from chest pain, common clinical symptoms were sweating in 60 (63.2%) cases, dyspnea in 41 (43.2%), nausea/vomiting in 38 (40%), dizziness in 17 (17.9%) and epigastric pain in nine (9.5%) cases. Common risk factors were smoking in 83 (87.7%) cases, hypertension 59 in (51.6 %), diabetes in 24 (25.3%), dyslipidemia in 24 (25.3%) and family history in six (6.3%) cases. Common angiographic variables were single vessel disease (SVD) in 45 (47.4%), double vessel disease (DVD) in 20 (21.1%) and triple vessel disease (TVD) in 30 (31.6%) cases. Infarct related artery were Right coronary artery (RCA) in 43 (45.3%), Left circumflex artery (LCx) in seven (7.4 %) and Left anterior descending artery (LAD) in 45 (47.4 %) cases.Conclusion: Patients visiting CMSTH had classical symptoms and risk factors of myocardial infarction. Single vessel disease and Left anterior descending infarction was the most common vessel involved.
    Type of Medium: Online Resource
    ISSN: 2091-0673 , 2091-0657
    URL: Article
    DOI: 10.3126/jcmsn.v13i4.18615
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2017
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  • 7
    Online Resource
    Online Resource
    ASD device closure in elderly adults
    Nepal Journals Online (JOL) ; 2019
    In:  Asian Journal of Medical Sciences Vol. 10, No. 3 ( 2019-05-01), p. 17-20
    Details
    In: Asian Journal of Medical Sciences, Nepal Journals Online (JOL), Vol. 10, No. 3 ( 2019-05-01), p. 17-20
    Abstract: Background: Closure of ASDs in elderly patients caused significant clinical and hemodynamic improvement after device closure. Aims and Objective: We aim to share our experience of ASD device closure in elderly adults. Materials and Methods: It was a prospective single center study done at Shahid Gangalal National Heart Centre. All elderly patients ( 〉 50years) who underwent ASD device closure fromFeb 2016 to July 2018 and completed three months of device closure were prospectively follow up for the symptoms, RA and RV dimension, Tricuspid Regurgitation and Tricuspid Regurgitation pressure gradient (TRPG). Results: During the study period 48 elderly adults underwent successful ASD device closure. Except one patient we could follow up all patients. Among the patient’s 33 were female, Age ranged from 50years to 72years with the mean age of 55 years. Shortness of breath was the most common symptom during presentation. ASD size ranged from 10mm to 33mm with the mean of 23mm. Device size ranged from 14mm to 40mm with the mean of 29mm. Amplatzer septal occluder was used in 47 patients. RA and RV were dilated in all patients. Mild TR was present in 26 patients, Moderate TR in 17 patients, Severe TR in 5 patients. Mean follow-up time was 12 months. Symptoms reduced in all patients expect one. RA and RV size reduced in all patients. Tricuspid regurgitation pressure gradient reduced from mean of 56 mmHg to Mean of 16 mmHg. During the follow up level of tricuspid regurgitation reduced, 11 patients had mild TR, Trace TR in 15 patients. Conclusion: ASD device closure can result in improvement in clinical and hemodynamic in elderly adults.
    Type of Medium: Online Resource
    ISSN: 2091-0576 , 2467-9100
    URL: Article
    DOI: 10.3126/ajms.v10i3.23195
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2019
    detail.hit.zdb_id: 2894889-0
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  • 8
    Online Resource
    Online Resource
    Outcome of Percutaneous Transvenous Mitral Commisurotomy According to Age, Gender and Heart Rhythm
    Nepal Journals Online (JOL) ; 2022
    In:  Journal of National Heart and Lung Society Nepal Vol. 1, No. 1 ( 2022-12-31), p. 7-11
    Details
    In: Journal of National Heart and Lung Society Nepal, Nepal Journals Online (JOL), Vol. 1, No. 1 ( 2022-12-31), p. 7-11
    Abstract: Background: Percutaneous transvenous mitral commisurotomy (PTMC) is the recommended treatment in the severe mitral stenosis with mitral valve area ≤ 1.5 sq. cm and favourable mitral valve morphology without Left atrium (LA) clot. Methods: A retrospective study done for one year among all the patients who had undergone PTMC in 2016. Successful PTMC was defined as increase in Mitral valve area (MVA) more than or equal to 1.5 sq. cm or increase in area by more than 50% from baseline. Data was analyze using SPSS-20. Results: Three hundred thirty sex patients with mean age 34.08 ±12.0 of which male were 97 ( 26.9 %.) and female were 239 (71.1 %). There were 225 (67%) sinus rhythm (SR) and 111 (33%) atrial fibrillation (AF). The median Pre PTMC area and Left atrial (LA) Pressure were 0.9 sq cm and 24 mmHg respectively. The overall success of PTMC was in 289 (86%). The successful outcome in age categories less than 20 years, 20-40, 40-60 and more than 60 years in order are 39 (83%), 174 (86.6%), 71 (86.6%) and 5 (83.3 %). Success for male was 84 (86.6%) and in female 205(86%). Success percentage in SR was 192 (86%) and in atrial fibrillation was 97 (87.4%). Conclusion: The outcome of PTMC in terms of change in mitral valve area was similar to the different age categories, gender and presence and absence of atrial fibrillation.
    Type of Medium: Online Resource
    ISSN: 2976-1468
    URL: Article
    DOI: 10.3126/jnhls.v1i1.52867
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2022
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  • 9
    Online Resource
    Online Resource
    Acute coronary syndrome in the young Nepalese population with their angiographic characteristics
    Nepal Journals Online (JOL) ; 2017
    In:  Journal of College of Medical Sciences-Nepal Vol. 13, No. 2 ( 2017-07-17), p. 235-240
    Details
    In: Journal of College of Medical Sciences-Nepal, Nepal Journals Online (JOL), Vol. 13, No. 2 ( 2017-07-17), p. 235-240
    Abstract: Background & Objectives: Acute coronary syndrome (ACS) is an emerging cardiac problem in the young population in Asia and Nepalese population is not an exception to this. Early ACS in young age imparts huge familial and social economic burden. Early identification and proper management strategy is still a challenging problem in developing countries like Nepal where there are limited coronary intervention centers. The study was conducted with objective to study the clinical spectrum, etiologies, coronary angiographic characteristics and their clinical outcomes.Materials & Methods:  This is a cross-sectional study carried out in a tertiary hospital in central Nepal. Forty patients with acute coronary syndrome with age less than 40 years were enrolled in the study.Results: Majority of the patients were males with male: female=1.8:1. Twenty six (65%) patients were having ST segment elevation myocardial infarction followed by non-ST elevation myocardial infarction in nine (22.50%) patients and unstable angina in five (12.50%). patients. The most common risk factors were smoking, systemic hypertension, diabetes mellitus and dyslipidemia. Majority were having single vessel disease. Twenty (50%) patients had undergone primary angioplasty followed by thrombolysis in seven patients and the rest were managed medically because of late presentation. In-hospital major adverse cardiac events and mortality were higher among STEMI than NSTEMI and unstable angina.Conclusion: Acute coronary syndrome in the young is increasing in the Nepalese population. This group of population should be well educated and made aware of the potential coronary risk factors and their modification. 
    Type of Medium: Online Resource
    ISSN: 2091-0673 , 2091-0657
    URL: Article
    DOI: 10.3126/jcmsn.v13i2.17147
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2017
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  • 10
    Online Resource
    Online Resource
    Takotsubo cardiomyopathy mimicking acute ST-segment elevation myocardial infarction in a 28-year-old woman
    Nepal Journals Online (JOL) ; 2014
    In:  Journal of Advances in Internal Medicine Vol. 3, No. 1 ( 2014-07-03), p. 38-41
    Details
    In: Journal of Advances in Internal Medicine, Nepal Journals Online (JOL), Vol. 3, No. 1 ( 2014-07-03), p. 38-41
    Abstract: DOITakotsubo cardiomyopathy is a rare type of nonischemic cardiomyopathy accompanied by a transient ballooning and akinesis of the apical segment of left ventricle. Here, we report a 28-year-old woman who presented with acute chest pain after an emotional stress. Electrocardiography showed STsegment elevation in leads II, III, aVF, V3-V6. Echocardiography, coronary angiography and left ventriculography showed typical features of Takotsubo cardiomyopathy. DOI: http://dx.doi.org/10.3126/jaim.v3i1.10703   Journal of Advances in Internal Medicine 2014;03(01):38-41
    Type of Medium: Online Resource
    ISSN: 2091-1440 , 2091-1432
    URL: Article
    DOI: 10.3126/jaim.v3i1.10703
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2014
    detail.hit.zdb_id: 2895109-8
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