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Lamichhane G, Acharya A, Marahatha R, Modi B, Paudel R, Adhikari A, Raut BK, Aryal S, Parajuli N. Microplastics in environment: global concern, challenges, and controlling measures. Int J Environ Sci Technol (Tehran) 2023; 20:4673-4694. [PMID: 35638092 PMCID: PMC9135010 DOI: 10.1007/s13762-022-04261-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 03/31/2022] [Accepted: 04/23/2022] [Indexed: 05/02/2023]
Abstract
Plastic pollution in various forms has emerged as the most severe environmental threat. Small plastic chunks, such as microplastics and nanoplastics derived from primary and secondary sources, are a major concern worldwide due to their adverse effects on the environment and public health. Several years have been spent developing robust spectroscopic techniques that should be considered top-notch; however, researchers are still trying to find efficient and straightforward methods for the analysis of microplastics but have yet to develop a viable solution. Because of the small size of these degraded plastics, they have been found in various species, from human brains to blood and digestive systems. Several pollution-controlling methods have been tested in recent years, and these methods are prominent and need to be developed. Bacterial degradation, sunlight-driven photocatalyst, fuels, and biodegradable plastics could be game-changers in future research on plastic pollution control. However, recent fledgling steps in controlling methods appear insufficient due to widespread contamination. As a result, proper regulation of environmental microplastics is a significant challenge, and the most equitable way to manage plastic pollution. Therefore, this paper discusses the current state of microplastics, some novel and well-known identification techniques, strategies for overcoming microplastic effects, and needed solutions to mitigate this planetary pollution. This review article, we believe, will fill a void in the field of plastic identification and pollution mitigation research.
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Affiliation(s)
- G. Lamichhane
- Biological Chemistry Lab, Central Department of Chemistry, Tribhuvan University, Kirtipur, 44618 Nepal
| | - A. Acharya
- Department of Geoscience, Interdisciplinary Graduate School of Science and Engineering, Shimane University, Matsue, Japan
| | - R. Marahatha
- Biological Chemistry Lab, Central Department of Chemistry, Tribhuvan University, Kirtipur, 44618 Nepal
| | - B. Modi
- Biological Chemistry Lab, Central Department of Chemistry, Tribhuvan University, Kirtipur, 44618 Nepal
| | - R. Paudel
- Biological Chemistry Lab, Central Department of Chemistry, Tribhuvan University, Kirtipur, 44618 Nepal
| | - A. Adhikari
- Kathmandu Research Institute for Biological Sciences, Lalitpur, Nepal
| | - B. K. Raut
- Biological Chemistry Lab, Central Department of Chemistry, Tribhuvan University, Kirtipur, 44618 Nepal
| | - S. Aryal
- Kathmandu Research Institute for Biological Sciences, Lalitpur, Nepal
| | - N. Parajuli
- Biological Chemistry Lab, Central Department of Chemistry, Tribhuvan University, Kirtipur, 44618 Nepal
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Paudel S, Parajuli N, Sharma R, Parajuli S. Chronic Spontaneous Urticaria: Clinical Profile, Autologous Serum Skin Test Positivity and Associated Impairment in Quality of Life in Nepalese Patients. Kathmandu Univ Med J (KUMJ) 2022; 20:448-451. [PMID: 37795722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Background Chronic Spontaneous Urticaria is considered to be an autoimmune phenomenon in half of the total cases. Autologous serum skin test is a simple screening test for the presence of auto-antibodies in chronic urticaria. Significant impairment in quality of life have been observed in autologous serum skin test positive cases. There are limited literatures on chronic spontaneous urticaria, autologous serum skin test and associated Dermatology Life Quality Index in Nepal till date. Objective To find the proportion of autologous serum skin test positive cases in chronic urticaria and impairment in quality of life in such patients. Method This was a retrospective review of outpatient records of patients diagnosed with chronic spontaneous urticaria, from January 2018 to December 2019, from a tertiary care hospital in Kathmandu, Nepal. Details of the patients, autologous serum skin test and dermatology life quality index scores were analyzed and presented. Result Among the total 114 cases positive autologous serum skin test was seen in 48.2% of cases. The mean total Dermatology Life Quality Index score was 8.06±6.64. A significantly higher quality of life impairment was observed in in patients with positive autologous serum skin test as compared to the negative ones. The odds of finding a positive autologous serum skin test in patients with angioedema was 2.1, however the difference was not statistically significant. Conclusion Chronic spontaneous urticaria was more common in females as compared to males. A positive autologous serum skin test was present in half of the patients which was in turn associated with a greater impairment of quality of life.
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Affiliation(s)
- S Paudel
- Civil Service Hospital, Kathmandu, Nepal
| | - N Parajuli
- National Academy of Medical Sciences, Kathmandu, Nepal
| | - R Sharma
- Civil Service Hospital, Kathmandu, Nepal
| | - S Parajuli
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
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Pearlman AS, Narang A, Hong H, Hsieh C, Chaudhry A, Chen C, Guttas S, Surette S, Parajuli N, Polivert N, Cadieu C, Martin RP, Thomas JD, Weissman NJ. 547 Point-of-care cardiac assessment using machine learning to guide image acquisition. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Bay Labs, Inc; San Francisco, CA
Background/Introduction: When used by experienced examiners, the utility of point-of-care (POC) ultrasound for assessing cardiac anatomy and function has been well established. However, in some clinical circumstances (Primary Care offices, Intensive Care Unit, some Emergency Rooms, or in remote settings) in which a rapid assessment of cardiac anatomy and dynamics can facilitate patient care, an examiner experienced at POC scanning may not be immediately available.
Purpose
To help novice users acquire clinically useful standard cardiac views using novel machine learning (ML) software.
Methods
We used an investigational device that employs ML software to provide real-time adaptive guidance of transducer position and orientation to help novice users acquire tomographic views of the heart. We tested the utility of this approach when 4 nurses with no prior training in sonography performed POC studies on 16 subjects (10 healthy, 6 with cardiac abnormalities; 9 men; body mass index normal in 6, overweight in 6, and obese in 4 subjects). Each nurse underwent didactic training and 4 hours of supervised practice using the ML program. Each nurse scanned each study subject using a scanner equipped with ML software to acquire 10 digital two-dimensional image clips, including: parasternal long axis, short axis at the aortic valve, mitral valve, and mid-left ventricle (LV), apical 2-, 4-, and 5-chamber, subcostal 4-chamber, and longitudinal views of the inferior vena cava (IVC). All video clips (n = 640) were later reviewed independently by 5 level 3-trained cardiologists who were blinded to subject, scanner, and each other"s assessments. The expert readers reviewed each set of 10 clips to determine if the following variables could be assessed qualitatively: LV size and function; right ventricular (RV) size and function; aortic, mitral and tricuspid valves; pericardial effusion; left atrial size; IVC size.
Results
The majority of expert readers concurred, independently, that the sets of images acquired by nurses using ML guidance allowed qualitative assessment of LV size and function in 98%, pericardial effusion in 98%, RV size and function in 92%, and aortic and mitral valve anatomy and dynamics in 94-97% of cases. Qualitative assessment of LA size was feasible in 95%. Images of the IVC were judged as adequate for assessment in 58%.
Conclusion
This preliminary study suggests the potential value of novel ML software by demonstrating that nurses with limited training can acquire tomographic images useful for qualitative assessment of the cardiac chambers and valves in more than 90% of the subjects examined. This approach might be useful when timely POC cardiac assessment is indicated in settings where an experienced examiner is not available. Further refinements in the guiding software are needed to improve the success rate of IVC imaging, since IVC size can be a useful indicator of volume status.
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Affiliation(s)
- A S Pearlman
- University of Washington, Seattle, United States of America
| | - A Narang
- Northwestern University, Chicago, United States of America
| | - H Hong
- Bay Labs, Inc, San Francisco, United States of America
| | - C Hsieh
- Bay Labs, Inc, San Francisco, United States of America
| | - A Chaudhry
- Bay Labs, Inc, San Francisco, United States of America
| | - C Chen
- Bay Labs, Inc, San Francisco, United States of America
| | - S Guttas
- Bay Labs, Inc, San Francisco, United States of America
| | - S Surette
- Bay Labs, Inc, San Francisco, United States of America
| | - N Parajuli
- Bay Labs, Inc, San Francisco, United States of America
| | - N Polivert
- Bay Labs, Inc, San Francisco, United States of America
| | - C Cadieu
- Bay Labs, Inc, San Francisco, United States of America
| | - R P Martin
- Bay Labs, Inc, San Francisco, United States of America
| | - J D Thomas
- Northwestern University, Chicago, United States of America
| | - N J Weissman
- Medstar Research Institute, Washington, DC, United States of America
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Parajuli N, Bairwa S, Kershaw E, Dyck J. THE EFFECTS OF ADIPOCYTE-SPECIFIC ADIPOSE TRIGLYCERIDE LIPASE DELETION ON CARDIAC FUNCTION. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
Sepsis can provoke kidney injury, which increases mortality. Human and animal studies have documented increased renal oxidative injury and mitochondrial damage during sepsis. However, few studies have attempted to dissect specific renal targets and/or types of oxidative injury using the cecal ligation and puncture (CLP) murine model of sepsis. The purpose of this short communication is to examine the extent of lipid peroxidation within renal mitochondria using CLP and blue native gel electrophoresis which separates intact mitochondrial respiratory complexes. Our results show that CLP induced increased 4-hydroxy-nonenal protein adduction (marker of lipid peroxidation) in renal homogenates and mitochondrial fractions. Blue native gel electrophoresis revealed that respiratory complex III was selectively targeted within mitochondrial fractions. This supports our prior report showing renal complex III inactivation following CLP. Future studies will identify specific renal proteins within complex III that are modified during sepsis to provide mechanistic insight on how mitochondrial respiration is inhibited during sepsis.
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Affiliation(s)
| | | | | | - LA MacMillan-Crow
- Corresponding author: Lee Ann MacMillan-Crow, Ph.D., Department of Pharmacology and Toxicology, University of Arkansas for Medical Sciences, 325 Jack Stephens Drive, Biomedical Building I, 323D, Little Rock, AR 72205, USA, Tel: 501-686-5289; Fax: 501-686-8970;
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Shrum S, MacMillan-Crow LA, Parajuli N. Cold Storage Exacerbates Renal and Mitochondrial Dysfunction Following Transplantation. J Kidney 2016; 2:114. [PMID: 27066594 PMCID: PMC4825688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Long-term renal function is compromised in patients receiving deceased donor kidneys which require cold storage exposure prior to transplantation. It is well established that extended cold storage induces renal damage and several labs, including our own, have demonstrated renal mitochondrial damage after cold storage alone. However, to our knowledge, few studies have assessed renal and mitochondrial function after transplantation of rat kidneys exposed to short-term (4 hr) cold storage compared to transplant without cold storage (autotransplantation). Our data reveal that cold storage plus transplantation exacerbated renal and mitochondrial dysfunction when compared to autotransplantation alone.
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Affiliation(s)
| | | | - N Parajuli
- Corresponding author: Nirmala Parajuli, Ph.D., University of Arkansas for Medical Sciences, 325 Jack Stephens Drive, Biomedical Bldg. I 333, Little Rock, AR 72205, USA, Tel: 501-686-5290; Fax: 501-686-8970;
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Dahal S, Rijal BP, Yogi KN, Sherchand JB, Parajuli K, Parajuli N, Pokhrel BM. Inadequate Empirical Antibiotic Therapy in Hospital Acquired Pneumonia. JNMA J Nepal Med Assoc 2015; 53:240-243. [PMID: 27746463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
INTRODUCTION Inadequate empirical antibiotic therapy for HAP is a common phenomena and one of the indicators of the poor stewardship. This study intended to analyze the efficacy of empirical antibiotics in the light of microbiological data in HAP cases. METHODS Suspected cases of HAP were followed for clinico-bacterial evidence, antimicrobial resistance and pre and post culture antibiotic use. The study was taken from February,2014 to July 2014 in department of Microbiology and department of Respiratory medicine prospectively. Data was analyzed by Microsoft Office Excel 2007. RESULTS Out of 758 cases investigated, 77(10 %) cases were HAP, 65(84%) of them were culture positive and 48(74 %) were late in onset. In early onset cases, isolates were Acinetobacter 10(42%), Escherichia coli 5(21%), S.aureus 4(17%), Klebsiella 1(4%) and Pseudomonas 1(4%). From the late onset cases Acinetobacter 15(28%), Klebsiella 17(32%) and Pseudomonas 13(24%) were isolated. All Acinetobacter, 78% Klebsiella and 36% Pseudomonas isolates were multi drug resistant. Empirical therapies were inadequate in 12(70%) of early onset cases and 44(92%) of late onset type. Cephalosporins were used in 7(41%) of early onset infections but found to be adequate only in 2(12%) cases. Polymyxins were avoided empirically but after cultures were used in 9(19%) cases. CONCLUSIONS Empirical antibiotics were vastly inadequate, more frequently so in late onset infections. Use of cephalosporins empirically in early onset infections and avoiding empirical use of polymyxin antibiotics in late onset infections contributed largely to the findings. Inadequate empirical regimen is a real time feedback for a practitioner to update his knowledge on the local microbiological trends.
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Affiliation(s)
- S Dahal
- Department of Microbiology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - B P Rijal
- Department of Microbiology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - K N Yogi
- Department of Respiratory Medicine, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - J B Sherchand
- Department of Microbiology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - K Parajuli
- Department of Microbiology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - N Parajuli
- Department of Microbiology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - B M Pokhrel
- Department of Microbiology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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Panta OB, Bhattarai D, Parajuli N. Medical Abortion Versus Manual Vacuum Aspiration in a Hilly District Hospital of Eastern Nepal: A Comparative Study. ACTA ACUST UNITED AC 2015; 11:206-9. [DOI: 10.3126/kumj.v11i3.12505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Backgroud Nepal government has approved medical abortion and manual vacuum aspiration for early first trimester pregnancy. Both the procedures have been approved by World Health Organization for use in early first trimester. Objectives The study aims to compare efficacy and safety of medical abortion with surgical abortion in a district hospital of rural eastern Nepal. Method An observational study conducted in district hospital, dhankuta from July 2010 to January 2011. Clients for abortion services were counseled about methods of abortion and were allowed to make decision on their own and classified as medical abortion group (N=48) (receiving 200milligram Mifepristone followed by 800 microgram misoprostol sublingually or vaginally on day two)and manual vacuum aspiration group (N=36). The two groups were compared for rate of complete abortion and other complications and contraception use after procedure. Results Rate of complete abortion was similar in both groups, 95.8% among medical abortion and 97.2% in manual vacuum aspiration. Moderate to severe expulsion bleeding was reported in 91.6% of cases after Medical Abortion but none required medical attention for hemorrhage. Condom was the most preferred contraceptive in medical abortion group and depo provera in manual vacuum aspiration group. Conclusion Medical method of abortion using mifepristone and misoprostol is equally safe and effective as manual vacuum aspiration in rural setting district hospitals of Nepal. DOI: http://dx.doi.org/10.3126/kumj.v11i3.12505 Kathmandu Univ Med J 2013; 43(3):206-209
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Shrestha R, Shrestha D, Dhoju D, Parajuli N, Bhandari B, Kayastha SR. Epidemiological and Outcome Analysis of Orthopedic Implants Removal in Kathmandu University Hospital. ACTA ACUST UNITED AC 2015; 11:139-43. [DOI: 10.3126/kumj.v11i2.12489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Orthopedic Implant removal is one of the commonly performed elective orthopedic surgeries. Implants are generally removed after the purpose of keeping implant is solved by healing of the fracture, but there is no consensus whether routine implant removal should be a policy for all fractures that were fixed. Objective This study aims to analyze the epidemiology and outcome of implant removal surgery carried out in the past three years in Kathmandu University Hospital. Methods Patients who underwent implant removal between 2010 January to 2012 December constituted the study cohort. Demographic data, indications, types of hardware and location of fractures were recorded. Similarly, duration of surgery, type of anesthesia and duration of hospital stay were recorded. All the patients who had undergone implant removal in this three years period were called for follow up examination but those who were not able to come were interviewed on telephone. Results There were 275 implant removals constituting 7.8% of total orthopedic operations and 26.3% of fracture fixations. Male to Female ratio was 189: 86. Pediatric age group (34.5%) had the highest incidence of implant removal. Moderate sized implants were the commonest hardwares removed (63.2%). Femur (27.3%) followed by radius (26.9%) were the commonest bone for implant removal. Average operative time was 47.3 minutes with average hospital inpatient stay of 2.6 days. Commonest indication for the implant removal procedure was pain (45%). Conclusion Implant removal procedures are one of the most commonly performed elective orthopedic surgeries. Though, after orthopedic implants removal, pain relief can be expected but it is not so predictive and hence patient should be well counseled before and the indications for implant removal has to be evaluated for better patient satisfaction and safety. DOI: http://dx.doi.org/10.3126/kumj.v11i2.12489 Kathmandu University Medical Journal Vol.11(2) 2013: 139-143
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Shrestha R, Shrestha SK, Kayastha SR, Parajuli N, Dhoju D, Shrestha D. A comparative study on epidemiology, spectrum and outcome analysis of physical trauma cases presenting to emergency department of Dhulikhel Hospital, Kathmandu University Hospital and its outreach centers in rural area. Kathmandu Univ Med J (KUMJ) 2014; 11:241-6. [PMID: 24442174 DOI: 10.3126/kumj.v11i3.12513] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physical trauma is one of the major cause of mortality and morbidity among young and active age group and its increasing trend is of main concern. There are only few studies concerning the spectrum of physical trauma in Nepal. OBJECTIVE This study aims to evaluate the epidemiological spectrum, the extent, severity of the physical trauma and the outcome evaluation of patients with physical trauma over a period of one year in the emergency department of the Kathmandu University Hospital and compare the same parameters with those patients presenting to the various outreach centers of the hospital in the community. METHODS Patient treatment files from the emergency department and the reports from various outreach centers were retrieved for a period of one year (May 2011 to April 2012). Epidemiological information, mode, type and anatomic location of injuries were recorded. Outcome evaluation was assessed by number of patients discharged from emergency department of the hospital or the outreach centers after the treatment, patients admitted for inpatient management and referred to other centers for further specialty management. RESULT In a period of one year, total 2205 (20%) of physical trauma cases presented to the emergency department and 1994 (6.12%) in the outreach centres. Most commonly involved age group in physical trauma both in Hospital set up and in Community set up were the young adults (15 to 49 years). Fall from height was the commonest mode of injury followed by road traffic accidents among the patients coming to the hospital while significant number of trauma patients coming to outreach centers were due to fall from height. In the hospital set up, 1525 (69.2%) of the cases were discharged while 537 (24.4%) needed inpatient management and 85 (3.8%) needed referral to other centers for the specialty management. In case of outreaches, half of the patients were discharged after the primary treatment and almost another half were referred to the hospital, mainly for need of further investigations. CONCLUSION Fall related injuries and road traffic accidents are the most common mode of trauma in the hospital set up and fall related injuries are the single most important mode of trauma seen in the outreaches. Mostly young adults in their active period of life are involved in physical trauma so appropriate preventive measures through public health approach should be included in comprehensive trauma management for reducing mortality and morbidity rates related to physical trauma.
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Affiliation(s)
- R Shrestha
- Department of Orthopedics and Traumatology, Dhulikhel Hospital- Kathmandu University Hospital, Kathmandu University School of medical Science, Dhulikhel Hospital, Kavre, Nepal
| | - S K Shrestha
- Department of Emergency, Dhulikhel Hospital- Kathmandu University Hospital, Kathmandu University School of medical Science, Dhulikhel Hospital, Kavre, Nepal
| | - S R Kayastha
- Department of Orthopedics and Traumatology, Dhulikhel Hospital- Kathmandu University Hospital, Kathmandu University School of medical Science, Dhulikhel Hospital, Kavre, Nepal
| | - N Parajuli
- Department of Orthopedics and Traumatology, Dhulikhel Hospital- Kathmandu University Hospital, Kathmandu University School of medical Science, Dhulikhel Hospital, Kavre, Nepal
| | - D Dhoju
- Department of Orthopedics and Traumatology, Dhulikhel Hospital- Kathmandu University Hospital, Kathmandu University School of medical Science, Dhulikhel Hospital, Kavre, Nepal
| | - D Shrestha
- Department of Orthopedics and Traumatology, Dhulikhel Hospital- Kathmandu University Hospital, Kathmandu University School of medical Science, Dhulikhel Hospital, Kavre, Nepal
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Pichl A, Seimetz M, Fysikopoulos A, Bednorz M, Parajuli N, Haag D, Reiter R, Grimminger J, Seeger W, Schermuly R, Grimminger F, Ghofrani HA, Weissmann N. A possible role of serotonin for the development of tobacco smoke-induced lung emphysema and pulmonary hypertension. Pneumologie 2014. [DOI: 10.1055/s-0034-1376815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Patel VB, Clarke NE, Wang Z, Putko B, Parajuli N, Lo J, Turner AJ, Oudit GY. Angiotensin II Induced Proteolytic Cleavage of Angiotensin Converting Enzyme 2 Is Mediated Via the Tnf-Alpha Converting Enzyme (TACE/ADAM-17): A Positive Feedback Mechanism in the Renin Angiotensin System. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Patel VB, Basu R, Lee J, Morton JS, Parajuli N, Davidge ST, Kassiri Z, Oudit GY. Angiotensin Converting Enzyme 2 Deficiency Exacerbates Angiotensin II Induced Loss of Smooth Muscle Cells Leading to Enhanced Adverse Vascular Remodeling. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Dhoju D, Shrestha D, Parajuli N, Dhakal G, Shrestha R. Ipsilateral supracondylar fracture and forearm bone injury in children: a retrospective review of thirty one cases. Kathmandu Univ Med J (KUMJ) 2012; 9:11-6. [PMID: 22610861 DOI: 10.3126/kumj.v9i2.6280] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Pediatric supracondylar fracture and forearm bone fracture is common in isolation but combined supracondylar fracture with ipsilateral forearm bone fracture, known as floating elbow is not common injury. The incidence of this association varies between 3% and 13%. Since the injury is rare and only limited literatures are available, choosing best management options for floating elbow is challenging. METHOD In retrospective review of 759 consecutive supracondylar fracture managed in between July 2005 to June 2011, children with combined supracondylar fracture with forearm bone injuries were identified and their demographic profiles, mode of injury, fracture types, treatment procedures, outcome and complications were analyzed. RESULT Thirty one patients (mean age 8.91 yrs, range 2-14 yrs; male 26; left side 18) had combined supracondylar fracture and ipsilateral forearm bone injury including four open fractures. There were 20 (64.51%) Gartland type III (13 type IIIA and 7 type III B), seven (22.58 %) type II, three (9.67 %) type I and one (3.22 %) flexion type supracondylar fracture. Nine patients had distal radius fracture, six had distal third both bone fracture, three had distal ulna fracture, two had mid shaft both bone injury and one with segmental ulna with distal radius fracture. There were Monteggia fracture dislocation, proximal ulna fracture, olecranon process fracture, undisplaced radial head fracture of one each and two undisplaced coronoid process fracture. Displaced forearm fracture required closed reduction and fixation with Kirschner wires or intramedullary nailing. Nineteen patients with Gartland type III fracture underwent operative intervention. Among them nine had closed reduction and K wire fixation for both supracondylar fracture and forearm bone injury. There were three radial nerve, one ulnar nerve and one median nerve injury and two postoperative ulnar nerve palsy. Three patients had pin tract related complications. Among type III, 16 (80%) patients had good to excellent, two had fair and one had poor result in terms of Flynn criteria in three months follow up. CONCLUSION Displaced supracondylar fracture with ipsilateral displaced forearm bone injuries need early operative management in the form of closed reduction and percutaneous pinning which provides not only stable fixation but also allows close observation for early sign and symptom of development of any compartment syndrome.
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Affiliation(s)
- D Dhoju
- Department of Orthopaedics and Traumatology, Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Nepal
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Pichl A, Parajuli N, Seimetz M, Stasch JP, Frey R, Schermuly RT, Seeger W, Grimminger F, Ghofrani HA, Weissmann N. Stimulation of Soluble Guanylate Cyclase by Riociguat prevents Tobacco smoke-induced Pulmonary Hypertension in mice. Pneumologie 2012. [DOI: 10.1055/s-0032-1315498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Parajuli N, Seimetz M, Roth M, Fuchs B, Schermuly R, Ghofrani H, Schudt C, Hesslinger C, Seeger W, Grimminger F, Weissmann N. Alveolar Remodeling in a Mouse Model of Chronic Tobacco Smoke Inhalation. Pneumologie 2008. [DOI: 10.1055/s-2008-1074472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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