I have been TOP cardiologist of Nepal.I am Founder President and Patron of Nepal cardiac society,Nepal Heart Foundation,Nepal Diabetes Society,Emeritus Chairman of Nepal Health Research Council and Founder of MrigendraSamjhana Medical Trust,a charity organisation created by donating substantial properties and actively involved for substantial charity works.
Mrigendra R. PandeyKathmandu, NepalAn investigator from India has reported a veryhigh incidence o... more Mrigendra R. PandeyKathmandu, NepalAn investigator from India has reported a veryhigh incidence of cor pulmonale (16.6%) of theadmitted cardiac cases in an urban hospital. Menand women were almost equally affected in thestudy (1.2:1.0) unlike previous studies that recordeda high preponderance of men over women [1,2].The investigator suggested very squalid livingconditions and the smoke-filled atmosphere inwhich these patients lived were contributory factors,but the investigator unable to followup withfield studies [3].It was the winter of 1976-1977, as chief of theMedical and Cardiology Department, I wasworking at Bir Hospital, which was the premierehospital of Nepal, and was serving both the urbanand rural populations. A large number of patientsadmitted to the medical ward were suffering fromchronic bronchitis and chronic obstructive pulmo-nary disease (COPD), often complicated by cor pul-monale. After spending a few days, they used to bedischarged from the hospital but most of themw...
Background : Fostering a culture of continued learning at healthcare facilities is a global prior... more Background : Fostering a culture of continued learning at healthcare facilities is a global priority for healthcare systems performance, patient safety, and quality improvement. In low- and middle-income countries, continuing medical education activities are almost non-existent in rural areas and so is in Nepal. National professional academies tend to be focused almost exclusively at major teaching hospitals in urban centers. In addition to playing a central role in healthcare provision, rural district-level hospitals in Nepal are formative for many young healthcare professionals who are posted there for mandatory government service. The district hospital in Nepal thus represents an important opportunity to be a center for learning. Greater investment in these types of programs may improve healthcare worker satisfaction and retention, thereby improving access to care in these remote areas. Methods : We conducted a qualitative study to describe the implementation of a continuing medi...
s Study on Primary Percutaneous Coronary Intervention (PPCI) in Patient with Acute ST elevation... more s Study on Primary Percutaneous Coronary Intervention (PPCI) in Patient with Acute ST elevation Myocardial Infarction: In-Hospital, 30-days and long term Survival Outcome A single centre study in Shahid Gangalal National Heart Centre (SGNHC), Kathmandu Nepal. Adhikari CM, Bhatta YD, Maskey A, Malla R, Rajbhandari R, Regmi SR et al 65 The association between endothelial dysfunction and metabolic syndrome in Nepalese cohorts with coronary risk factors Gautam MP, Ghimire U, Gautam S, Chaurasia AK, Guruprasad S, Bhattacharya R et al 66 Prevalence of metabolic syndrome in dhulikhel municipality Gyawali P, Takhanchhe JS, Pant N, Gurung S, Koju R, 67 Clinical profile of patients with HF with Reduced EF presenting to CMS-TH, A tertiary care hospital in Central Nepal. Gautam S, Gautam MP, Sharma SK, Dubey L, Laudari S, Dhungel S et al 68 Preventing renal and cardiovascular risk by renal function assessment: insights from a crosssectional study in low-income countries and the US Sha...
डा. मृगेन्द्र राज पाण्डेले पाच दसक भन्दा बढी नेपालको स्वास्थ्य क्षेत्रमा विशिष्ट योगदान गर्नु भएक... more डा. मृगेन्द्र राज पाण्डेले पाच दसक भन्दा बढी नेपालको स्वास्थ्य क्षेत्रमा विशिष्ट योगदान गर्नु भएको छ । उहाँले नेपालको स्वास्थ्य नीति निर्माण, जनचेतना फैलाउने र अनुसन्धानमा महत्त्वपूर्ण योगदान पुर्याउनु भएको छ । उहाँले नेपालमा स्वास्थ्य अनुसन्धान परिषद स्थापना, विर अस्पतालमा मेडिकल र सर्जरी विभाग स्थापना लगायत स्वास्थ्य क्षेत्र सुधारमा पनि महत्त्वपूर्ण योगदान पुर्याउनु भएको छ ।
A prospective study was conducted to determine the magnitude of morbidity and mortality caused by... more A prospective study was conducted to determine the magnitude of morbidity and mortality caused by acute respiratory infections (ARI) among children under 5 years of age and to assess the feasibility of reducing mortality owing to ARI by the use of community health workers. Villages selected for this study were situated on the south-west edge of Kathmandu Valley, about 24 km from the city centre. The study group consisted of 1019 children under the age of 5 years at the beginning of the study and followed for 3 years. During the 1st year, baseline information was collected. During the 2nd and 3rd years, intervention measures (health education, immunization and antibiotics for children with signs suggesting pneumonia) were taken and their effect assessed. There was a 59% reduction in the ARI-specific death rate among study children between surveillance year and intervention year I and a further 25% reduction in the ARI-specific death rate between intervention years I and II. Despite a substantial reduction in ARI mortality with the interventions, there was still an unacceptably high mortality from chronic diarrhoea, malnutrition and other factors. This implies that the programme to control ARI, diarrhoea, malnutrition and immunizable diseases should be integrated into one, within the framework of a primary health care strategy.
The major aim of this study was to determine the prevalence of rheumatic heart disease in Yemen. ... more The major aim of this study was to determine the prevalence of rheumatic heart disease in Yemen. Between October 1997 and March 1998, a prospective cluster-sampling screening study was carried out on 5000 schoolchildren (2504 female and 2496 male), aged 5 to 18 years. Suspected cases were subjected to electrocardiography, chest radiography, and Doppler echocardiography. Although no case of active rheumatic fever was found, 12 girls and 6 boys were affected by the disease, giving a prevalence of 3.6 per 1000, which is higher than that reported from neighboring countries. All confirmed and suspected cases were given penicillin G benzathine every 3 weeks, according to body weight, after a test dose. Prevention programs for rheumatic fever, together with prevention of streptococcal throat infections, are goals for the near future.
ABSTRACTCardiovascular disease is the commonest cause of death globally and is the major contribu... more ABSTRACTCardiovascular disease is the commonest cause of death globally and is the major contributor to the burdenof premature mortality and morbidity. Coronary artery disease ( CAD) is greatest killer of mankind. Coronaryartery disease in western industrialized countries show a declining trend. However developing countrieshave shown an alarming increase. The identification of major risk factors and effective control of themthrough population based strategies of prevention were mainly responsible for this decline.A few cases ofacute myocardial infarction were seen in Kathmandu ,Nepal in 1950 and in the sixties the incidence startedrising rapidly. In a study between 1960-1968 a total of 150 cases were reported with myocardial infarctionin Kathmandu , Nepal. Although national datas for incidence and prevalence on CAD in Nepal is notavailable, hospital based datas on admission pattern in different hospitals of Kathmandu, capital city ofNepal show 40 fold increase in incidence of acute ...
Platelet aggregation requires agonist-induced αIIbβ3 activation, a process mediated by Rap1 and t... more Platelet aggregation requires agonist-induced αIIbβ3 activation, a process mediated by Rap1 and talin. To study mechanisms, we engineered αIIbβ3 Chinese hamster ovary (CHO) cells to conditionally express talin and protease-activated receptor (PAR) thrombin receptors. Human PAR1 or murine PAR4 stimulation activates αIIbβ3, which was measured with antibody PAC-1, indicating complete pathway reconstitution. Knockdown of Rap1–guanosine triphosphate–interacting adaptor molecule (RIAM), a Rap1 effector, blocks this response. In living cells, RIAM overexpression stimulates and RIAM knockdown blocks talin recruitment to αIIbβ3, which is monitored by bimolecular fluorescence complementation. Mutations in talin or β3 that disrupt their mutual interaction block both talin recruitment and αIIbβ3 activation. However, one talin mutant (L325R) is recruited to αIIbβ3 but cannot activate it. In platelets, RIAM localizes to filopodia and lamellipodia, and, in megakaryocytes, RIAM knockdown blocks PAR4-mediated αIIbβ3 activation. The RIAM-related protein lamellipodin promotes talin recruitment and αIIbβ3 activity in CHO cells but is not expressed in megakaryocytes or platelets. Thus, talin recruitment to αIIbβ3 by RIAM mediates agonist-induced αIIbβ3 activation, with implications for hemostasis and thrombosis.
Tracheal injuries account for 15% of all airway injuries and in majority of the cases involve rou... more Tracheal injuries account for 15% of all airway injuries and in majority of the cases involve routine tracheal intubation and appropriate anaesthesia care.1 The authors would like to describe a patient who developed subcutaneous emphysema and tension pneumomediastinum related to multiple intubation attempts resulting in cardiac arrest.
Mrigendra R. PandeyKathmandu, NepalAn investigator from India has reported a veryhigh incidence o... more Mrigendra R. PandeyKathmandu, NepalAn investigator from India has reported a veryhigh incidence of cor pulmonale (16.6%) of theadmitted cardiac cases in an urban hospital. Menand women were almost equally affected in thestudy (1.2:1.0) unlike previous studies that recordeda high preponderance of men over women [1,2].The investigator suggested very squalid livingconditions and the smoke-filled atmosphere inwhich these patients lived were contributory factors,but the investigator unable to followup withfield studies [3].It was the winter of 1976-1977, as chief of theMedical and Cardiology Department, I wasworking at Bir Hospital, which was the premierehospital of Nepal, and was serving both the urbanand rural populations. A large number of patientsadmitted to the medical ward were suffering fromchronic bronchitis and chronic obstructive pulmo-nary disease (COPD), often complicated by cor pul-monale. After spending a few days, they used to bedischarged from the hospital but most of themw...
Background : Fostering a culture of continued learning at healthcare facilities is a global prior... more Background : Fostering a culture of continued learning at healthcare facilities is a global priority for healthcare systems performance, patient safety, and quality improvement. In low- and middle-income countries, continuing medical education activities are almost non-existent in rural areas and so is in Nepal. National professional academies tend to be focused almost exclusively at major teaching hospitals in urban centers. In addition to playing a central role in healthcare provision, rural district-level hospitals in Nepal are formative for many young healthcare professionals who are posted there for mandatory government service. The district hospital in Nepal thus represents an important opportunity to be a center for learning. Greater investment in these types of programs may improve healthcare worker satisfaction and retention, thereby improving access to care in these remote areas. Methods : We conducted a qualitative study to describe the implementation of a continuing medi...
s Study on Primary Percutaneous Coronary Intervention (PPCI) in Patient with Acute ST elevation... more s Study on Primary Percutaneous Coronary Intervention (PPCI) in Patient with Acute ST elevation Myocardial Infarction: In-Hospital, 30-days and long term Survival Outcome A single centre study in Shahid Gangalal National Heart Centre (SGNHC), Kathmandu Nepal. Adhikari CM, Bhatta YD, Maskey A, Malla R, Rajbhandari R, Regmi SR et al 65 The association between endothelial dysfunction and metabolic syndrome in Nepalese cohorts with coronary risk factors Gautam MP, Ghimire U, Gautam S, Chaurasia AK, Guruprasad S, Bhattacharya R et al 66 Prevalence of metabolic syndrome in dhulikhel municipality Gyawali P, Takhanchhe JS, Pant N, Gurung S, Koju R, 67 Clinical profile of patients with HF with Reduced EF presenting to CMS-TH, A tertiary care hospital in Central Nepal. Gautam S, Gautam MP, Sharma SK, Dubey L, Laudari S, Dhungel S et al 68 Preventing renal and cardiovascular risk by renal function assessment: insights from a crosssectional study in low-income countries and the US Sha...
डा. मृगेन्द्र राज पाण्डेले पाच दसक भन्दा बढी नेपालको स्वास्थ्य क्षेत्रमा विशिष्ट योगदान गर्नु भएक... more डा. मृगेन्द्र राज पाण्डेले पाच दसक भन्दा बढी नेपालको स्वास्थ्य क्षेत्रमा विशिष्ट योगदान गर्नु भएको छ । उहाँले नेपालको स्वास्थ्य नीति निर्माण, जनचेतना फैलाउने र अनुसन्धानमा महत्त्वपूर्ण योगदान पुर्याउनु भएको छ । उहाँले नेपालमा स्वास्थ्य अनुसन्धान परिषद स्थापना, विर अस्पतालमा मेडिकल र सर्जरी विभाग स्थापना लगायत स्वास्थ्य क्षेत्र सुधारमा पनि महत्त्वपूर्ण योगदान पुर्याउनु भएको छ ।
A prospective study was conducted to determine the magnitude of morbidity and mortality caused by... more A prospective study was conducted to determine the magnitude of morbidity and mortality caused by acute respiratory infections (ARI) among children under 5 years of age and to assess the feasibility of reducing mortality owing to ARI by the use of community health workers. Villages selected for this study were situated on the south-west edge of Kathmandu Valley, about 24 km from the city centre. The study group consisted of 1019 children under the age of 5 years at the beginning of the study and followed for 3 years. During the 1st year, baseline information was collected. During the 2nd and 3rd years, intervention measures (health education, immunization and antibiotics for children with signs suggesting pneumonia) were taken and their effect assessed. There was a 59% reduction in the ARI-specific death rate among study children between surveillance year and intervention year I and a further 25% reduction in the ARI-specific death rate between intervention years I and II. Despite a substantial reduction in ARI mortality with the interventions, there was still an unacceptably high mortality from chronic diarrhoea, malnutrition and other factors. This implies that the programme to control ARI, diarrhoea, malnutrition and immunizable diseases should be integrated into one, within the framework of a primary health care strategy.
The major aim of this study was to determine the prevalence of rheumatic heart disease in Yemen. ... more The major aim of this study was to determine the prevalence of rheumatic heart disease in Yemen. Between October 1997 and March 1998, a prospective cluster-sampling screening study was carried out on 5000 schoolchildren (2504 female and 2496 male), aged 5 to 18 years. Suspected cases were subjected to electrocardiography, chest radiography, and Doppler echocardiography. Although no case of active rheumatic fever was found, 12 girls and 6 boys were affected by the disease, giving a prevalence of 3.6 per 1000, which is higher than that reported from neighboring countries. All confirmed and suspected cases were given penicillin G benzathine every 3 weeks, according to body weight, after a test dose. Prevention programs for rheumatic fever, together with prevention of streptococcal throat infections, are goals for the near future.
ABSTRACTCardiovascular disease is the commonest cause of death globally and is the major contribu... more ABSTRACTCardiovascular disease is the commonest cause of death globally and is the major contributor to the burdenof premature mortality and morbidity. Coronary artery disease ( CAD) is greatest killer of mankind. Coronaryartery disease in western industrialized countries show a declining trend. However developing countrieshave shown an alarming increase. The identification of major risk factors and effective control of themthrough population based strategies of prevention were mainly responsible for this decline.A few cases ofacute myocardial infarction were seen in Kathmandu ,Nepal in 1950 and in the sixties the incidence startedrising rapidly. In a study between 1960-1968 a total of 150 cases were reported with myocardial infarctionin Kathmandu , Nepal. Although national datas for incidence and prevalence on CAD in Nepal is notavailable, hospital based datas on admission pattern in different hospitals of Kathmandu, capital city ofNepal show 40 fold increase in incidence of acute ...
Platelet aggregation requires agonist-induced αIIbβ3 activation, a process mediated by Rap1 and t... more Platelet aggregation requires agonist-induced αIIbβ3 activation, a process mediated by Rap1 and talin. To study mechanisms, we engineered αIIbβ3 Chinese hamster ovary (CHO) cells to conditionally express talin and protease-activated receptor (PAR) thrombin receptors. Human PAR1 or murine PAR4 stimulation activates αIIbβ3, which was measured with antibody PAC-1, indicating complete pathway reconstitution. Knockdown of Rap1–guanosine triphosphate–interacting adaptor molecule (RIAM), a Rap1 effector, blocks this response. In living cells, RIAM overexpression stimulates and RIAM knockdown blocks talin recruitment to αIIbβ3, which is monitored by bimolecular fluorescence complementation. Mutations in talin or β3 that disrupt their mutual interaction block both talin recruitment and αIIbβ3 activation. However, one talin mutant (L325R) is recruited to αIIbβ3 but cannot activate it. In platelets, RIAM localizes to filopodia and lamellipodia, and, in megakaryocytes, RIAM knockdown blocks PAR4-mediated αIIbβ3 activation. The RIAM-related protein lamellipodin promotes talin recruitment and αIIbβ3 activity in CHO cells but is not expressed in megakaryocytes or platelets. Thus, talin recruitment to αIIbβ3 by RIAM mediates agonist-induced αIIbβ3 activation, with implications for hemostasis and thrombosis.
Tracheal injuries account for 15% of all airway injuries and in majority of the cases involve rou... more Tracheal injuries account for 15% of all airway injuries and in majority of the cases involve routine tracheal intubation and appropriate anaesthesia care.1 The authors would like to describe a patient who developed subcutaneous emphysema and tension pneumomediastinum related to multiple intubation attempts resulting in cardiac arrest.
Uploads