Browsing by Author "Acharya, Achyut Bhakta"
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Publication Bronchiectasis-COPD Overlap Syndrome (BCOS) among the Nepalese Patients: Emerging disease from a developing country(Nepalese Respiratory Society, 2023) Acharya, Achyut Bhakta; Bhattarai, Narendra; Mishra, Deebya Raj; Karki, Prahlad; Gupta, Mukesh Kumar; Lamsal, Madhab; Khanal, BasudaAbstract: Background and objective: There is no clearly specified diagnostic criteria to identify BCOS in Nepalese context. So this first, observational cross-sectional study was conducted to determine the current situation, main clinical practices, and features of BCOS in Nepalese patients, exploring its clinical trajectory and severity. Methods: This is a hospital based descriptive cross-sectional study conducted, where patients presenting with respiratory symptoms complex were subsequently enrolled by purposive sampling. Descriptive Statistics was calculated using Absolute and Relative Frequencies for categorical variables and mean and standard deviation for numerical ones. P-value of <0.05 was considered significant. Results: Out of 236 patients of Respiratory Symptoms Complex, prevalence of BCOS was 22.03%. 57.7% were males with mean age of 67.8 years. Among BCOS cohorts, 92.3% were smokers and 73 % had significant exposure to indoor air pollution. 63.5% of the patients had past history of tuberculosis and cardio-metabolic co-morbidities were seen in 34.6% of the patients. The most frequent symptoms were cough and shortness of breath and the commonest sign was bilateral basal coarse crackles. Frequent exacerbations were present in 25% of the patients and PFT revealed obstructive pattern in 71% of the BCOS patients with a mean FACED score of 3.94±1.62. Conclusion: Among the patients presenting with Respiratory symptom complex in Nepal, BCOS is common and is more prevalent in elderly male, having a high co-morbidities, usually following a course of slowly progressive breathlessness, with higher incidence of exacerbation and poorer functional outcome.Publication Mesothelioma with Nonbacterial Thrombotic Endocarditis: A Case Report Authors(Nepal Medical Association, 2021) Verma, Avatar; Bhatta, Narendra; Mishra, Deebya Raj; Acharya, Achyut Bhakta; Shahi, Rejina; LImbu, Sion Hangma; Katuwal, Srijan; Lama, UrmilaAbstract: Non-bacterial thrombotic endocarditis is a rare condition characterized by noninfectious vegetation on cardiac valves which are often associated with malignancy. It often presents with features of embolism rather than cardiac failure. These are usually seen in autoimmune conditions, disseminated intravascular coagulation, malignancy of gut and lung but has also been reported in other malignancies as well. This entity is rare but one must have a clinical suspicion of the disease especially in a patient suffering from malignancy presenting with the embolic phenomenon. In this report, we are presenting a case of non-bacterial thrombotic endocarditis in an inpatient with pleural mesothelioma, a rare malignant neoplasm arising from pleura in a 35 years old mason, and a rare association as well.Publication Navigating challenges in management of drug resistant tuberculosis: Case experience from Nepal(Nepalese Respiratory Society, 2022) Verma, Avatar; Bhatta, Narendra; Mishra, Deebya Raj; Acharya, Achyut Bhakta; Shahi, Rejina; Limbu, Sion Hangma; Katuwal, SrijanAbstract: Drug resistant tuberculosis (DR TB) a severe form of TB is a disease of concern. Its treatment requires multiple toxic drugs for prolonged duration because of which, often have complicated course requiring close supervision, continuous encouragement from physician, management of side effects and modification of drug regimen for successful outcome. In this report, we are presenting a case of diabetic patient suffering from DR TB highlighting key diagnostic and management challenges.Publication Small Cell Lung Carcinoma with Pancoast Syndrome: A Case Report(Nepal Medical Association, 2022) Limbu, Sion Hangma; Bhatta, Narendra; Mishra, Deebya Raj; Acharya, Achyut Bhakta; Verma, Avatar; Shahi, Rejina; Katuwal, Srijan; Singh, Sunil KumarAbstract: Small cell lung cancer mostly arises centrally in the large bronchi. The literature search revealed very limited cases of small cell lung cancer arising at the upper part of the pulmonary sulcus near the thoracic inlet as superior sulcus tumor and also manifesting with typical Pancoast syndrome. We report a case of a 71 years old male patient, presenting with features of Pancoast syndrome including Horner’s syndrome with completed three cycles of chemotherapy resulting in partial response which concludes that small cell lung carcinoma has to be considered despite the clinical findings like pancoast syndrome.