Browsing by Author "Adhikari, A"
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Publication Clinical Spectrum of Spontaneous Bacterial Peritonitis in Tertiary Care Centre(Institute of Medicine, 2013) Pathak, R; Harsh, S; Adhikari, A; Khadga, PKAbstract Introduction: Cirrhosis is a common diagnosis in the inpatient population seeking care at the gastroenterology department of the Institute Of Medicine. Spontaneous Bacterial Peritonitis (SBP) is commonly associated with decompensated liver cirrhosis and has been associated with frequent adverse outcome. This small study was designed to spectrum of disease and profile of patient having Spontaneous Bacterial Peritonitis. Methods: The retrospective study was conducted in patient admitted in department of gastroenterology. A total of 51 patients suffering from cirrhosis with ascites was studied. All subject underwent different investigations, like abdominal paracentesis, abdominal Ultrasonography and biochemical analysis, these tests were analyzed. MELD score was calculated for all the patient. Results: Total of 51 patients with Spontaneous Bacterial Peritonitis were enrolled. Majority Of patient had alcohol as the cause of cirrhosis, Jaundice, abdominal pain and fever along with hepatic encephalopathy were chief presenting complaints. A mortality rate of 22% was seen in this small sample of patients. Conclusions: SBP is a major concern in case of hepatic cirrhosis as it can cause considerable risk of adverse outcome and prolong the hospital stay. Early diagnosis and aggressive treatment should be practiced in order to eliminate the risk. Keywords: Spontaneous Bacterial Peritoniti, Cirrhosis, Ascites, MELDPublication Endovascular Treatment for Traumatic Thoracic Aortic Injury: A Case Report(Institute of Medicine, 2018) Shrestha, UK; Shrestha, KR; Gurung, D; Upreti, MR; Adhikari, A; Gurung, AAbstract As majority of blunt traumatic injury with aortic tear die, we see limited numbers of survival in the hospital. Thoracic endovascular treatment for traumatic aortic injury is rare. Endovascular treatment, where available, is the trend for traumatic aortic injury for all age group. Both morbidity and mortality are significantly decreased with endovascular intervention. Twenty nine years old male patient driving a car collided with truck and had thoracic aortic pseudoaneurysm with multiple skeletal fractures that underwent successful endovascular stent graft along with fixation of all fractured bones. Key words: Endovascular stent graft, Thoracic aortic injury, Thoracic aortic pseudoaneurysm, Thoracic endovascular aortic repairPublication Incarcerated Uterine Prolapse: A Result of Neglect(Kathmandu University, 2024) Adhikari, A; Poudel, A; Dangal, GABSTRACT An 80-year-old lady was brought with the three-month history of irreducible prolapse with infected ulcer at anterior vaginal wall. She initially attempted home remedies for infection with locally available materials. On examination she was ill looking, febrile with stage IV prolapse according to pelvic organ prolapse quantification classification. She was treated initially with antiseptic wash, followed by local estrogen therapy and glycerine. Prolapse was repositioned when edema decreased and held in place with silicon ring pessary with definitive management planned for later date. KEY WORDS Incarcerated prolapse, Irreducible prolapse, UlcerPublication Rectal injury attributable to enema(Institute of Medicine, 2017) Pradhan, S; Adhikari, A; Bhandari, RSAbstract Constipation is one of the most common complaints in the general population, and is associated with substantial economic cost. Postoperative ileus (POI) maybe one of the contributory factor for no passage of stool. Despite a lack of strong evidence for their clinical utility, laxatives or prokinetics have been used to treat POI in clinical practice. Many a times, patients self-medicate or take over-the-counter drugs to treat constipation and sometime end up with complications requiring urgent medical consultation. Dietary modification, laxatives are some of the first line treatment of constipation. Bowel cleansing enemas are also frequently used to relieve constipation. Though, very effective, sometimes may cause serious adverse events. Some of the common side effects are anal irritation, burning sensation, diarrhea, nausea and cramps. Bowel injuries following use of bowel cleansing enema is a rare incident. We report two cases that developed rectal injury following use of enema (glycerin 15% w/v and sodium chloride 15% w/v).