Browsing by Author "Bhandari, Abashesh"
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Publication A Case of Juvenile Polyposis Syndrome in a 13-year-old: A Case Report(Nepal Medical Association, 2023) Bhandari, Abashesh; Basnet, Bhupendra Kumar; Chaudhary, Ashlesha; Chaudhary, AashutoshAbstract Juvenile polyposis syndrome is an autosomal dominant syndrome characterised by hamartomatous polyps in the gastrointestinal tract and has a high risk for colon carcinoma. This case explores the presentation of multiple polyps throughout the gastrointestinal tract, located in the stomach, proximal duodenum, colon, rectum and up to the anal canal. The locations and number of these polyps themselves were not typical and the histopathological studies suggested the condition to be an inflammatory fibroid polyp, which is a rare, benign and solitary neoplasm. Prompt and accurate diagnostic modality remains the keystone in the identification and management of such condition which was a limitation in this case as the patient was lost to follow up before a definitive diagnosis was made.Publication Alcoholic Liver Disease among Patients Admitted to the Department of Internal Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Chaudhary, Ashlesha; Chaudhary, Arun Kumar; Chaudhary, Aashutosh; Bhandari, Abashesh; Dahal, Sujata; Bhusal, SuzitAbstract Introduction: Alcoholic liver diseases comprise a spectrum of liver diseases including fatty liver, alcoholic hepatitis, and cirrhosis. Diagnosis at advanced stages is frequent for this condition and data regarding the prevalence of such patients at early stages are limited. The aim of this study is to find out the prevalence of alcoholic liver disease among patients admitted to the Department of Internal Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among 538 patients admitted to the Department of Internal Medicine of a tertiary care centre in Nepal between 3rd November, 2021 and 22nd February, 2022 after receiving ethical approval from the Institutional Review Committee of the hospital (Reference number: 006-078/079). Convenience sampling was done. Data were collected and entered in Microsoft Excel and analysed using Statistical Package for the Social Sciences version 24.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data along with mean and standard deviation for continuous data. Results: Among 538 patients, alcoholic liver disease was seen in 42 (7.80%) (5.53-10.07 at 95% Confidence Interval). The mean age of the patients was 53.85±10.88 years. Among these patients 25 (59.52%) were males and 17 (40.47%) of them were females. Conclusions: Our study showed that the prevalence of alcoholic liver disease was lower as compared to similarly reported literature.Publication Alcoholic Liver Disease among Patients Admitted to the Department of Internal Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study Authors(Nepal Medical Association, 2022) Chaudhary, Ashlesha; Chaudhary, Arun Kumar; Chaudhary, Aashutosh; Bhandari, Abashesh; Dahal, Sujata; Bhusal, SuzitAbstract: Introduction: Alcoholic liver diseases comprise a spectrum of liver diseases including fatty liver, alcoholic hepatitis, and cirrhosis. Diagnosis at advanced stages is frequent for this condition and data regarding the prevalence of such patients at early stages are limited. The aim of this study is to find out the prevalence of alcoholic liver disease among patients admitted to the Department of Internal Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among 538 patients admitted to the Department of Internal Medicine of a tertiary care centre in Nepal between 3rd November, 2021 and 22nd February, 2022 after receiving ethical approval from the Institutional Review Committee of the hospital (Reference number: 006-078/079). Convenience sampling was done. Data were collected and entered in Microsoft Excel and analysed using Statistical Package for the Social Sciences version 24.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data along with mean and standard deviation for continuous data. Results: Among 538 patients, alcoholic liver disease was seen in 42 (7.80%) (5.53-10.07 at 95% Confidence Interval). The mean age of the patients was 53.85±10.88 years. Among these patients 25 (59.52%) were males and 17 (40.47%) of them were females. Conclusions: Our study showed that the prevalence of alcoholic liver disease was lower as compared to similarly reported literature.Publication Hyponatremia in Chronic Liver Disease among Patients Presenting to a Tertiary Care Hospital: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Bhandari, Abashesh; Chaudhary, AshleshaAbstract: Introduction: Hyponatremia is a frequent problem in chronic liver disease. To the best of our knowledge, no study of hyponatremia in chronic liver disease has been conducted in our setting. The aim of this study is to study the prevalence of hyponatremia in patients with chronic liver disease attending the outpatient department of a tertiary care hospital. Methods: This descriptive cross-sectional study was conducted in 114 patients with chronic liver disease attending the out-patient department of a tertiary care hospital in Kathmandu, Nepal between November 2020 and July 2021. Ethical approval was taken from the Institutional Review Committee of Nepal Medical College and Teaching Hospital (Reference number: 028-077/078). Convenience sampling was done. The collected data was entered and analyzed in Microsoft Excel. Calculation of point estimate at 95% confidence interval was done along with frequency and proportion for binary data. Results: Among 114 patients with chronic liver disease studied, 47 (41.22%) (32.18-50.25 at 95% Confidence Interval) patients had hyponatremia (≤130mmol/L) with mean age of 53.44±7.57 years. Thirty (63.8%) patients out of these were males and 17 (36.2%) patients were females. Conclusions: The prevalence of hyponatremia among patients with chronic liver disease was found to be higher when compared to other similar studies.Publication Low Vitamin D Levels in Patients with Irritable Bowel Syndrome of a Tertiary Care Hospital: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Bhandari, Abashesh; Chaudhary, AshleshaAbstract: Introduction: Vitamin D deficiency is one of the common disorders prevalent among both developed and developing countries. Irritable Bowel Syndrome has been linked to many diseases and conditions, one of them being Vitamin D deficiency. To the best of our knowledge, no study of vitamin D deficiency status has been done yet in Nepalese setup. This study aims to find out the prevalence of low levels of Vitamin D in patients with Irritable Bowel Syndrome attending the outpatient department of a tertiary care hospital. Methods: This descriptive cross-sectional study was conducted in patients with Irritable Bowel Syndrome attending the outpatient department of a tertiary care hospital in Kathmandu, Nepal between November 2020 and July 2021. Ethical approval was taken from the Institutional Review Committee of Nepal Medical College and Teaching Hospital (Ref No: 027-077/078). Convenient sampling was done. The collected data was entered and analyzed in Microsoft Excel. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of a total of 71 patients with Irritable Bowel Syndrome, the prevalence of low levels of vitamin D was 44 (61.97%) (95% Confidence Interval= 50.67-73.26). Out of the patients with low vitamin levels, insufficiency was seen in 23 (52.27%) and deficiency was seen in 21 (47.72%). Conclusions: Our study found the prevalence of low Vitamin D levels among patients with Irritable Bowel Syndrome to be lower when compared to other studies.Publication Ulcerative Colitis with Superior Sagittal Sinus Thrombosis: A Case Report(Nepal Medical Association, 2023) Basnet, Somika; Bhandari, Abashesh; Basnet, Bhupendra Kumar; Thapaliya, SabinAbstract Ulcerative colitis is a chronic inflammatory, idiopathic, condition of the mucosa of the colon. Cerebral venous thrombosis is one of the serious and rare complications of inflammatory bowel disease. We report a case of a 27-year-old female patient with complaints of loose stool 5 to 6 episodes per day mixed with blood for 10 days. The patient has severe per rectal bleed, not controlled despite adequate measures and a few days later developed altered sensorium and fits. This case highlights prompt diagnosis and early treatment managing both severe ulcerative colitis and sagittal venous thrombosis. Immediate recognition of her disease improved her condition drastically and increased her survival.Publication Use of Novel Biological Agent in Severe Ulcerative Colitis with Poor Response to Initial Therapy: A Case Report(Nepal Medical Association, 2022) Bhandari, Abashesh; Basnet, Bhupendra KumarAbstract Ulcerative colitis is a condition of chronic inflammation affecting the large intestine. The disease is typically characterized by periods of active inflammation alternating with periods of remission. For patients with moderate to severe ulcerative colitis, the first line for induction therapy options includes biologic agents (with or without an immunomodulator) or glucocorticoids. This case highlights the first successful case of ulcerative colitis treated with adalimumab with mesalamine and azathioprine. The patient was initially treated with mesalamine and azathioprine which did not result in significant clinical improvement but the addition of subcutaneous adalimumab showed a remarkable response with drastic improvement in just one year of treatment. Hence, adalimumab could be considered as an option in the management of severe cases in Nepal.