Browsing by Author "Bhandari, P"
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Publication A Recurrent Case of Ameloblastic Fibroma in 37-year Old Male(Kathmandu University, 2023) Maharjan, N; Bajracharya, D; Ojha, B; Bhandari, P; Koju, SABSTRACT Ameloblastic fibroma (AF) is a benign mixed epithelial and mesenchymal odontogenic tumor. This was previously grouped in odontogenic tumor showing odontogenic epithelium with odontogenic ectomesenchyme, with or without hard tissue formation. This report describes a case of ameloblastic fibroma in a 37-year- old male who came with the complain of swelling in the left side of lower jaw since one year. Enucleation of the mass followed by reconstruction was done six years back. However, after two years of initial treatment; radiographic findings suggested recurrence. Histopathological examination confirmed the diagnosis of ameloblastic fibroma. Patient had no clinical and radiographic evidence of recurrence in three and six months’ follow-up. Because of the higher proliferative capacity and malignant degree of the mesenchymal component in the recurrent neoplasm, sarcomatous transformation may occur. Hence, a long term clinical and radiographical follow-up is essential due to its transformation into ameloblastic fibrosarcoma. KEY WORDS Ameloblastic, Benign, Recurrence, Fibroma, TumorsPublication Co-infection of COVID-19 with Malaria and Dengue -A Hospital based Study in Kathmandu, Nepal(Kathmandu University, 2024) Bajracharya, B; Shrestha, P; Shrestha, D; Karna, AK; Mahato, RK; Shrestha, S; Baral,B; Bhandari, P; Sah, P; Bastola, A; Pandey, BDABSTRACT Background In tropical countries like Nepal, the COVID-19 pandemic unfolded within a population already grappling with various tropical infectious diseases. Co-infection with malaria and dengue holds clinical significance when managing COVID-19 patients in regions endemic to these diseases. Objective To identify malaria and dengue infections in febrile or symptomatic patients suspected of COVID-19 at the Sukraraj Tropical and Infectious Disease Hospital, Kathmandu. Method Over two months, a prospective study was conducted on febrile or symptomatic patients suspected of COVID-19 visiting Sukraraj Tropical and Infectious Disease Hospital, Kathmandu. One hundred and twenty-three patients suspected of COVID-19 were tested for SARS-CoV-2 through RT-PCR as well as for malaria and dengue infection using rapid diagnostic test kits. Result Out of 123 patients suspected of COVID-19, 64 were confirmed to have COVID-19. No evidence of SARS-CoV-2 and malaria co-infection was found among the 123 tested patients. However, two patients admitted for COVID-19 tested positive for dengue virus infection. The patients with co-infections with dengue or scrub typhus were likely to have a longer hospital stays (OR 2.5; 95% CI: 0.22-29.26), though lacking a significant association. Conclusion The two patients diagnosed with dengue virus and SARS-CoV-2 were identified during their hospital visit and both recovered after receiving treatment. Given that COVID-19 patients manifest symptoms resembling many tropical infectious diseases, the study underscores the clinical importance of testing for multiple circulating infections in patients from endemic areas. This approach ensures appropriate and timely management reducing the risk of severity or mortality. KEY WORDS Co-infection, COVID-19, Dengue, Malaria, NepalPublication Extended Spectrum β-lactamase (ESBL) Producing Multi Drug Resistant (MDR) Urinary Pathogens in a Children Hospital from Nepal(Kathmandu University, 2018) Sharma, KR; Bhandari, P; Adhikari, N; Tripathi, P; Khanal, S; Tiwari, BRABSTRACT Background Multidrug resistant in clinical bacterial isolates has increasingly been reported through out the world and is associated with high morbidity, mortality and increased health care costs. It is important to determine the status of multidrug resistance pattern to understand the current resistance trend so that appropriate antibiotics can be used in practice. Objective To determine the antibiotic resistant profile and prevalence of extended spectrum β-lactamase producing multidrug resistant strains in pediatric patients of Kanti Children’s Hospital, Kathmandu, Nepal. Method Urine sample was cultured by standard microbiological techniques and bacterial isolates were identified using different biochemical tests. Antibiotic susceptibility testing was performed by Kirby Bauer disc diffusion method and extended spectrum β-lactamase detection was carried out using combined disc method as recommended by Clinical Laboratory Standard Institute guidelines. Result All together 65 different bacteria were isolated and subsequently identified. E. coli was the most common isolate with 46 (71%) isolates 63% of these isolates were multidrug resistant. Gram negative isolates were most resistant to nalidixic acid (81.97%) followed by ampicillin (69.35%) and co-trimoxazole (69.35%). The extended spectrum β-lactamase producing isolates were 43% among total isolates. Conclusion Higher rate of Extended Spectrum β-lactamase production among multidrug resistant isolates suggested routine extended spectrum β-lactamase testing in clinical isolates. KEY WORDS Antimicrobial, Multidrug resistant, Urinary tract infectionPublication Paroxysmal Nocturnal Haemoglobinuria (classic category)(Institute of Medicine, 2016) Bhandari, P; Shrestha, AAbstract Paroxysmal nocturnal haemoglobinuria (PNH) is a rare disease. The prevalence of clinically significant PNH (i.e. classic PNH) plus patients with relatively large clones that arises in the setting of another marrow failure syndrome is likely in the order of less than 1 case per 200,000 population. Here we present a case of classic PNH who presented with acute kidney injury (AKI) requiring haemodialysis secondary to intravascular haemolysis and haemoglobin of 3.6 gm %. Her diagnosis was suggested by positive HAMS test and confirmed by Flow Cytometry. Patient recovered from AKI after starting danazol and her haemolysis was reduced but not controlled fully. Patient is awaiting treatment with either eculizumab or allogenic bone marrow transplantation. Keywords: Paroxysmal Nocturnal Haemoglobinuria, hemolysis, oliuguria, flow cytometry, eculizumab