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Browsing by Author "Bhattarai, Tulsi"

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    Cotrimoxazole Induced Steven Johnson Syndrome: A Case Report
    (Nepal Medical Association, 2020) Acharya, Ayushma; Acharya, Shreedhar Prasad; Bhattarai, Tulsi
    Abstract: Steven Johnson syndrome and toxic epidermal necrolysis are severe and rare adverse drug reactions usually caused by drugs like antiepileptics, penicillin and allopurinol and sometimes also due to infections, malignancy or idiopathic in some cases. Here we are reporting a case of a 50 years female who came with complaint of a burning sensation on the upper half of the body with atypical flat target lesion that later coalesced involving her face, chest and bilateral upper limbs. On examination, positive nikolsky sign and tenderness with <10% body surface area involvement was noticed. The diagnosis of cotrimoxazole induced Steven Johnson syndrome was made. Patient was shifted to ICU and given supportive care along with prophylactic teicoplanin, itraconazole and dexamethasone. The mechanism of eruptions in our patient was due to cotrimoxazole. Cotrimoxazole induced Steven Johnson syndrome is rare and the supportive management with broad spectrum antibiotic and the corticosteroid was enough to beat this life-threatening condition.
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    Microalbuminuria among Patients with Diabetes Mellitus Visiting the Department of Nephrology in a Tertiary Care Centre: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2023) Bhattarai, Tulsi; Pandey, Asim; Parajuli, Samriddhi; Khanal, Prajwal; Dongol, Angel; Devkota, Rahul; Neupane, Sohil; Bhattarai, Bharat Kumar
    Abstract Introduction: Microalbuminuria is an abnormal increase in albumin excretion rate with a specific range of 30-299 mg of albumin/g of creatinine or excretion of 20-200 mg/l of albumin in spot urine samples. Diabetic patients with microalbuminuria are at increased risk for cardiovascular death as compared with normoalbuminuria. The aim of this study was to find out the prevalence of microalbuminuria among patients visiting the Department of Nephrology in a tertiary care centre. Methods: This is a descriptive cross-sectional study conducted among diabetic patients visiting the Department of Nephrology in a tertiary care centre after obtaining ethical approval from the Institutional Review Committee (Reference number: 04072022/04). The study was conducted between 1 October 2022 to 30 November 2022 where patients providing written consent and had documented diabetes were included in the study whereas patients without documented diabetes, having comorbidities such as congestive heart failure, nephritic/nephrotic syndrome and those who refused to give consent were excluded from the study. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 103 patients, microalbuminuria was found to be in 19 (18.45%) (10.96-25.94, 95% Confidence Interval). Out of 19 patients, 8 (42.11%) were male and 11 (57.89%) were female. The mean HbA1c among participants with microalbuminuria was 7.67±0.67%. Conclusions: The prevalence of microalbuminuria among diabetic patients was similar to other studies done in similar settings.

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