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Browsing by Author "Dahal, Sujata"

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    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, Suzit
    Abstract 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.
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    Emergency Caesarean Section in a COVID-19 Infected Mother in a Primary Health Care Centre
    (Nepal Medical Association, 2022) KC, Anil; Subedi, Prativa; Dahal, Sujata; Poudel, Ujjawal
    Abstract People from rural areas of Nepal struggle to have access to adequate medical care on time. Most of the tertiary centres are overburdened by patients, while the peripheral health facilities have been unable to function efficiently due to a lack of infrastructures and skilled manpower needed to run hospitals smoothly. We present a case of a 21-year-old primigravida at 41 weeks and 3 days of gestation with mild COVID-19 symptoms who underwent a Caesarean section for non-progression of labour and foetal distress at a primary health care centre in Nepal; however, both maternal and foetal outcomes were favourable. Therefore, upgrading the quality of care in peripheral health facilities can help in the achievement of accessibility, equity, and quality in health care service in Nepal.
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    Experiences of Young Doctors Working in Rural Nepal
    (Nepal Medical Association, 2022) Dahal, Sujata; Khanal, Surendra; Rijal, Swornima; Bhandari, Puja; Pandey, Rakshya
    Abstract Medical graduates studying on full and partial scholarships are subjected to a mandatory two years of bonding service program to overcome regional inequalities in the distribution of health workers between rural and urban areas. It might be a challenging journey, but it is crucial for the personal and professional growth of young doctors. Working in places distant from home and medical school can also be difficult, especially when the doctors are not adequately trained. During the bond, young graduates are exposed to a variety of clinical and non-clinical circumstances, which can aid in their maturation.
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    Organophosphorus Poisoning among Patients Admitted to the Intensive Care Unit of the Department of Internal Medicine in a Tertiary Care Centre: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2022) Bhusal, Suzit; Bhandari, Rupa; Dahal, Sujata; Niroula, Aliska; Basnet, Krity; Chaudhary, Ashlesha; Pant, Subash
    Abstract Introduction: Organophosphates are potent cholinesterase inhibitors that when ingested in excessive amounts can be fatal. Organophosphorus poisoning has become an important clinical problem with increased mortality in the country from accidental or intentional ingestion of, or exposure to the pesticide. This study aimed to find out the prevalence of organophosphorus poisoning among patients admitted to the Intensive Care Unit of the Department of Internal Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients admitted to the Intensive Care Unit of the Department of Internal Medicine of a tertiary care centre after receiving ethical approval from the Institutional Review Committee (Reference number: 2003202205). The study was conducted between 1 February 2021 and 1 February 2022 using hospital records. Convenience sampling was done among the patients who met the eligibility criteria. The diagnosis of organophosphorus poisoning was made based on the patient’s history, clinical examination and the measurement of serum acetylcholinesterase levels. Point estimate and 95% Confidence Interval were calculated. Results: Among 1108 patients admitted, organophosphorus poisoning was seen in 50 (4.15%) (3.29-5.73, 95% Confidence Interval). Conclusions: Our study found that the prevalence of organophosphorus poisoning was lower when compared to similar studies done in similar settings.
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    Status Dystonicus with Atypical Presentation in Developmentally Delay Child: A Case Report
    (Nepal Medical Association, 2022) Yadav, Shailendra Kumar; Yadav, Pratibha; Maharjan, Gyabina; Dahal, Sujata; Khati, Nirajan
    Abstract Status dystonicus is characterised by involuntary sustained or intermittent muscle contractions of muscles causing repetitive twisting movements, abnormal postures of the body, or both is a rare but life-threatening movement disorder. Early diagnosis and management of status dystonicus prevent serious complications. We report a 2 years old previously developmental delay diagnosed girl who presented with generalised contractions of the whole body. Tightening of limbs is aggravated by touching her backside which is a very unique feature. Dystonia is associated with severe sweating and was confused with a seizure event. The patient was treated with midazolam, clonidine, phenytoin, gabapentin, pyridoxine, baclofen, and trihexyphenidyl. She was admitted to the intensive care unit for monitoring. The patient partially recovered after 10 days of treatment.

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