Browsing by Author "Das, A"
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Publication A Case of Hereditary Pancreatitis Presenting as Recurrent Abdominal Pain in a 11 Year Old Girl(Nepal Paediatric Society (JNPS), 2015) Das, A; Basu, MAbstract: Recurrent abdominal pain is a common problem among children. Since its first description by John Apley in 1958, the condition has remained poorly understood with a multitude of factors being implicated in causation. The symptoms tend to be vague and investigations seldom show organic disease. But the importance to evaluate each child with recurrent abdominal pain should be considered important nevertheless, particularly, in protracted cases. Here, we present a case who presented with history of recurrent abdominal pain for several years before being diagnosed as a case of hereditary pancreatitis. This stresses the importance of evaluating each case with a detailed and complete history, physical examination and selected investigations.Publication A Rare Case of Bilateral Aspergillomas in a Patient of Ankylosing Spondylitis(Kathmandu University, 2016) Das, A; Pandit, S; Das, SK; Basuthakur, S; Das, SABSTRACT Pulmonary involvement by Aspergillus sp. mainly includes allergic bronchopulmonary aspergillosis, aspergilloma, and invasive aspergillosis. Aspergilloma (Fungal ball) is the most common form of aspergillous pulmonary involvement, which occurs in preexisting pulmonary cavities, especially secondary to pulmonary tuberculosis. Ankylosing spondylitis is a rare cause of upper lobe fibro-cavitary lesions in pulmonary parenchyma. It may also lead to development of fungal balls in pulmonary cavities. Most common presentation is mild to massive hemoptysis; dyspnoea, chronic cough, expectoration may be other presentation; even the patient may remain asymptomatic. Intaracavitary mobile mass is a valuable sign for fungal ball, best detected by computed tomography (CT) scan of thorax. Lobectomy is the treatment of choice to stop the hemoptysis, if the general condition of the patient is fit; otherwise associated co-morbidities complicate the post-operative scenario. In this situation, bronchial artery embolization may be used as a temporary measure to control hemoptysis. Here, we report a case of bilateral aspergillomas within the cavities located in upper lobes of both lungs in a 74 years old male who was suffering from ankylosing spondylitis for last 42 years. KEY WORDS Aspergilloma, ankylosing spondylitis, hemoptysis, lobectomyPublication Rheumatic fever and rheumatic heart disease: how often we suspect infective endocarditis(Institute of Medicine, 2012) Shrestha, P N; Das, A; Rayamajhi, A; Mahaseth, CAbstract Introduction: Rheumatic fever and rheumatic heart disease is a common problem in developing countries. Rheumatic valvular heart disease is one of the important risk factor for infective endocarditis. Methods: Retrospective study was conducted among 56 children admitted in cardiology ward of Kanti children hospital with the diagnosis of rheumatic fever or rheumatic heart disease during May 2008 to M ay 2010. Results: We found male to female ratio 2: 1, median age 12 (5- 14yrs) with the most affected age group of 11- 12 years. Common symptoms were fever (66%), dyspnea (68%), joint pain (50%), palpitation (30%), cough (16%) and chest pain (12%). Only 9% of patients had positive history of sore throat. Six ty percent patients were presented with features of congestive cardiac failure (CCF). A SO positive was found in 25 (44.6%) cases. The most common valvular lesion was mitral regurgitation (M R). Moderate to severe mitral regurgitation was found in 89% of cases. Tricuspid regurgitation (T R) was found in 57% of patients and aortic regurgitation (A R) in 55% of cases. Thirty-two patients (57%} had PA H in which 8 patients has severe PAH and 24 patients had mild to moderate PAH . Infective endocarditis was diagnosed in twenty patients (35.7%). Out of 20 patients 14 (70%) had vegetation in echocardiography. The mortality was 11% in this study. Conclusion: Infective endocarditis is the major complication of rheumatic heart disease among children of Nepal and so clinical suspecian is important whenever patients with rheumatic heart disease present with fever. Keywords: dyspnea, endocarditis, rheumatic fever, rheumtic heart disease