Browsing by Author "Dhamala, Sumit"
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Publication 11β Hydroxylase Deficiency in a Child with Hypothyroidism: A Case Report(Nepal Medical Association, 2023) Shah, Bipesh Kumar; Koirala, Richa; Dhamala, Sumit; Bhatta, Mukesh; Khatiwada, ShekharAbstract Congenital adrenal hyperplasia occurs due to enzymatic defects in the adrenocortical steroidogenesis. 11β hydroxylase deficiency is the second most common cause of congenital adrenal hyperplasia which presents with hypertension and features of androgen excess. Hypertension has also been found to cause end-organ damage in children with 11β hydroxylase deficiency. We report a case of a 10-year-old male child with hypothyroidism under thyroid replacement therapy, presenting with features of severe hypertension and androgen excess, later on, diagnosed as congenital adrenal hyperplasia due to 11β hydroxylase deficiency.Publication Dengue Shock Complicated with Scrub Typhus in a Child: A Case Report(Nepal Paediatric Society (JNPS), 2023) Shah, Bipesh Kumar; Shrestha, Shova; Dhamala, SumitAbstract: Dengue and scrub typhus mixed infection is not commonly reported in the paediatric age group. Here, we report a case of a female child from the eastern part of Nepal who presented with abdominal pain, fever, respiratory distress and shock. The overlapping clinical features and laboratory findings complicate the diagnosis of polymicrobial infection, thus delaying treatment, and bringing up complications. Thus, our case emphasizes that a high index of clinical suspicion, vigilant physical examination, and appropriate laboratory tests should be employed for the early diagnosis and prompt treatment of coexisting infection, considering the local endemicity of both the diseases.