Browsing by Author "Dhital, Bishnu Mani"
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Publication Atropine and Kounis syndrome, a rare association mimicking ST segment elevation myocardial infarction in a young patient: A Case Report(Nepalese Respiratory Society, 2023) Hussain, Asraf; Regmi, Shyam Raj; Dhital, Bishnu Mani; Thapa, Shovit; Dhungana, Tirth; Khan, Amir; Thapa, Sagar; Murarka, Rohit; Shrestha, Ashok; Chaudhary, Ramgobind; Kurmi, RamnarayanAbstract: Kounis syndrome is a hypersensitivity acute coronary disorder which occurs with allergic reaction with drugs, food and insect bite. Atropine is rarely found to be reported with such allergic reactions in the literatures. In this report, we describe a case of a 25 years old male, with a background history of psychotic disorder and cannabis dependent syndrome with persistent bradycardia. When challenged with atropine he developed chest pain, shortness of breath and urticarial rash. ECG showed ST segment changes which settled after symptomatic management. Coronary angiogram revealed normal coronary arteries. Though uncommonly reported, it is one of the confusing and underdiagnosed serious conditions for treating physicians which can potentially mimic ST segment elevation myocardial infarction.Publication Collateral Development in Patients Undergoing Coronary Angiography in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Gautam, Ajeevan; Dhital, Bishnu Mani; Pokhrel, Manas; Kafle, AmritAbstract Introduction: Coronary artery disease is one of the major cardiovascular diseases affecting the global human population. When the primary stenotic or blocked channel fails to deliver enough blood to the myocardium, the coronary collateral circulation serves as a backup source of blood supply. The aim of this study was to find out the prevalence of collateral development in patients undergoing coronary angiography in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among patients with peripheral vascular injuries that underwent operative management in a tertiary care centre from November 2021 to April 2022. Ethical approval was taken from the Institutional Review Committee (Registration number: CMC-IRC/078/079-027). Convenience sampling technique was used. Data for the study was retrieved from operation records of the patients along with their treatment summaries. Point estimate and 95% Confidence Interval were calculated. Results: Among 170 patients undergoing coronary angiography, 84 (49.41%) (41.6-56.6, 95% Confidence Interval) had developed collateral circulation. The mean age was 62.8±11.7 years. Conclusions: The prevalence of collateral development in the coronary artery was similar to other published literature.