Browsing by Author "Dhungana, Tirth"
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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 Stroke among Patients Admitted to a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Kurmi, Ram Narayan; Mandal, Laxman; Singh, Raj; Chaudhary, Prateek Kumar; Dhungana, Tirth; Lamichanne, Sandesh; Bastola, Nimish Raj; Pokharel, PrajjwalAbstract Introduction: Stroke is the second most common cause of mortality after ischemic heart disease and the leading cause of morbidity around the world. This study aimed to find out the stroke among patients admitted to a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Internal Medicine and Neurosurgery from 15 July 2021 to 15 June 2022 after taking ethical approval from Institutional Review Committee (Reference number: 78/79-083). Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 5034 patients, 149 (2.95%) (2.48-3.41, 95% Confidence Interval) patients had stroke. Out of 149 cases, male to female ratio was 1.06 with a mean age of 65.05±14.06 years. The most common presentation was hemiparesis 128 (85.90%). Hypertension 106 (71.14%) was the most common underlying condition. The frontal area 17 (32.02%) was the most common site of ischemic stroke. Putamen (55.26%) was most common site in hemorrhagic stroke. The mean hospital stays was 6.3±5.18 days. There were 5 (3.40%) cases of in-hospital mortality. Conclusions: The prevalence of stroke was similar to other studies done in similar settings.