Browsing by Author "Katuwal, Srijan"
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Publication Acute Pneumonitis after instillation of Povidone iodine for Chemical Pleurodesis in Secondary Spontaneous Pneumothorax: A case report(Nepalese Respiratory Society, 2022) Shahi, Rejina; Bhatta, Narendra; Mishra, Deebya Raj; Verma, Avatar; Katuwal, Srijan; Limbu, Sion Hang; Regmi, GunjanAbstract: Secondary spontaneous pneumothorax is common in adult and is often life threatening. Surgical intervention is preferred, however chemical pleurodesis is also widely recommended in the treatment of recurrent pneumothorax of different etiologies. Variety of agents such as erythromycin, tetracycline, autologous blood and talc slurry are available for chemical pleurodesis among which povidone iodine is cheap, easily available, effective and safe. In this paper, we report the case of acute pneumonitis after pleurodesis using povidone iodine in a 33 years old female with a known case of lymphangioleiomyomatosis with a history of recurrent pneumothorax. Chemical pleurodesis was performed using povidone iodine after complete expansion of lung and absence of persistent air leak which was confirmed clinically and radiologically. Post procedure, the patient complained of right sided chest pain and cough. Fever, sputum production and shortness of breath was absent. Chest X-ray revealed new consolidation and infiltrations in the right middle zone. Subsequent CT chest showed extensive parenchymal consolidation and ground glass opacities in the right middle lobe, representing pneumonia with acute lung injury. The acute pneumonitis spontaneously resolved with supportive care and the patient was discharged after seven days. Though drug induced pneumonitis is not a usual complication of povidone iodine, it is a possibility and has to be considered.Publication Mesothelioma with Nonbacterial Thrombotic Endocarditis: A Case Report Authors(Nepal Medical Association, 2021) Verma, Avatar; Bhatta, Narendra; Mishra, Deebya Raj; Acharya, Achyut Bhakta; Shahi, Rejina; LImbu, Sion Hangma; Katuwal, Srijan; Lama, UrmilaAbstract: Non-bacterial thrombotic endocarditis is a rare condition characterized by noninfectious vegetation on cardiac valves which are often associated with malignancy. It often presents with features of embolism rather than cardiac failure. These are usually seen in autoimmune conditions, disseminated intravascular coagulation, malignancy of gut and lung but has also been reported in other malignancies as well. This entity is rare but one must have a clinical suspicion of the disease especially in a patient suffering from malignancy presenting with the embolic phenomenon. In this report, we are presenting a case of non-bacterial thrombotic endocarditis in an inpatient with pleural mesothelioma, a rare malignant neoplasm arising from pleura in a 35 years old mason, and a rare association as well.Publication Navigating challenges in management of drug resistant tuberculosis: Case experience from Nepal(Nepalese Respiratory Society, 2022) Verma, Avatar; Bhatta, Narendra; Mishra, Deebya Raj; Acharya, Achyut Bhakta; Shahi, Rejina; Limbu, Sion Hangma; Katuwal, SrijanAbstract: Drug resistant tuberculosis (DR TB) a severe form of TB is a disease of concern. Its treatment requires multiple toxic drugs for prolonged duration because of which, often have complicated course requiring close supervision, continuous encouragement from physician, management of side effects and modification of drug regimen for successful outcome. In this report, we are presenting a case of diabetic patient suffering from DR TB highlighting key diagnostic and management challenges.Publication Small Cell Lung Carcinoma with Pancoast Syndrome: A Case Report(Nepal Medical Association, 2022) Limbu, Sion Hangma; Bhatta, Narendra; Mishra, Deebya Raj; Acharya, Achyut Bhakta; Verma, Avatar; Shahi, Rejina; Katuwal, Srijan; Singh, Sunil KumarAbstract: Small cell lung cancer mostly arises centrally in the large bronchi. The literature search revealed very limited cases of small cell lung cancer arising at the upper part of the pulmonary sulcus near the thoracic inlet as superior sulcus tumor and also manifesting with typical Pancoast syndrome. We report a case of a 71 years old male patient, presenting with features of Pancoast syndrome including Horner’s syndrome with completed three cycles of chemotherapy resulting in partial response which concludes that small cell lung carcinoma has to be considered despite the clinical findings like pancoast syndrome.