Browsing by Author "Khadka, Tunam"
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Publication Acid Peptic Disease among Patients with Acute Abdomen Visiting the Department of Emergency Medicine in a Tertiary Care Centre(Nepal Medical Association, 2023) Thapa, Rashmi; Pokharel, Mohir; Paudel, Saroj; Khadka, Tunam; Sapkota, Priyanka; Rana, Rohit; Pokharel, Moneec; Chhetri, DineshAbstract Introduction: Acid peptic disease is caused by excessive acid secretion or weakened mucosal defense. Symptoms include epigastric pain, bloating, and nausea. Factors like gastric acid, Helicobacter pylori infection, alcohol consumption, smoking, and stress contribute to peptic ulcers. Imbalances between offensive and defensive factors can lead to ulcers. Acid-related disorders impact the quality of life and mortality. Accurate diagnosis and prompt treatment are vital. This study aimed to find out the prevalence of acid peptic disease among patients with acute abdomen in the Department of Emergency Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted from 2 April 2022 and 2 April 2023 among the patients presented in the Department of Emergency Medicine in a tertiary care centre. Ethical approval was obtained from the Institutional Review Committee. All patients presenting with acute abdominal pain in the Emergency Department were included in the study. Patients not giving consent were excluded from the study. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of the 400 patients with acute abdomen, the prevalence of acid peptic disease was found to be 87 (21.75%) (17.71-25.79, 95% Confidence Interval). Conclusions: The prevalence of acid peptic disease among patients with acute abdomen was found to be lower than in other studies performed in similar settings.Publication Cap Polyposis: A Case Report(Nepal Medical Association, 2023) Khadka, Tunam; Giri, Ganesh Kumar; Sherpa, Pasang; Shrestha, Nischal; Poudyal, SanjayaAbstract Cap polyposis is a gastrointestinal disease with multiple inflammatory polyps between the distal colon and rectum. Its symptoms overlap with inflammatory bowel disease with typical endoscopic features of multiple sessile polyps in the rectum and sigmoid colon, located at the apices of transverse folds. Microscopically, the polyps consist of elongated, tortuous, and distended crypts covered by a “cap” of inflammatory granulation tissue. In this report, we present a case of a 18-year-old male patient who underwent polypectomy for polyposis in multiple settings. He presented with one year of painless rectal bleeding and polyposis in a recto-sigmoid area on colonoscopy, with a single polyp in the sigmoid area and multiple polyps in the rectum. He was managed with immediate and interval polypectomy. Though cap polyposis is rare, it can be cured as it is laparoscopically resectable.Publication Dyslipidemia among Patients with Ischemic Stroke Admitted to the Department of Medicine of a Tertiary Care Centre(Nepal Medical Association, 2023) Khadka, Tunam; Giri, Ganesh Kumar; Sherpa, Pasang; Ghimire, Urbi; Parajuli, Shamin; Pudasaini, Ashok; Shrestha, SajanAbstract Introduction: Sudden neurological deficits due to an acute focal vascular injury of the central nervous system is stroke. It is a major cause of morbidity and mortality. Dyslipidemia is any abnormality in the parameter of the lipid profile which has been associated with stroke. The aim of this study was to find out the prevalence of dyslipidemia among patients with ischemic stroke in the Department of Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in a tertiary care centre among admitted ischemic stroke patients from 5 August 2022 to 14 March 2023 after obtaining ethical approval from the Institutional Review Committee. Overnight fasting blood samples were collected for lipid profile. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 79 ischemic stroke patients, 42 (53.16%) (42.09-64.23, at 95% Confidence Interval) had dyslipidemia where high cholesterol was seen in 21 (50%), high triglyceride in 22 (52.38%), high low-density lipoprotein 14 (33.33%) and low high-density lipoprotein in 20 (47.61%). Conclusions: The prevalence of dyslipidemia among ischemic stroke patients was lower than the similar studies done in similar settings.Publication Pediatric Usher Syndrome Type 2A with Coexisting Rheumatic Heart Disease and Upper Gastro-Intestinal Bleed: A Case Report(Nepal Medical Association, 2024) Yadav, Bishal; Khadka, Tunam; Shah, Toyendra Jung; Phuyal, Mandish Prasad; Lamichane, Rajesh; Chaurasiya, BikashAbstract Usher syndrome is a rare autosomal recessive disorder characterized by progressive sensorineural hearing loss and retinitis pigmentosa, typically present from birth and later symptoms, including loss of night vision and peripheral vision slowly progressing to blindness. The condition exhibits clinical and genetic diversity and currently lacks the definitive treatment. This report presents a case of a ten-year-old female diagnosed with Usher syndrome type IIA via whole exome sequencing. The delayed onset of visual symptoms often leads to a misdiagnosis to isolated deafness in early years. The early identification allows for better prognosis through surveillance and intervention in hearing and visual impairments. If usher patients can receive a timely diagnosis, genetic molecular therapies may help preserve the photoreceptors, subsequently development of blindness could be delayed or possibly be prevented.