Browsing by Author "Khanal, Bipin"
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Publication Chronic Diarrhoea: A Rare Presentation Of Vitamin B12 Deficiency Anemia In Children(Nepal Paediatric Society (JNPS), 2021) Shrestha, Pun Narayan; Khanal, Bipin; Joshi, PrakashAbstract Vitamin B12 deficiency in children often under reported and usually presents with nonspecific manifestations like neuropsychiatric symptoms, anaemia, glossitis and chronic diarrhoea. Vegetarianism, minimal intake of animal products, poverty and malnutrition may lead to vitamin B12 deficiency. Laboratory reports often show pancytopenia, megaloblasts in bone marrow and low serum cynocobalamine. Injectable vitamin B12 is the treatment of choice. We would like to highlight this case report in view of vitamin B12 deficiency presenting as diarrhoea.Publication Diagnostic Accuracy of Ultrasound in Patients with Suspected Acute Appendicitis in Rapti Academy of Health Sciences(Rapti Academy of Health Sciences (RAHS), 2024) Khanal, Bipin; BC, Bom; Acharya, Alina; Majagaiya, SamirAbstract: Introduction: Acute appendicitis is a leading cause of acute abdominal pain globally. It is typically diagnosed clinically using various scoring systems, with ultrasound and computed tomography used in certain cases. Ultrasound is often the preferred test for several reasons. This study aims to assess the diagnostic accuracy of ultrasound in suspected acute appendicitis. Methods: This descriptive, cross-sectional study was conducted in the Radiology Department of Rapti Academy of Health Sciences. It included 89 patients with suspected appendicitis who underwent abdominal ultrasound from July to November, 2024 and met the inclusion criteria. Ultrasound findings were compared with histopathological results, and sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated. Results: Most of the patients were male which was 48 (53.9%) with the most common age group being from 21 to 35 years. The mean age was 37 years. The most common ultrasonographic feature of acute appendicitis was increased diameter of the appendix of more than 6 mm seen in 78 (87.6%) cases. The sensitivity and specificity of ultrasonography were 97.6% and 42.9%, respectively. The positive predictive value and negative predictive value were 95.2% and 60%, respectively. The diagnostic accuracy was 93.1%. Conclusion: Ultrasound demonstrated high sensitivity and positive predictive value, making it an effective test for confirming the presence of the disease. Ultrasound is accessible, affordable, and radiation-free, but its low specificity limits its reliability. CT can be used for confirmation, though it's costly and involves radiation.Publication Spectrum of HRCT Chest Findings in RT-PCR positive COVID-19 Patients at a Tertiary Care Center in Mid-Western Nepal: A Retrospective Cross-Sectional Study(Rapti Academy of Health Sciences (RAHS), 2024) B. C., Bom; Khanal, Bipin; K. C., Achhita; Subedi, Raj Kumar; K. C., AnuprashAbstract: Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes a pulmonary infection called as coronavirus disease (COVID-19). High-resolution computed tomography (HRCT) of the chest plays a crucial role in diagnosis, assessing the lung involvement with its severity in COVID-19. The objective of this study was to describe the pattern of HRCT chest findings in lab-proven, real- time RT-PCR-positive COVID-19 patients. Methods: This was a descriptive cross-sectional study conducted at Rapti Academy of Health Sciences (RAHS), the then COVID-19 patient treatment site in Lumbini province, from February 2021 to October 2021 among 78 RT-PCR-positive COVID-19 patients based on HRCT chest findings. Data collection was done after receiving ethical approval from the Institutional Review Committee of RAHS. Data analysis was performed using Statistical Package for the Social Sciences version 27. Results: Among 78 RT-PCR-positive COVID-19 patients, 51 were male and 27 were female, with a mean age of 51.28±14.35 years. HRCT chest showed ground glass opacities (GGO) in 74 (94.87%), followed by atelectatic band in 24 (30.77%), interlobular septal thickening in 22 (28.21%), consolidation in 20 (25.64%), GGO and consolidation in 17 (21.79%), crazy-paving pattern in 11 (14.1%), and other chest findings in 5 (6.41%) patients. Conclusion: The most common HRCT chest findings of COVID-19 were ground-glass opacities, while atelectatic band, interlobular septal thickening, consolidation, and crazy-paving pattern were other important findings. Thus, HRCT chest imaging is crucial for both diagnosing and assessing the severity of COVID-19 patients.