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Browsing by Author "Khanal, Inesh"

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    Admission Rate of Patients Visiting Emergency Department in a Tertiary Care Center in Kathmandu: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2024) Tiwari, Sanjeeb; Tiwari, Jyotshna Sharma; Jha, Jay Bhushan; Regmi, Sushant; Yadav, Dhirendra; Kafle, Ravi; Khanal, Inesh; Shrestha, Aakripa Rani; Shrestha, Shubham; Shakya, Yagya Laxmi; Maharjan, Ramesh Kumar; Gupta, Sanjaya Kumar
    Abstract Introduction: Emergency departments serve as the initial point of contact for patients with a wide range of conditions. Not all patients visiting get admitted to the hospital. The admission rate varies from 20% in the United States to 40.83% in Nepal. Given the variability in these results across different regions, there is a need to better understand the admission rates from the Emergency Department. Methods: A descriptive cross-sectional study was conducted after obtaining ethical approval( Reference Number: 58 (6-11)E2 081/082) in the Emergency Department of a tertiary health care center. Retrospective data was collected from the data register. The data from April 2023 to April 2024 was collected. A sample size of 222 was calculated and convenience sampling was done. Demographic details like age, sex, and data regarding admission status were collected. Data was collected in MS Excel and was analyzed using JASP software. Results: Out of 222 patients that presented to the emergency department, 53 (23.87%)(18.26-29.47,95 % Confidence Interval) were admitted to the ward or intensive care unit of the hospital, whereas 167 (75.23) got discharged, 1 (0.45%) was brought dead and 1 (0.45%) expired. The median age of patients was 43 (IQR: 26-62). The admission rate of females was 20 (17.24%), whereas for males it was 33 (31.13%). Conclusions: The prevalence of admission of patients visiting the emergency department was higher than similar US based studies. There was a higher percentage of female patients presenting to theemergency department, while those being admitted were mostly males.
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    Dengue and Scrub Typhus Co-infection at a Tertiary Care Centre in Nepal: A Case Series in Pediatric Patients
    (Nepal Medical Association, 2025) KC, Sriram; Pradhan, Bulbul; Khanal, Inesh; Shrestha, Aakripa Rani
    Abstract This case series highlights four pediatric patients with coinfection of dengue fever and scrub typhus, presenting at Patan Hospital. Dengue fever is caused by flavivirus transmitted by Aedes mosquitoes, and scrub typhus is caused by Orientia tsutsugamushi transmitted by Leptotrombidium mites, which share overlapping symptoms such as fever, headache, and abdominal pain, complicating the diagnosis. The cases were from different geographical regions of Nepal with varied presentation: from febrile illness to severe manifestations like meningoencephalitis and raised intracranial pressure. Two patients presented with hepatosplenomegaly, one with severe rash, and another with pneumonia-like symptoms. Laboratory findings confirmed coinfection, and management included IV antibiotics, antipyretics, and supportive management. Complications such as thrombocytopenia, transaminitis, and allergic reactions required interventions. This case series highlights the importance of early suspicion and treatment of coinfection to reduce prolonged hospitalization and prevent end-organ dysfunction, and mortality, especially in endemic regions.
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    Navigating Medical School with AI: A Student’s Perspective
    (Nepal Medical Association, 2025) Bhatta, Rohit Raj; Khanal, Inesh
    Abstract Medical school is a strange place where everything feels both déjà vu and jamais vu. You've seen this disease before, but somehow, you still have no idea what’s going on. Traditionally, we've relied on textbooks, scholarly articles, guidance from senior colleagues, and patient interactions to bridge these gaps but with recent advancements in computational models and algorithms, Artificial Intelligence has been a blessing.

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