Browsing by Author "Lamichhane, Sandesh"
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Publication Methemoglobinemia due to Hemolysis Secondary to Infection in a Child: A Case Report(Nepal Medical Association, 2022) Parajuli, Biraj; Shrestha, Swikriti; Lamichhane, Sandesh; Subedi, Subash; KC, SujataAbstract Methemoglobinemia is a rare condition characterised by hypoxic state manifesting as headache, nausea, fatigue, and confusion. We report a 2-year-old boy presenting with fever and cough for 7 days with an episode of hypoxia as the saturation declined and did not improve on face mask oxygenation. On further evaluation, acute intravascular hemolysis was established following decreased haemoglobin level, increased levels of lactate dehydrogenase, and unconjugated bilirubin in the setting of documented infection. Assessment of arterial blood gas showed a significantly raised saturation gap and detection of methemoglobin confirmed the diagnosis. He was managed conservatively with packed red blood cells transfusion following which hypoxia was corrected. Methemoglobinemia as a result of hemolysis can be a non-cardio-respiratory cause of hypoxia and inciting aetiology needs to be addressed.Publication Traumatic Brain Injury among Patients Admitted in Neurosurgical Unit in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Shrestha, Ajit; Paudel, Nimesh; Adhikari, Ganesh; Shrestha, Swikriti; Lamichhane, Sandesh; Subedi, Subash; Jaishwal, NeelamAbstract Introduction: Traumatic brain injuries are one of the leading causes of mortality, morbidity, and economic burden in context to Nepal. Non-contrast computed tomography is used for rapid diagnosis and repeat computed tomography helps to detect the progression and complications of cerebral injury. The aim of this study was to find out the prevalence of traumatic brain injury among patients admitted in the neurosurgical unit in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among patients admitted to the neurosurgery unit in the tertiary care centre from 1 August 2019 to 29 August 2020. Ethical approval was taken from Institutional Review Committee (Reference number: CMC-IRC/075/076-156). Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 350 patients admitted in the neurosurgical unit, the prevalence of traumatic brain injury was 140 (40%) (34.87-45.13, 95% Confidence Interval). Change in management was required among 28 (20%) when computed tomography was done within 12-24 hours. Among them, 27 (19.29%) underwent surgical intervention after a repeat computed tomography scan. Conclusions: The prevalence of traumatic brain injury was found to be higher than similar studies done in similar settings.Publication Upper Gastrointestinal Bleeding Induced by Gastric Ulcer Secondary to Strongyloidiasis: A Case Report(Nepal Medical Association, 2023) Dhakal, Bishal; Dawadi, Sagun; Pathak, Bishnu Deep; Regmi, Binit Upadhaya; Sitaula, Deekshanta; Pudasaini, Prasamsa; Lamichhane, Sandesh; Karki, Abinash; Simkhada, NabinAbstract Strongyloidiasis, a parasitic infestation by Strongyloides stercoralis, involves the gastrointestinal tract with a spectrum from duodenitis to enterocolitis. However, gastric involvement with the manifestation of upper gastrointestinal bleeding is an extremely rare condition due to Strongyloides stercoralis. Due to irregular excretion of larvae, unclear symptoms, paucity of effective diagnostic tools and low parasitic load, makes clinicians difficult to reach the diagnosis of strongyloidiasis. Here, we present a case of upper gastrointestinal bleeding due to a large gastric ulcer whose aetiology was identified to be Strongyloides stercoralis infection of the gastric region by the diagnosis of exclusion.