Browsing by Author "Manandhar, Sunil Raja"
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Publication Hypoplastic Left Heart Syndrome: A Case Report(Nepal Medical Association, 2023) Manandhar, Sunil Raja; Ghimire, Anjila; Rai, Dipendra; Shrestha, Sabina; Adhikari, PrithaAbstract Hypoplastic left heart syndrome is a rare critical congenital heart defect constituting a prevalence of 1/3,500 to 1/12,500 live births in which there is obstructions to the blood flow within the left heart. Here we present a case of a full-term 38 weeks male baby with a birth weight of 3.5 kg, and no obvious physical deformity referred to our centre at 22 hours of life for respiratory distress and cyanosis. At 23 hours of life, he was diagnosed with hypoplastic left heart syndrome and kept on Prostaglandin E1 infusion till the 12th day of life. The baby had a large ventricular septal defect and atrial septal defect with a severely hypoplastic left ventricle, hypoplastic aortic root, ascending aorta and post-ductal coarctation of the aorta. The diagnosis was reconfirmed by computed tomography cardiac angiography on the 10th day of life with the same cardiac findings suggestive of hypoplastic left heart syndrome.Publication Kangaroo Mother Care (KMC) Therapy: A Bonding Between Mother and Baby(Perinatal Society of Nepal (PESON), 2023) Manandhar, Sunil RajaNAPublication MIS-C Like Features in a Patient of Atypical Kawasaki Disease: A Case Report(Nepal Medical Association, 2024) Karki, Anisha; Jha, Abhishek; Sapkota, Shova; Kashyap, Nikita; Manandhar, Sunil RajaAbstract Kawasaki Disease is multisystem vasculitis affecting young children and infants. While the diagnosis of a typical form of Kawasaki Disease is obvious, there are some patients who do not fulfill the classic diagnostic criteria for the disease which is termed as 'incomplete Kawasaki Disease' or 'Atypical Kawasaki Disease'. We present a case of a 6 months old child with fever who after failing to respond to IV antibiotics showed considerable improvement after administering aspirin and Intravenous Immunoglobulin thus diagnosed as Atypical Kawasaki Disease. Moreover, due to sharing of similar features by both Kawasaki Disease and Multiple Inflammatory Syndrome in Children, the case posed a diagnostic dilemma.Publication Tuberous Sclerosis Complex in a 17-month-old: A Case Report(Nepal Medical Association, 2023) K.C., Sarjan; Bohaju, Anjana; Manandhar, Sunil Raja; Shrestha, Anup; Aryal, Erika; Maharjan, PradeepAbstract Tuberous sclerosis complex is a rare autosomal dominant genetic disorder that affects multiple organ systems, primarily affecting the central nervous system. It develops with a pathogenic mutation in tumour suppressor genes i.e. Tuberous Sclerosis Complex 1 or Tuberous Sclerosis Complex 2 which codes for protein hamartin and tuberin leading to unopposed hyperactivation of the mammalian target of the rapamycin signalling pathway. It presents with a triad of facial angiofibroma, intellectual disability, and epilepsy. We present a case of a 17-month female toddler with abnormal body movement with loss of consciousness and later developing into generalised jerky movements. On magnetic resonance imaging, a diagnosis of tuberous sclerosis was made. The patient underwent symptomatic management with anti-epileptic. As seizures in these cases are subtle, they remain undiagnosed for a long time leading to delays in management and developing refractory seizures.