Browsing by Author "Neupane, Asmita"
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Publication Arteriovenous Malformations in Proximal Part of Ileum: A Case Report(Nepal Medical Association, 2021) Saeed, Saad; Naz, Sidra; Iqbal, Abbas; Irfan, Maryam; Khan, Shahab; Jaiswal, Vikash; Neupane, AsmitaAbstract: Arteriovenous malformations in the ileum are a rare cause of gastrointestinal bleeding in young adults with few reported cases and pose difficulty in diagnosing. They usually present with chronic gastrointestinal bleed. A 30-year-old woman presented with an acute episode of hematochezia with a history of intermittent melena for 1.5 years. Complete blood count revealed a low hemoglobin level of 3.5g/dl and hypochromic microcytic anemia. Oesophago-gastro-duodenoscopy was normal; however, a colonoscopy revealed the terminal ileum and colon filled with blood. Computed tomography-Angiogram showed local intraluminal contrast extravasation in the ileum. Explorative laparotomy and on-table enteroscopy were performed identifying a small elevated, pigmented, and eroded mucosa (5 to 6 mm) in proximal ileum; resection and primary anastomosis were performed. The patient was followed after surgical resection and her symptoms improved dramatically with no additional episodes of melena and with the normalization of hemoglobin.Publication Encounter with Huge Yolk Sac Ovarian Tumor in a Child: A Case Report(Nepal Medical Association, 2023) Adhikari, Suman Bikram; Swornakar, Prabina; Paudel, Prabesh; Neupane, AsmitaAbstract Yolk sac tumour frequently arises in the gonads as a type of germ cell tumour, though rare is a highly malignant ovarian tumour in children and prompt treatment should be done. We hereby report a case of malignant ovarian tumour presenting with an abdominal lump and increased urinary frequency. Different diagnostic modalities were used such as ultrasonography of the whole abdomen, contrast-enhanced computed tomography abdomen pelvis and tumour markers of beta-human chorionic gonadotropin and alpha-fetoprotein. This revealed an 18.2x14.3x10 cm mass likely a neoplastic germ cell tumour with minimal ascites. A tumour mass was found to arise from the left ovary and complete excision of the tumour along the left fallopian tube was done. Adjuvant chemotherapy started immediately. We hereby present a case of a 9-year-old girl with a huge yolk sac tumour of the left ovary which is rare in our setting and is presented here to differentiate any ovarian mass in this age group.Publication Extensive Drug Resistant Acinetobacter Species Isolates in Sputum Sample of Patient Admitted in Intensive Care Unit of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Prasai, Astha; Pant, Abhishek; Neupane, Asmita; Pant, Subash; Pradhan, SaileshAbstract: Introduction: Increasing antibiotic resistance has created a global public health threat worldwide. Acinetobacter species is one of the important pathogenic organisms in the hospital setting due to its ability to persist in the hospital environment for long. Its resistance to commonly used antibiotics can prolong hospital stay, increase financial burden, and increase morbidity and mortality. This study aims to find the prevalence of extensive drug resistant Acinetobacter species in the sputum sample of Intensive Care Unit patients admitted in a tertiary care center. Methods: A descriptive cross-sectional study was conducted in a tertiary care center among the hospital records from May 2017 to May 2021, after ethical approval (Reference number: 2104202101). All the Intensive Care Unit patients with isolated acinetobacter species in their sputum samples within the past four years were collected and Statistical Package for Social Sciences version 25 was used for analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Of the total 409, 196 (47.9%) (95% Confidence Interval= 43.06-52.74) of Acinetobacter species in the sputum sample had extensive drug resistance. Of these, 193 (98.5%) and 1 (0.5%) of the extensive drug resistant Acinetobacter species were resistant to carbapenem and polymyxin respectively. Conclusions: Prevalence of extensive drug resistant acinetobacter was found higher compared to other studies.Publication Hernia among Patients Admitted to the Department of Surgery of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Deo, Kishor Kumar; Shrestha, Reshika; GC, Saroj; Maharjan, Sujata; Shrestha, Aishwarya; Neupane, AsmitaAbstract Introduction: Hernia is one of the most common surgery-requiring conditions. Despite this, hernia still needs to be studied in more detail. The main objective of the study was to find out the prevalence of hernia among patients admitted to the Department of Surgery of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients admitted to the Department of Surgery of a tertiary care centre from 1 July 2021 to 31 December 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: 202/2079/80). The patient admitted to the Department of Surgery during the study period was included and those with incomplete data were excluded. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 3236 patients, the prevalence of hernia was 749 (23.14%) (21.69-24.59, 95% Confidence Interval). The inguinal hernia was the most common type found in 574 (77.25%), followed by an umbilical hernia in 64 (8.61%). A total of 79 (10.55%) had comorbidity among patients with hernia. Conclusions: The prevalence of hernia in our study was found to be higher than in other studies done in similar setting. Easily accessible health facilities, competent primary surgical care and health education should be taken into account by the policymakers to reduce the morbidity and mortality of this condition.Publication Mesenteroaxial Gastric Volvulus: A Case Report(Nepal Medical Association, 2021) Pandey, Sampanna; Paudel, Madhav; Parajuli, Anuj; Ghimire, Roshan; Neupane, AsmitaAbstract: Gastric volvulus is defined as an abnormal rotation of the stomach. Classical textbook presentation may not always be present. Meticulous assessment and broadened differential diagnosis are thus crucial. Various types have been described in literature. Low threshold for detection with aggressive resuscitation and immediate surgical exploration on suspected incarceration or perforation are mandatory. We report a case of 16-years-female who had atypical presentation of mesenteroaxial gastric volvulus. Emergency exploratory laparotomy with wedge resection and primary repair of stomach with anterolateral gastropexy was performed. She had uneventful recovery with discharge on fifth postoperative day.Publication Unleashing Potential of a Medical Student in a Medical Journal: Dual Full-time Responsibilities(Nepal Medical Association, 2021) Neupane, AsmitaAbstract: “Only those who will risk going too far can possibly find out how far one can go”-TS Elliot. Joining the editorial support as a medical student, at the Journal of Nepal Medical Association, full-time responsibilities, were challenging to perform. Applying and getting into the Journal of Nepal Medical Association team was only the start of a very vast learning experience. Learning leadership qualities, time management skills, communication skills and technical skills, helped me to excel in my duty as assistant editor and a medical student. Involving in the training and working with authors and the editorial team, I have learned about the actual research and its scenario in Nepal.