Browsing by Author "Pandey, Asim"
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Publication Chronic Lithium Toxicity in Old Age Patients Taking Angiotensin Receptor Blocker: A Case Report(Nepal Medical Association, 2023) Pandey, Asim; Khanal, Kunjan; Jha, Anushree; Basnet, Prava; Bhattarai, DipeshAbstract Chronic lithium toxicity is a potentially serious side effect on patients taking lithium for a prolonged period with the diagnosis of mood disorders. The toxicity is even higher in patients taking drugs that interfere with the metabolism of lithium like angiotensin receptor blockers and in older patients with reduced kidney function. In this report, we present the case of a 62-year-old woman who presented to the emergency department with symptoms including loose stools, generalised body weakness, slurred speech, coarse hand tremors, and dystonia persisting for fifteen days. She had been under lithium therapy for bipolar type 1 disorder for 15 years before experiencing these symptoms, which emerged shortly after the addition of telmisartan (angiotensinogen receptor blocker) for hypertension.Publication Etoricoxib Induced Toxic Epidermal Necrolysis in a case of Systemic Lupus Erythematosus: A Case Report(Nepal Medical Association, 2022) Pandey, Asim; Parajuli, Samriddhi; Dhungel, Alok; Devkota, Rahul; Dongol, AngelAbstract Toxic epidermal necrolysis is a potentially life-threatening dermatological condition whose pathogenesis and exact treatment are not yet known. Drugs like anticonvulsants, allopurinol and non-steroidal anti-inflammatory drugs like etoricoxib, a selective cyclo-oxygenase-2 inhibitor prescribed for pain management are associated with a high risk of toxic epidermal necrolysis. It is also associated with immunodeficiency and dysregulated immune reactions like systemic lupus erythematosus, an autoimmune disease in which organs and cells undergo damage initially mediated by tissue binding auto-antibodies and immune complexes. Here, a 34 year old lady was presented in emergency with multiple maculopapular rashes over the neck and trunk region after treatment with etoricoxib for osteoarthritis of the left foot.Publication Microalbuminuria among Patients with Diabetes Mellitus Visiting the Department of Nephrology in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Bhattarai, Tulsi; Pandey, Asim; Parajuli, Samriddhi; Khanal, Prajwal; Dongol, Angel; Devkota, Rahul; Neupane, Sohil; Bhattarai, Bharat KumarAbstract Introduction: Microalbuminuria is an abnormal increase in albumin excretion rate with a specific range of 30-299 mg of albumin/g of creatinine or excretion of 20-200 mg/l of albumin in spot urine samples. Diabetic patients with microalbuminuria are at increased risk for cardiovascular death as compared with normoalbuminuria. The aim of this study was to find out the prevalence of microalbuminuria among patients visiting the Department of Nephrology in a tertiary care centre. Methods: This is a descriptive cross-sectional study conducted among diabetic patients visiting the Department of Nephrology in a tertiary care centre after obtaining ethical approval from the Institutional Review Committee (Reference number: 04072022/04). The study was conducted between 1 October 2022 to 30 November 2022 where patients providing written consent and had documented diabetes were included in the study whereas patients without documented diabetes, having comorbidities such as congestive heart failure, nephritic/nephrotic syndrome and those who refused to give consent were excluded from the study. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 103 patients, microalbuminuria was found to be in 19 (18.45%) (10.96-25.94, 95% Confidence Interval). Out of 19 patients, 8 (42.11%) were male and 11 (57.89%) were female. The mean HbA1c among participants with microalbuminuria was 7.67±0.67%. Conclusions: The prevalence of microalbuminuria among diabetic patients was similar to other studies done in similar settings.Publication Migraine among Patients Presenting With Headaches to the Department of Internal Medicine in a Tertiary Care Centre(Nepal Medical Association, 2023) Dhungel, Alok; Pandey, Asim; Parajuli, Samriddhi; Khanal, Prajwal; Maskey, Nawanit; Luitel, AshayaAbstract Introduction: Migraine is one of the common neurovascular disorders characterized by persistent headaches ranging from moderate to severe pain. It has a high prevalence affecting more than one billion population each year across the world and has high morbidity, especially among young adults and females. The exact cause and mechanism of the migraine is unknown. The aim of this study was to find out the prevalence of migraine among patients presenting with headaches to the Department of Internal Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Internal Medicine in a tertiary care centre from 1 August 2022 to 31 October 2022. Ethical approval was taken from the Institutional Review Committee. All the patients presenting to the Department of Internal Medicine with headaches as primary complaints were included. Patients with incomplete information and altered sensorium were excluded. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 69 patients, the prevalence of migraine was 13 (18.84%) (9.61-28.07, 95% Confidence Interval). Of those diagnosed with migraine headaches, 4 (30.77%) were male patients, and 9 (69.23%) were female patients. The mean age of diagnosis of migraine headache was 30±11.5 years. Conclusions: The prevalence of migraine among patients presenting with headaches to the Department of Internal Medicine was found to be higher than in the other studies done in similar settings.Publication Multiple Wasp Stings Leading to Rhabdomyolysis Induced Acute Kidney Injury with Incidental Ectopic Kidney: A Case Report(Nepal Medical Association, 2022) Dongol,Angel; Sapkota, Abhin; Devkota, Rahul; Pandey, Asim; Bhattarai, Tulsi RamAbstract Rhabdomyolysis refers to skeletal muscle breakdown causing a release of different intracellular proteins including myoglobin and several electrolytes in the bloodstream. Elevations diagnose rhabdomyolysis in serum creatine kinase. Mass envenomation by multiple wasp stings can cause rhabdomyolysis followed by acute kidney injury, although it is scarce. A 24-year-old male presented to our tertiary centre in an anaphylaxis-like state after multiple wasps sting, rapidly developing rhabdomyolysis followed by acute kidney injury. Despite having an ectopic kidney with a pre-existing renal parenchymal disease, he recovered and was discharged, which in itself is a rare entity of low clinical incidence. Wasp stings can potentially result in serious clinical manifestations, which need to be watched over, assessed and promptly treated.Publication Multiple Wasp Stings Leading to Rhabdomyolysis Induced Acute Kidney Injury with Incidental Ectopic Kidney: A Case Report(Nepal Medical Association, 2022) Dongol, Angel; Sapkota, Abhin; Devkota, Rahul; Pandey, Asim; Bhattarai, Tulsi RamAbstract Rhabdomyolysis refers to skeletal muscle breakdown causing a release of different intracellular proteins including myoglobin and several electrolytes in the bloodstream. Elevations diagnose rhabdomyolysis in serum creatine kinase. Mass envenomation by multiple wasp stings can cause rhabdomyolysis followed by acute kidney injury, although it is scarce. A 24-year-old male presented to our tertiary centre in an anaphylaxis-like state after multiple wasps sting, rapidly developing rhabdomyolysis followed by acute kidney injury. Despite having an ectopic kidney with a pre-existing renal parenchymal disease, he recovered and was discharged, which in itself is a rare entity of low clinical incidence. Wasp stings can potentially result in serious clinical manifestations, which need to be watched over, assessed and promptly treated.