Browsing by Author "Rai, Nilshan"
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Publication Bulbar Onset Amyotrophic Lateral Sclerosis: A Case Report(Nepal Medical Association, 2023) Rai, Kabindra; Rai, Nilshan; Thapa, Milan Kumar Chhantel; Shrestha, Rajan; Singh, Sampurna; Thapa, MonikaAbstract Amyotrophic lateral sclerosis is a rare, progressive, incurable neurodegenerative disorder that affects motor neurons leading to progressive muscle weakness, disability, and eventually death. A 45-year-old male, initially presented with hoarseness, flickering of tongue, and intermittent aspirations. In course of three years, patient developed motor aphasia, frequent aspirations and an inability to hold his neck. Patient was diagnosed with a bulbar onset type of amyotrophic lateral sclerosis on the basis of neurodegenerative features with normal radiographic imaging. For the prevention of recurrent aspiration pneumonia, he was managed with a percutaneous endoscopic gastrostomy tube. As he started developing respiratory failure tracheostomy was performed and kept on a continuous bi-level positive airway pressure ventilator, in the meantime, two courses of injection Edaravone were given. Early evaluation, diagnosis and management of the condition is a cornerstone for better prognosis of disease and survival.Publication Hypertensive Retinopathy among Hypertensive Patients in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Basnet, Anjila; Rai, Nilshan; Sahani, Shambhu Kumar; Pathak, Anil; Nepali, BishalAbstract Introduction: Hypertension manifests in the eyes as retinopathy, choroidopathy, and optic neuropathy of which retinopathy can be used as a predictor for systemic morbidities and mortalities. The study aims to determine the prevalence of hypertensive retinopathy among hypertensive patients visiting the outpatient Department of Ophthalmology in a tertiary care center. Methods: A descriptive cross-sectional study was conducted among hypertensive patients from 4th April to 19th November 2023 after obtaining ethical approval from the Institutional Review Committee (Reference number: 2079/80/96). A Convenience sampling method was used. The Point estimate was calculated at a 95% Confidence Interval. Results: Among 161 hypertensive patients, hypertensive retinopathy was present in 70 (43.48%) (35.82-51.14, 95% Confidence Interval). Grade I hypertensive retinopathy accounted for 35 (50%) followed by Grade II HR in 17 (24.29%), Grade III HR in 14 (20%) and Grade IV HR in 4 (5.71%) in the study participants. Conclusions: The prevalence of hypertensive retinopathy was found to be higher than other studies done in similar settings.Publication Intracranial Calcification and Seizure with Down Syndrome: A Case Report(Nepal Medical Association, 2022) Rai, Nilshan; Thapa, Monika; Pokharel, Merina; Acharya, Jinee; Yadav, DhirendraAbstract Down syndrome is a genetic disorder caused by an extra copy of chromosome number 21. New onset of seizure in adults with Down syndrome is rare. The exact pathogenesis of intracranial calcification and seizure in Down syndrome is unknown, however, a possible association between hypocalcemia and vitamin D deficiency in Down syndrome was reported. An 18-year-old girl with nasal bridge, mongoloid slants, clinodactyly and saddle gap of toes, and prominent Downs phenotypes was present with a low level of parathyroid hormone, calcium, and vitamin D. Due to a higher prevalence of intracranial calcification in people with Down syndrome, there is an increased possibility of hypocalcemia and vitamin D deficiency. Hence, serum levels of calcium and vitamin D should always be checked before starting treatment with anti-epileptic drugs.Publication Intracranial Calcification and Seizure with Down Syndrome: A Case Report(Nepal Medical Association, 2022) Rai, Nilshan; Thapa, Monika; Pokharel, Merina; Acharya, Jinee; Yadav, DhirendraAbstract Down syndrome is a genetic disorder caused by an extra copy of chromosome number 21. New onset of seizure in adults with Down syndrome is rare. The exact pathogenesis of intracranial calcification and seizure in Down syndrome is unknown, however, a possible association between hypocalcemia and vitamin D deficiency in Down syndrome was reported. An 18-year-old girl with nasal bridge, mongoloid slants, clinodactyly and saddle gap of toes, and prominent Downs phenotypes was present with a low level of parathyroid hormone, calcium, and vitamin D. Due to a higher prevalence of intracranial calcification in people with Down syndrome, there is an increased possibility of hypocalcemia and vitamin D deficiency. Hence, serum levels of calcium and vitamin D should always be checked before starting treatment with anti-epileptic drugs.Publication Overweight among Medical Students in a Medical College(Nepal Medical Association, 2023) Rai, Nilshan; Bhattarai, Binita; Rai, Paruhangma; Pathak, Anil; Sahani, Shambhu Kumar; Gurung, PabitraAbstract Introduction: Overweight is defined as a condition in which abnormal accumulation of fat directly affects an individual personality and health leading to a marked increase in morbidity and mortality. It has a direct impact on both the psychological aspects of an individual's personality and their overall health. The objective of this study was to find out the prevalence of overweight among medical students in a medical college. Methods: A descriptive cross-sectional study was done among first and second-year medical students in a medical college between 20 February 2023 to 3 March 2023 after receiving ethical approval from the Institutional Review Committee. Students studying Bachelor of Medicine, Bachelor of Surgery and Bachelor of Dental Surgery during the study period who gave consent were included and those students with a recent medical history of fever, typhoid, diarrhoea, thyroid disorder, metabolic disorders, or any other relevant medical condition within the preceding 1 month, potentially influencing body weight, were excluded. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 164 students, the prevalence of overweight was 43 (26.22%) (19.49-32.95, 95% Confidence Interval). The mean age was 20.65±1.08 years. Conclusions: The prevalence of overweight among medical students was higher than in other studies done in similar settings.