Browsing by Author "Sah, Muneshwar"
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Publication Association between Serum Uric Acid Levels and Stroke Severity inAcute Ischemic Stroke: A Cross-Sectional Study(Nepal APF Hospital, 2026) Sah, Dayanand Prasad; Shah, Santosh Prasad; Subedi, Bhusan Kumar; Khatri, Ganga Ram; Poudyal, Himani; Sah, Muneshwar; Bastola, Basanta Kumar; Gaire, PrabinAbstract: Background: Ischemic stroke (IS) represents a significant global health burden, with multiple established risk factors. Studies have suggested a potential link between serum uric acid (SUA) levels and stroke risk. Some studies propose that elevated SUA may contribute to the pathophysiology of stroke through mechanisms such as oxidative stress and inflammation. This study explore the association between SUA and the incidence of acute ischemic stroke, taking into account confounding variables such as age, sex, comorbidities, lifestyles pattern. Methods: The hospital based cross sectional observational study conducted with sample size of 95 including patients of either sex above the age of 18 years with acute ischemic stroke within 7 days of presentation and confirmed by neuroimaging. The study excluded patients with hemorrhagic stroke, known malignancies, chemotherapy, recent surgery, trauma, or drugs affecting SUA level. SUA levels and National Institutes of Health Stroke Scale (NIHS score) were calculated to assess stroke severity. Results: The study found a higher incidence of stroke among males (56%), with smoking being the most common risk factor (64%) followed by hypertension (54%). The study found that 86.32% of patients had serum uric acid levels below 6.8mg/dl, while 13.68% had levels above 6.8mg/dl. Patients with low uric acid levels were seen having a higher risk of stroke as the severity of stroke was highest among those with serum uric acid levels (4.0-5.0 mg/dl) however there found statistically not significant association between serum uric acid level and NIHSS (p=0.52). Conclusion: The mean serum uric acid was 5.19 mg/dl (SD 1.48) and mean NIHSS was 11.24 (SD 3.9). There is no correlation between Serum uric acid and severity of ischemic stroke by NIHSS(p=0.52).Publication COVID-19 Reinfection in a Young Medical Doctor: A Case Report(Nepal Medical Association, 2021) Gaire, Dhruba; Sah, Muneshwar; Singh, BishnuAbstract: There is hardly any report of reinfection due to coronavirus disease 2019 (COVID-19) in medical professionals from Nepal. We report a case of a 32-year-old doctor with COVID-19 reinfection. Symptoms during the first infection were mild. After one month, he was reinfected and developed diarrhea as well as a continuous high fever. His d-dimer and ferritin were much increased. Computed tomography chest showed bilateral lymph nodes, minimal pleural effusion, and scattered linear fibrosis. After discharge, his depression and myalgia persisted for one month. During reinfection, his symptoms were more severe and cost of treatment was almost eight times his monthly salary and he could not work for six weeks. Possible reasons for severe reinfection and differential diagnoses like cytokine storm, multisystem inflammatory syndrome, reactivation of COVID-19, and infection due to new variants were discussed. Whether infected or vaccinated or not, all should take recommended vaccination and primary-preventive as well as health-promotive measures.