Browsing by Author "Sapkota, Abhin"
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Publication Esophageal Actinomycosis in an Immunocompetent Patient Mimicking Carcinoma: A Case Report(Nepal Medical Association, 2022) Poudel, Shekhar; Sapkota, Abhin; Devkota, Rahul; Poudel, Sujan Chandra; Dangol, AngelAbstract Esophageal actinomycosis is a rare occurrence that presents a diagnostic challenge due to its vague clinical picture. The common symptoms include dysphagia, odynophagia and epigastric pain. These symptoms, although alarming, are usually non-specific. In this report, we describe an immunocompetent 38-year-old woman who presented with dysphagia and burning chest pain. Her initial examination and investigations suggested carcinoma of the oesophagus. On further evaluation and histopathology examination, she was diagnosed with esophageal actinomycosis and managed with antibiotics and symptomatic relief. She had significant improvement on follow up examination. The diagnosis of this condition in an immunocompetent patient can be confusing and requires a high degree of suspicion.Publication Macrophage Activation Syndrome secondary to Systemic Juvenile Idiopathic Arthritis: A Case Report(Nepal Medical Association, 2021) Kafle, Rishikesh; Bhatta, Anwesh; Gami, Sumit; Sapkota, Abhin; Sharma, Dipesh; Yadav, Arabindra; Chikanbanjar, Vijaya KumarAbstract: Macrophage activation syndrome is a rare but a life threatening condition commonly associated with Systemic Juvenile Idiopathic Arthritis. Its clinical presentation includes fever, hepatosplenomegaly, hypertriglyceridemia, hypofibrinogenemia, hyperferritinemia and impaired liver enzymes. The symptoms are alarming yet non-specific and often lead to a delayed diagnosis. A 12 year male presented with a history of intermittent fever and was started on antibiotics but failed to respond after several days of hospital stay. After a series of investigations to rule out multiple diagnoses he was diagnosed as a case of Macrophage Activation Syndrome secondary to Systemic onset Juvenile Arthritis and was treated with steroids.Publication Multiple Neonatal Teeth in a Preterm Neonate: A Case Report Authors(Nepal Medical Association, 2021) Gautam, Uttara; Phuyal, Rajan; Sapkota, Abhin; Chikanbanjar, Vijaya KumarAbstract: Prematurity and low birth weight are significantly associated with delayed dentition. Few cases of the eruption of a tooth immediately at or after birth in preterm neonates have been reported in the literature, although this is a rare presentation. The aetiology of this rare biological aberration is yet to be established but has been associated with hereditary predilection, nutritional factor, endocrine causes, infection, and some syndromes. Here, we present a case of a preterm male neonate at 28 weeks of gestation with very low birth weight and respiratory distress who presented with three neonatal teeth, two maxillary central incisors, and one mandibular central incisor and its subsequent management.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.Publication Pneumothorax in a Preterm Neonate: A Case Report(Nepal Medical Association, 2021) Phuyal, Rajan; Basnet, Ritika; Sapkota, Abhin; Gautam, Uttara; Chikanbanjar, Vijay KumarAbstract: A pneumothorax is an abnormal collection of air in the pleural space between the lung and chest wall. Although this condition commonly occurs in adults, it can also present as complication in neonates requiring assisted ventilation and has high morbidity and mortality. Chest tube placement and needle drainage are some common approaches in management. A late preterm infant born at 35+2 weeks of gestation was admitted in Neonatal Intensive Care Unit for the management of respiratory distress. He was kept on mechanical Continuous Positive Airway Pressure owing to worsening respiratory distress. Chest X-ray revealed pneumothorax that was successfully managed with venous catheter drainage on second intercostal space with underwater seal. He was discharge on 10th day of Neonatal Intensive Care Unit admission with stable vitals and normal breathing pattern.