Browsing by Author "Shah, Bipesh Kumar"
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Publication 11β Hydroxylase Deficiency in a Child with Hypothyroidism: A Case Report(Nepal Medical Association, 2023) Shah, Bipesh Kumar; Koirala, Richa; Dhamala, Sumit; Bhatta, Mukesh; Khatiwada, ShekharAbstract Congenital adrenal hyperplasia occurs due to enzymatic defects in the adrenocortical steroidogenesis. 11β hydroxylase deficiency is the second most common cause of congenital adrenal hyperplasia which presents with hypertension and features of androgen excess. Hypertension has also been found to cause end-organ damage in children with 11β hydroxylase deficiency. We report a case of a 10-year-old male child with hypothyroidism under thyroid replacement therapy, presenting with features of severe hypertension and androgen excess, later on, diagnosed as congenital adrenal hyperplasia due to 11β hydroxylase deficiency.Publication Arthralgia as an Initial Presentation of Kawasaki Disease: A Case Report(Nepal Paediatric Society (JNPS), 2023) Shah, Bipesh KumarAbstract: Kawasaki disease is an acute necrotizing vasculitis of medium sized vessels occurring in children aged six months to five years with predisposition to involve coronary arteries. Fever followed by mucous membrane changes are the frequent manifestation of the disease. Arthralgia occurring at the outset of Kawasaki disease is less common which can become challenging in the diagnosis of Kawasaki disease. There are no such cases reported in literature.Publication Dengue Shock Complicated with Scrub Typhus in a Child: A Case Report(Nepal Paediatric Society (JNPS), 2023) Shah, Bipesh Kumar; Shrestha, Shova; Dhamala, SumitAbstract: Dengue and scrub typhus mixed infection is not commonly reported in the paediatric age group. Here, we report a case of a female child from the eastern part of Nepal who presented with abdominal pain, fever, respiratory distress and shock. The overlapping clinical features and laboratory findings complicate the diagnosis of polymicrobial infection, thus delaying treatment, and bringing up complications. Thus, our case emphasizes that a high index of clinical suspicion, vigilant physical examination, and appropriate laboratory tests should be employed for the early diagnosis and prompt treatment of coexisting infection, considering the local endemicity of both the diseases.Publication Serum Electrolyte Abnormality in Children Admitted to Paediatric Emergency and ward: A Cross-Sectional Study(Perinatal Society of Nepal (PESON), 2024) Shah, Bipesh Kumar; Paudel, Niraz; Paudel, Alina; Aryal, ShreshaAbstract:: Introduction: The electrolyte disturbances resulting from underlying disease can adversely affect outcomes in children. Few previous studies have been conducted inthe paediatric intensive care unit regarding electrolytes disturbances. This study aimed at calculatingtheprevalence of dyselectrolytemia involving sodium and potassium in the paediatric emergency, and ward of a tertiary care center. Methods: This was a prospective cross-sectional study carried out in a tertiary center from 10th November 2023 to 30th December 2023, after obtaining ethical clearance (reference: 216/080/081-IRC). A total of 112 children from one month to 18 years of age were included via the convenience sampling method. The variables included age, sex, diagnosis, serum sodium, and potassium. Results: The serum electrolyte abnormality was observed in 49.1% of patients. The most common admitting diagnosis was pneumonia in 47.3%. The mean age of children was 3.7 years with male preponderance (58%). The most prevalent electrolyte abnormality was hyponatremia (45.5%), followed by hyperkalemia (8%), hypokalemia (0.9%), and no cases of hypernatremia. Approximately, half (49%) of children with pneumonia had hyponatremia. Conclusions:There is a high burden of serum electrolyte abnormalityin children admitted to paediatric emergency and ward of which hyponatremia appears to be the commonest.Publication Severe Acute Respiratory Distress in a Child with Hypereosinophilic Syndrome: A Case Report(Nepal Medical Association, 2024) Shah, Bipesh Kumar; Yadav, Shankar Prasad; Nagpal, Dheeraj; Pokhrel, Naveen; Lamichhane, SamikshaAbstract Hypereosinophilic syndrome with respiratory distress and multiorgan involvement is not so common in children. It is essential to identify this entity based on clinical, laboratory, and imaging features. Corticosteroids should be instituted at the earliest to stabilize the patient and prevent organ damage. Tropical infections are a common secondary cause in children warranting the administration of Diethylcarbamazine. We present a case of an adolescent male in respiratory distress with marked eosinophilia and organs involving the lungs (pulmonary infiltrates with effusion), heart (pericardial effusion), and abdomen (ascites with infiltrates in the liver) which was managed with steroids and anthelmintics. The case highlights the importance of identifying patients with Hypereosinophilic syndrome in pursuing thorough evaluation and commencing therapy.