Browsing by Author "Sharma, AK"
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Publication Benign and malignant breast disease presenting to Bhaktapur Cancer Hospital(Kathmandu University, 2005) Sharma, A; Bandari, R; Gilbert, D; Sharma, AKObjective: In the absence of formal breast screening services in Nepal, patients must self present upon developing symptoms relating to the breast. Clinical examination and diagnostic tests are then used to differentiate benign and malignant conditions. Referral / presentation patterns are not well studied and this paper aims to investigate this. Method: Here we present the clinico-pathological diagnoses of patients presenting to Bhaktapur Cancer Hospital with breast related complaints within a six month period, and report upon their subsequent management. Results: 727 patients presented with breast related complaints, of whom 34 were diagnosed with breast cancer. These tended to present at late stage and their subsequent management is discussed. Conclusion: As the incidence of breast cancer in Nepal is likely to be under-reported and more than likely rising, patient awareness campaigns are underway in order to facilitate the earlier diagnosis of malignant disease and thus beneficially influence treatment outcomes. To this end the need for the development of dedicated breast services is highlighted.Publication clinical Manifestation of Ocular Motor Nerve Palsies in a Tertiary Eye Hospital of Kathmandu, Nepal(Institute of Medicine, 2014) Sitaula, S; Sharma, AK; Shrestha, GB; Gajurel, BP; Shrestha, GSAbstract Introduction: Ocular motor nerve palsies are one of the leading causes of ocular morbidity in the neuro-ophthalmology clinic. Objective: This study was aimed to determine the aetiology of ocular motor nerve palsies in a tertiary referral eye center of Nepal. Methods: This hospital based cross-sectional descriptive study was carried out over a period of one and a half years. All cases of ocular motor nerve palsies were evaluated and relevant laboratory investigations and imaging studies were done. Results: Ninety–one patients with ocular motor nerve palsies were examined, of which 53 (58%) were males and 38(42%) were females. The mean age was 39.4 years ±18.29 years. Majority of the cases (n=78, 86%) had unilateral involvement and the most common chief complaint was double vision (n=58, 63.7%). The sixth cranial nerve palsy was most commonly seen (n=49, 53.85%) followed by third nerve palsy (n=22, 24.18%). Fourth cranial nerve palsy and combined cranial nerve palsies accounted for 10.99% each (n=10). Aetiology of ocular motor nerve palsies could not be determined in 31.8% of the cases. Among the identifiable etiologies were vascular diseases (n=24, 26.3%), infections (n=14, 15.3%), trauma (n=14, 15.3%) and neoplasms (n=9, 9.8%). Imaging studies were done in 92 %(n=84) of cases. In cases of combined cranial nerve palsies, positive diagnostic findings were noted in 50% (n=5) of the cases with imaging studies. Conclusion: The sixth cranial nerve palsy was the most common ocular motor nerve palsy in our study. The most common identifiable aetiology was vascular diseases followed by trauma. Besides ophthalmic examination, neurological evaluation and imaging plays an important role in diagnosis. Keywords: aetiology, imaging, ocular motor nerve palsyPublication Idiopathic lobular panniculitis (Weber Christian disease): A case report(Kathmandu University, 2006) Sharma, AK; Sharma, PRWeber Christian disease, an idiopathic relapsing febrile subcutaneous and visceral panniculitis is a rare disease in children. We report a case of Weber Christian disease for he first time from Kanti Children’s Hospital.Publication Systemic Lupus Erythematosus with antiphospholipid Syndrome Presenting as Seizure Disorder and Retinopathy(Institute of Medicine, 2014) Sharma, AK; Sitaula, S; Thapa, M; Gautam, P; Shrestha, GS; Gajurel, BP; Sigdel, MRNA.Publication Turner Syndrome, Uncommonly Diagnosed Cause of Short Stature: Case Report and Review of Literature(Nepal Paediatric Society (JNPS), 2013) Basnet, S; Eleena, A; Sharma, AKAbstract: Many children are frequently brought to the paediatric clinic for evaluation of short stature. Evaluation for these children does not go beyond x-ray for bone age estimation and growth hormone analysis. Most of them are considered having constitutional or genetic cause for their short stature. However, shuttle dysmorphic features could be missed in many of them. Hence, many children might be having chromosomal anomaly as an underlying cause. We report a case of 40 months who had been evaluated several times in the past for pneumonia, otitis media and short stature is finally diagnosed to have Turner syndrome.