Browsing by Author "Shrestha, Bibek"
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Publication Central Venous Catheter-related Thrombosis in a Dialysis Patient: A Case Report(Nepal Medical Association, 2022) Regmi, Sachit; Manandhar, Dilasha; Pyakurel, Sulav; Shrestha, Bibek; Khanal, Pitamber; Paudel, Sandip; Gyawali, PawanAbstract Hemodialysis is one of the treatment modalities for advanced kidney disease and can help an individual live an active life despite failing kidneys. Although it improves the quality of life, it is not completely risk-free. It has several complications, among which, thrombus formation is common. We report a case of a 63-year-old man who presented at our institution for regular hemodialysis with recurrent arteriovenous graft failure. Because doppler ultrasound is a non-invasive procedure that can identify a thrombus in a vein, it is the best initial option for patients with internal jugular vein thrombosis. The use of ultrasound not only can guide a catheter pathway but can also help in early diagnosis and prevent complications following catheterization in a vein with a thrombus.Publication Current Status and Future Potential of Machine Learning in Diagnostic Imaging of Endometriosis : A Literature Review(Nepal Medical Association, 2025) Shrestha, Palpasa; Shrestha, Bibek; Shrestha, Jati; Chen, JunAbstract The presence of endometrial tissue outside the uterus is a defining characteristic of endometriosis, a chronic systemic illness that affects women of childbearing age. Despite its enigmatic nature, laparoscopy remains the gold standard for diagnosis, while noninvasive methods such as transvaginal ultrasonography and magnetic resonance imaging are commonly used to aid in preoperative planning. In healthcare, AI has emerged as a game-changing innovation, enhancing patient outcomes, reducing costs, and revolutionizing healthcare delivery, particularly in diagnostic radiology. Images can be analyzed using machine learning, a pattern recognition method. The machine learning algorithm first computes the image characteristics deemed significant for making predictions or diagnoses about unseen images.Publication Massive Middle Cerebral Artery Ischemic Stroke Associated with Severe Acute Respiratory Distress Syndrome in H1N1 Influenza: A Case Report Authors(Nepal Medical Association, 2022) Bhattarai, Suju; Karki, Bipin; Pokhrel, Shweta; Regmi, Sachit; Shrestha, Bibek; Shrestha, Pramesh SunderAbstract: Influenza has a common occurrence during its peak seasons. It usually causes disease of the respiratory tract including severe acute respiratory distress syndrome. However, it may also cause disease and complication of other organ systems. We present a rare complication of influenza in which a patient secondary to influenza developed massive middle cerebral artery ischemic stroke. The patient however survived following recovery of both severe acute respiratory distress syndrome and ischemic stroke after decompressive craniectomy and a prolonged intensive care unit stay. This case report is to highlight the importance of influenza related complications besides the pulmonary infliction which can lead to morbidity and even mortality if not managed on time.Publication Moyamoya Disease with Intraventricular Hemorrhage in a Child: A Case Report(Institute of Medicine, 2025) Regmi, Nisha; Shrestha, Bibek; Karn, Vivek; Regmi, Pradeep RajABSTRACT Moyamoya disease is a rare progressive cerebrovascular disorder in Nepal characterized by stenosis or occlusion of cerebral arteries with abnormal collateral vessels, and hemorrhagic presentation in children is extremely uncommon. We report an 8-year-old girl with intraventricular hemorrhage presenting with seizures, vomiting, and decreased consciousness. Imaging revealed characteristic angiographic features of Moyamoya disease. She was managed with external ventricular drainage and supportive treatment, achieving significant recovery. This case highlights the importance of considering Moyamoya disease in pediatric hemorrhagic stroke and underscores the need for early imaging and timely intervention. Keywords: Moyamoya Disease; intraventricular hemorrhage; pediatric stroke