Browsing by Author "Shrestha, Nischal"
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Publication A Baby Born with Ectopia Cordis, Omphalocele, Cleft Lips and Palate: A Case Report(Nepal Medical Association, 2022) Shrestha, NischalAbstract: Ectopia cordis is a rare congenital defect with the prevalence of 5 to 8 per million live births. Here we report a rare case of preterm female live birth with ectopia cordis associated with omphalocele, cleft lip, and palate. In this case, 14+ weeks ultrasound did not show any fetal abnormalities and parents were unaware of the condition until 35+ weeks when ultrasound detected the anomaly a few days before delivery. After delivery, they didn’t give consent for further intervention which led to neonatal mortality 3 hours after birth. If the condition was diagnosed in time, an earlier intervention could have been done.Publication Acute Kidney Injury in COVID-19 Patients Admitted at a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Manandhar, Diwakar; Manandhar, Dhiraj Narayan; Chhetri, Pramod Kumar; Acharya, Nishant; Yogi, Rubash Nath; Upreti, Anup Raj; Yadav, Radhay Shyam; Shrestha, Nischal; Joshi, SammiAbstract Introduction: Coronavirus disease can affect the renal system in various forms ranging from mild proteinuria to acute kidney injury, some even needing renal replacement therapy. This study aimed to find out the prevalence of acute kidney injury in patients admitted with COVID-19 at a tertiary care centre. Methods: This descriptive cross-sectional study was done in patients admitted in COVID-19 ward in our hospital from July 2021 to June 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: 066-077/078). The serum creatinine level was used for the diagnosis of acute kidney injury. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Out of 80 patients with COVID-19, the prevalence of acute kidney injury was 25 (31.25%) (21.09-41.41, 95% Confidence Interval). Conclusions: The prevalence of acute kidney injury in COVID-19 patients was similar to other studies done in similar settings.Publication Adenocarcinoma among Patients Diagnosed with Lung Cancer in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Ansari, Farmud; Ghimire, Ram Hari; Shrestha, Nischal; Yadav, SushilAbstract Introduction: Lung cancer is the leading cause of cancer deaths all over the world and adenocarcinoma is the most common type. Diagnosis is made usually at an advanced stage of lung cancer in patients, making it nearly impossible to cure. The aim of this study is to find out prevalence of adenocarcinoma among patients diagnosed with lung cancer in a tertiary care centre. Methods: A descriptive cross-sectional study was carried out in the Department of Pulmonary Medicine of a tertiary care centre among 69 patients from October, 2018 to September, 2019. Ethical approval was taken from the Institutional Review Committee of a tertiary care hospital (Reference number: 54/2018). A convenience sampling technique was used. Data were entered and analysed using the Statistical Package for the Social Sciences version 21.0. Point estimate at 90% Confidence Interval and descriptive statistics were interpreted as frequency, percentage, or as mean and standard deviations. Results: Among 69 lung cancer patients, adenocarcinoma was seen in 27 (39.13%) (29.47-48.79 at 90% Confidence Interval). Out of 27, 10 (37.04%) were male and 17 (62.96%) were female. Chronic obstructive pulmonary disease was the major comorbidity seen among 17 (62.96%) patients. Conclusions: The prevalence of adenocarcinoma was similar to other studies done in similar settings.Publication Cap Polyposis: A Case Report(Nepal Medical Association, 2023) Khadka, Tunam; Giri, Ganesh Kumar; Sherpa, Pasang; Shrestha, Nischal; Poudyal, SanjayaAbstract Cap polyposis is a gastrointestinal disease with multiple inflammatory polyps between the distal colon and rectum. Its symptoms overlap with inflammatory bowel disease with typical endoscopic features of multiple sessile polyps in the rectum and sigmoid colon, located at the apices of transverse folds. Microscopically, the polyps consist of elongated, tortuous, and distended crypts covered by a “cap” of inflammatory granulation tissue. In this report, we present a case of a 18-year-old male patient who underwent polypectomy for polyposis in multiple settings. He presented with one year of painless rectal bleeding and polyposis in a recto-sigmoid area on colonoscopy, with a single polyp in the sigmoid area and multiple polyps in the rectum. He was managed with immediate and interval polypectomy. Though cap polyposis is rare, it can be cured as it is laparoscopically resectable.Publication Tympanic Membrane Perforation among Patients Presenting to Department of Otorhinolaryngology of a Tertiary Care Hospital: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Ghimire, Bibek; Basnet, Meenakshi; Aryal, Gyan Raj; Shrestha, NischalAbstract Introduction: Intact tympanic membrane acts as a partition between the external ear and middle ear. Tympanic membrane perforation is one of the commonest causes of conductive hearing loss. Perforation size is the most important determination of hearing loss. The aim of this study was to find out the prevalence of tympanic membrane perforation among patients presenting to the otorhinolaryngology department of a tertiary care hospital. Methods: A descriptive cross-sectional study was carried out in the Department of Otorhinolaryngology and Head Neck Surgery of a tertiary care hospital from March 2021 to August 2021. Ethical approval was taken from Institutional Review Committee (Reference number: 57112021). Convenience sampling was done and data was collected from 414 patients presenting to the department. Collected data were entered, analyzed in Statistical Package for the Social Sciences version 21.0 and documented for study. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Among 414 patients, tympanic membrane perforation was seen in 100 (24.15%) (20.02-28.27 at 95% Confidence Interval). Among 100 patients with a total of 153 perforated eardrums, mild hearing loss was seen in the majority of the cases. Posterior perforation had a mean hearing loss of 40.41±5.96 dB, central had 39.09±3.13 dB, and anterior had 35.15±5.88 dB. Conclusions: Our study showed the prevalence of tympanic membrane perforation to be high when compared to other similar studies. Hearing loss was observed in all cases; the majority with mild hearing loss. The degree of hearing loss was more in larger and posterior perforation.Publication Typhoid Fever among Patients Diagnosed with Dengue in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Mahato, Arun Kumar; Shrestha, Nischal; Gharti, Sakar Babu; Shah, MadhuAbstract Introduction: Dengue and typhoid fever are different entities with overlapping signs and symptoms which are indistinguishable and there have been few reports of co-infections from endemic areas. The resemblance of symptoms makes accurate clinical diagnosis and treatment difficult. Both are major health problems mainly during monsoon and co-infection, if not timely diagnosed and treated can be fatal. The aim of this study was to find out the prevalence of typhoid fever among patients diagnosed with dengue at a tertiary care centre. Methods: A descriptive cross-sectional study was done among patients of age >15 years with dengue fever attending the medicine outpatient department in a tertiary care centre from 1 July 2021 to 30 June 2022. Ethical approval was taken from the Institutional Review Committee (Reference number: 466/2020). Convenience sampling was used. Patients with other risk factors for febrile illness were excluded from the study. Point estimate and 90% Confidence Interval were calculated. Results: Among 95 dengue cases, typhoid fever was observed in 18 (18.95%) (12.36-25.54, 90% Confidence Interval). The mean age of presentation was 35±9 years with a male to female ratio of 0.8:1. Fever was the most common presentation with a mean temperature of 100.8±2.1°F. Conclusions: The prevalence of typhoid fever among dengue-positive cases was higher as compared to other studies done in similar settings.Publication Varicella Pneumonia in an Immunocompetent Middle-aged Adult Male: A Case Report(Nepal Medical Association, 2022) Shrestha, Nischal; Bhatta, Karuna; Rai, Anjan; Khatun, SanzidaAbstract Varicella pneumonia is uncommon among adults and can present as potentially life-threatening complications of varicella. Here we report a case of a 43-year-old man with no known history of chronic disease and no allergic history who presented to our hospital emergency department with widespread skin eruptions over the entire body and hemoptysis. Varicella pneumonia was diagnosed based on the patient being in contact with his 6-year-old son who had contracted chickenpox 10 days back, typical cutaneous lesions, pulmonary symptoms and radiographic findings. The patient was treated with oral acyclovir and was admitted to the intensive care unit for monitoring. The patient recovered completely after 10 days of treatment.