Browsing by Author "Shrestha, Nischal"
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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 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 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.