Browsing by Author "Shrestha, Rajan"
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Publication Bulbar Onset Amyotrophic Lateral Sclerosis: A Case Report(Nepal Medical Association, 2023) Rai, Kabindra; Rai, Nilshan; Thapa, Milan Kumar Chhantel; Shrestha, Rajan; Singh, Sampurna; Thapa, MonikaAbstract Amyotrophic lateral sclerosis is a rare, progressive, incurable neurodegenerative disorder that affects motor neurons leading to progressive muscle weakness, disability, and eventually death. A 45-year-old male, initially presented with hoarseness, flickering of tongue, and intermittent aspirations. In course of three years, patient developed motor aphasia, frequent aspirations and an inability to hold his neck. Patient was diagnosed with a bulbar onset type of amyotrophic lateral sclerosis on the basis of neurodegenerative features with normal radiographic imaging. For the prevention of recurrent aspiration pneumonia, he was managed with a percutaneous endoscopic gastrostomy tube. As he started developing respiratory failure tracheostomy was performed and kept on a continuous bi-level positive airway pressure ventilator, in the meantime, two courses of injection Edaravone were given. Early evaluation, diagnosis and management of the condition is a cornerstone for better prognosis of disease and survival.Publication Diabetes Mellitus among Adult Outpatients Visiting a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Khatri, Bijay; Kayastha, Manish; Shrestha, Rajan; Bhattarai, Janak Raj; Majhi, Sangita; Upadhyay, Sanjib Kumar; Upadhyay, Madan Prasad; Kafle, Kumud KumarAbstract Introduction: Diabetes mellitus is a chronic metabolic disease characterised by elevated blood sugar levels and is a pandemic of public health importance. Screening programs can help reduce morbidity and mortality by preventing or delaying complications. This study aimed to find out the prevalence of diabetes mellitus among adult outpatients visiting a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among outpatients visiting a tertiary care centre between 1 January 2019 to 31 December 2019. Ethical approval was obtained from the Ethical Review Board (Registration number: 408/2020 P). Patients with unknown history of diabetes participating in free random blood sugar examinations were included in the study. Systematic random sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 385 adult outpatients, 17 (4.42%) (2.37–6.47, 95% Confidence Interval) had diabetes. The mean random blood sugar level of the diabetic patients was 281.41±57.49 mg/dl. Conclusions: The prevalence of diabetes mellitus among adult outpatients was similar to previous studies conducted in similar settings. Random blood sugar test in hospital outpatient settings is feasible to identify people with diabetes mellitus.