Browsing by Author "Sitaula, Deekshanta"
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Publication Caffey Disease: A Diagnostic Dilemma(Nepal Paediatric Society (JNPS), 2021) Regmi, Shanti; Adhikari, Sudhir; Sitaula, Deekshanta; Regmi, Ananda Prasad; Neupane, Gaurav; Parajuli, Biraj; Poudel, SumitaAbstract Caffey disease is a rare, self limiting condition which usually presents in early infancy. The clinical features include fever, irritability, inflammatory swelling of soft tissue due to acute inflammation of the periosteum and subperiosteal new bone formation. Possible differential diagnoses are osteomyelitis, hypervitaminosis A, scurvy, bone tumours, prolonged use of Prostaglandin E1 (PGE1) and child abuse. Although self-limiting, it can cause diagnostic dilemma leading to delayed diagnosis and unnecessary investigations. Here, we report a case of two month old male infant presenting with painful left scapular mass.Publication Cesarean Section Among all Deliveries in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Tamrakar, Renuka; Sapkota, Sachin; Sitaula, Deekshanta; Thapa, Rohit; Pokharel, Bandana; Acharya, Suchita; Parajuli, AakritiAbstract: Introduction: Worldwide there is a tremendous increase in cesarean section rate over the last decades which has been a global public health issue. This study aimed to find out the prevalence of cesarean delivery in a tertiary care center of Nepal. Methods: A descriptive cross-sectional study was conducted among pregnant women at tertiary care centre from 15th September 2019 to 15th October 2020. Ethical clearance was taken from the Institutional Review Committee (Ref: CMC-IRC/077/078-200). Convenience sampling was done to reach the sample size. Basic demographic data, clinical indications and neonatal outcomes were noted. Data entry was done using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 3193 total deliveries, cesarean deliveries were 1412 (44.22%) at 95% Confidence Interval (42.49-45.94). Among caesarean deliveries 1086 (76.9%) were emergency cesarean sections. Most common indication for cesarean section was fetal distress (24.9%). Among 1437 newborns, 1428 (99.4%) were live births, 1387 (98.2%) were singleton and 801 (55.7%) were male. Nearly one third 418 (29.1%) neonates required neonatal intensive care unit admission and transient tachypnoea of newborns (44.28% in emergency and 60.46% in elective cesarean delivery) was the most common indication for admission. Conclusions: The prevalence of cesarean delivery was found to be higher than that recommended by the World Health Organisation. Fetal distress was the leading indication for cesarean deliveries.Publication Upper Gastrointestinal Bleeding Induced by Gastric Ulcer Secondary to Strongyloidiasis: A Case Report(Nepal Medical Association, 2023) Dhakal, Bishal; Dawadi, Sagun; Pathak, Bishnu Deep; Regmi, Binit Upadhaya; Sitaula, Deekshanta; Pudasaini, Prasamsa; Lamichhane, Sandesh; Karki, Abinash; Simkhada, NabinAbstract Strongyloidiasis, a parasitic infestation by Strongyloides stercoralis, involves the gastrointestinal tract with a spectrum from duodenitis to enterocolitis. However, gastric involvement with the manifestation of upper gastrointestinal bleeding is an extremely rare condition due to Strongyloides stercoralis. Due to irregular excretion of larvae, unclear symptoms, paucity of effective diagnostic tools and low parasitic load, makes clinicians difficult to reach the diagnosis of strongyloidiasis. Here, we present a case of upper gastrointestinal bleeding due to a large gastric ulcer whose aetiology was identified to be Strongyloides stercoralis infection of the gastric region by the diagnosis of exclusion.