Browsing by Author "Tamang, A"
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Publication Clinical and Endoscopic Findings in Patients Presenting with Upper Gastrointestinal Bleeding at a Tertiary Care Hospital(Kathmandu University, 2024) Sharma, P; Sapkota, P; Pathak, S; Lamsal, A; Joshi, S; Parajuli, S; Rajak, S; Gautam, S; Tamang, AABSTRACT Background Upper gastrointestinal (UGI) bleeding is a severe medical condition that requires prompt evaluation and management. Understanding the clinical and endoscopic findings in patients presenting with upper gastrointestinal bleeding is essential for accurate diagnosis and effective treatment. Objective To investigate the age and sex composition, clinical presentations, and endoscopic findings of patients with upper gastrointestinal bleeding at a tertiary care hospital. Method A total of 561 patients with upper gastrointestinal bleeding were included in the study. Data on age, sex, and clinical presentation were collected for each patient. Endoscopic findings were recorded, and the relative frequency of various upper gastrointestinal lesions was analyzed. Result The age distribution of patients revealed that 40.82% were between 15 and 45 years, 32.98% were aged 46 to 65 years, and 26.20% were above 65 years. Among the patients, 73.08% were male and 26.92% were female. Hematemesis was observed in 248 cases, while melena was present in 136 cases, and both were present in 171 cases. Recent onset anemia with positive occult blood was reported in 6 patients. The most common endoscopic finding was varices (39.39%), followed by ulcers (15.51%). Mallory Weiss tear was noted in 5.53% of cases. Conclusion According to our findings, varices are the most common endoscopic finding in individuals with upper gastrointestinal bleeding rather than peptic ulcer disease. The considerable increase in varices emphasizes the critical importance of early identification and care in high-risk individuals, as well as contributing to a better understanding of upper gastrointestinal bleeding. KEY WORDS Bleeding, Endoscopy, Esophageal varices, Gastric varices, Gastrointestinal hemorrhage, Upper gastrointestinal tractPublication Rickettsial Infection amongst Febrile Illness Patient in a Tertiary Care Hospital: A Retrospective Cross-sectional Study(Kathmandu University, 2022) Gurung, RB; Sapkota, P; Bhatt, S; Tamang, A; Joshi, S; Khadka, S; Jaisy, DN; Chalise, S; Shrestha, PABSTRACT Background Rickettsial infection is an emerging neglected tropical disease in the Southeast Asia. In past few years Nepal is also reporting escalating prevalence of rickettsia. The under evaluation is resulting it as undiagnosed or are simply labeled as pyrexia of unknown origin. Objective To find out the prevalence of rickettsia in a hospital setting, assess the socio- demographic and other relevant clinical features of the rickettsia patients. Method This is a hospital based retrospective cross-sectional study from October 2020 to October 2021. This study reviewed the medical records of the department. Result The study included 105 eligible patients and the prevalence rate was 4.38 per 100 patients. The mean age of the participants was 42 years, and the mean hospital stay was 3 (SD ±2.06) days. More than 55% of the participants had fever for less than or equal to 5 days and 9% had Eschar present. Vomiting, headache, and myalgia were the most common symptoms and hypertension, and diabetes were the common comorbidities. Pneumonia and the acute kidney injury were the two complications of the patients as stated in the study. The severity of the thrombocytopenia deducted from admission time to discharge, and the case fatality was 4%. Conclusion The future studies shall consider on collaborative clinical and entomological research. This would help in better understanding of the etiology of supposedly unknown febrile illness and the under-investigated field of emerging rickettsia in Nepal. KEY WORDS Eschar, Febrile illness, IgM titer, Rickettsia, Thrombocytopenia