Browsing by Author "Thapa, Suresh"
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Publication A Giant Pheochromocytoma Presenting in Pheochromocytoma Crisis: A Case Report(Nepal Medical Association, 2023) Bogati, Kanchan; Baniya, Sunil; Thapa, Suresh; Regmi, Upendra Krishna; Karki, Niranjan; Pokhrel, ManishAbstract Giant pheochromocytomas are rare tumors, with the majority being clinically silent. Clinically manifesting pheochromocytoma can present with symptoms of catecholamine excess, but nonspecific symptoms and variable clinical patterns of hypertension make it difficult to diagnose. Missing the diagnosis can lead to cardiovascular catastrophes like a pheochromocytoma crisis and even death. We report a 45-year-old woman on antihypertensives, repeatedly visiting a hospital for recurrent headaches finally presented in a hypertensive crisis at an emergency department. Management was started along with an injection of labetalol, which led to an unpredicted abrupt blood pressure fall, and was successfully resuscitated. Imaging and plasma metanephrine studies revealed an underlying giant pheochromocytoma, which was cured after successful surgical resection. A high degree of clinical suspicion, elaborate and focused history-taking, and initial ultrasound imaging can guide us toward the early diagnosis of pheochromocytoma. Before the alpha blockade, beta-blockers should not be used in any cases of pheochromocytoma.Publication Spondylolysis among Patients Without Low Back Pain in a Diagnostic Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Sharma, Bishwanath; Panta, Om Biju; Thapa, Bikash Raj; Thapa, SureshAbstract Introduction: Spondylolysis can either be asymptomatic or can cause significant low back pain. It is sometimes associated with the translation of one vertebra over another and is termed spondylolisthesis. The aim of the study was to find out the prevalence of spondylolysis among patients without low back pain in a diagnostic centre. Methods: A descriptive cross-sectional study was carried out in a referral diagnostic centre from 15 December 2018 to 14 December 2021 . Ethical approval was obtained from the Nepal Health Research Council (Reference number: 2903). Images of a computed tomography scan of the abdomen performed for other abdominal causes and without low back pain were reconstructed in the sagittal and coronal plane and evaluated for the presence of spondylolysis and spondylolisthesis in the lumbar spine. Demographic data were taken from the hospital records. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 768 patients without low back pain, spondylolysis was found in 59 (7.68%) (5.80-9.56, 95% Confidence Interval). Spondylolisthesis was found in only 16 (27.1%) individuals with spondylolysis. The majority of spondylolysis cases were encountered in L5 level in 54 (91.53%). The mean age of patients with spondylolysis was 41.9±14.46 years. Male to female ratio was 1:1.18. Conclusions: The prevalence of spondylolysis in our study was found to be similar to other studies done in similar settings.Publication Ultrasonography Findings of Testicular Tuberculosis in Nepalese Patients: A Case Series(Nepal Medical Association, 2024) Thapa, Madan; Kafle, Sushmit; Lamichhane, Pratik; Thapa, SureshAbstract Extrapulmonary tuberculosis constitutes about 20% of all cases of tuberculosis. It involves organs other than the lungs, such as lymph nodes, the genitourinary tract, abdomen, skin, joints and bones, and meninges. Tuberculosis of the testis is a rare disease. The diagnosis of testicular tuberculosis could be confused with testicular cancer, sarcoidosis or metastases. Herein, we describe the ultrasonography of five patients with testicular tuberculosis. This case series highlights the importance of ultrasonography in the diagnosis of rare form of extra pulmonary tuberculosis.