Browsing by Author "Yadav, Manish"
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Publication Cartap Poisoning with Paroxysmal Supraventricular Tachycardia: A Case Report(Nepal Medical Association, 2024) Shah, Newton Ashish; Rajbhandari, Bibek; Banstola,Santosh; Acharya, Manish; Joshi, Rupesh; Luitel, Shree Krishna; Yadav, ManishAbstract Cartap, a nereistoxin derivative from the marine annelid Lumbriconeresis heteropoda, is widely used as a pesticide, targeting pests like caterpillars. While the WHO classifies it as moderately hazardous, with a recommended daily intake of 0.05 mg/kg, human toxicity reports are limited. A 34-year-old female was admitted after consuming an unknown poison. She reported epigastric pain, burning sensations, sweating, vomiting, dyspnea, palpitations, and restlessness, compounded by alcohol intake. Initially treated for organophosphate poisoning, her cholinesterase level was 8.91. It was later confirmed she ingested 100 ml of 50% concentration cartap. Treatment included amiodarone for supraventricular tachycardia and intravenous N-acetylcysteine, magnesium sulfate, and midazolam for general tonic clonic seizure. Cartap, toxic through ingestion and skin contact, can cause symptoms such as vomiting, convulsions, and cardiac issues like supraventricular tachycardia. Supportive care is crucial, and awareness of its risks is necessary.Publication Paraquat Toxicity Leading to Acute Kidney Injury: A Case Report in an Adult Patient(Nepal Medical Association, 2024) Shah, Newton Ashish; Yadav, Manish; Sah, Rupesh; Rajbhandari, BibekAbstract Paraquat poisoning poses a significant and emerging public health challenge in developing countries. The distribution and usage of Paraquat, a potent herbicide, remain unrestricted in many regions despite its high fatality rate and absence of a specific antidote. Paraquat mostly involves lungs but can also involve the kidneys and liver. Diagnostic challenges and a lack of available samples at presentation contribute to underreporting and limited awareness among healthcare providers, making paraquat poisoning a neglected toxicological emergency. Herein, we present a case of a 40-year-old male who presented to the emergency department on the fourth day after ingesting paraquat in a suicidal attempt. Upon presentation, he had erosion on the tongue and posterior pharyngeal wall, along with deranged renal function tests and elevated serum creatinine levels. The patient developed acute kidney injury, with serum creatinine levels rapidly rising from normal to 3.85 mg/dl, accompanied by a decrease in daily urine output. He was managed conservatively, and his hospital stay was uneventful.Publication Prevalence of Thyroid Dysfunction among Patients with Type II diabetes Mellitus in Tertiary Care Center: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Kandel, Lokraj; Shakya, Yagya Laxmi; Gupta, Sanjay; Shah, Newton Ashish; Yadav, ManishAbstract Introduction: Diabetes mellitus (DM) and thyroid dysfunction (TD) are two of the most prevalent endocrine disorders globally. Both conditions have significant effects on metabolism and are known to influence each other. Thyroid hormones play a crucial role in glucose homeostasis by affecting insulin secretion, sensitivity, and glucose metabolism.Conversely, altered glucose metabolism in diabetes can impact thyroid function, leading to a higher prevalence of thyroid disorders in diabetic patients. Understanding this relationship is important for improving the clinical management of patients with Type II DM. However, there is limited data on the prevalence of thyroid dysfunction in diabetic populations within specific regions. Methods: A cross-sectional descriptive study was conducted from February to September 2023 among 209 patients diagnosed with Type II DM at a tertiary care center after obtaining ethical approval from Institutional Review Committee(Reference No: 367 (6-11) E2). Thyroid function was assessed using thyroid-stimulating hormone (TSH), free T3 (FT3), and free T4 (FT4) levels. Thyroid dysfunction was classified into hypothyroidism and hyperthyroidism based on standard clinical and laboratory criteria. Data management involved entry into Microsoft Excel, verification for accuracy, and subsequent analysis using SPSS version 29. Results: The study included 209 patients with 128 (61.24%) females and a mean age of 65.87±13.7 years. The prevalence of thyroid disorders was 77 (36.84%) 53(25.36%) hypothyroidism,24 (11.48%) hyperthyroidism among patient with type II diabetes mellitus. Conclusions: Our study shows a high prevalence of thyroid disorders, especially subclinical hypothyroidism, in individuals with type 2 diabetes. Poorly controlled blood glucose (HbA1c ≥ 7.5) significantly increases the risk, underscoring the need for routine thyroid screening in T2DM management.