Browsing by Author "Yadav, Sushil Kumar"
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Publication Attenuation Measurements of the Kidney on Unenhanced CT in Ureterolithiasis(Institute of Medicine, Tribhuvan University, 2024) Gupta, Avinash; Regmi, Pradeep Raj; Shrestha, Suraj; Adhikati, Aayush; Yadav, Sushil Kumar; Katwal, Shailendra; Khadayat, RameshAbstract Introduction: Urolithiasis is a common disease worldwide that affects a wide range of patients. This study evaluated the diagnostic utility of attenuation values of bilateral kidneys on unenhanced helical Computed Tomography (CT) in ureterolithiasis patients. Methods: This cross-sectional study was performed in patients with ureteric calculus referred for unenhanced helical CT of the kidney, ureter, and bladder (CT-KUB). The attenuation of the renal parenchyma in Hounsfield units (HU) was measured, and a mean attenuation value was determined for obstructed and contralateral kidneys of each patient and compared. Results: Among the 95 patients, 40 had ureteric stones on the left kidney and 55 on the right kidney. Lower average attenuation value in obstructed kidneys (on the side of the ureteric stone) was seen in 75 (78.9%) patients. 79% (N=69) of patients and 3.15% (N=3) of patients showed zero average attenuation difference. Mean attenuation values in the upper pole, middle portion, and lower pole were 28.60 HU, 30.23 HU, and 30.59 HU for obstructed kidneys and 32.74 HU, 33.41 HU, and 31.93 HU for contralateral kidneys. Mean of mean attenuation values in the three regions were 29.81 HU for obstructed kidneys and 32.69 HU for contralateral kidneys. A significant difference of 2.88 HU was found in mean attenuation values between the obstructed kidneys and the contralateral kidneys. Conclusion: Attenuation values between the kidneys can serve as a means of differentiating between obstructed and non-obstructed kidneys in unenhanced CT KUB.Publication Refractory Cardiogenic Shock Secondary to Acute Myocarditis in a Child with Multisystem Inflammatory Syndrome Associated with COVID-19: A Case Report(Nepal Medical Association, 2022) Karki, Susmin; Agrawal, Saurav; Rayamajhi, Aadesh; Yadav, Sushil Kumar; Basnet, SrijanaAbstract Children with Coronavirus disease 2019 infection usually have mild symptoms but rarely may present with a life-threatening condition called a multisystem inflammatory syndrome. We report a case of COVID-19-related multisystem inflammatory syndrome in an 8-year-old boy who presented with cardiogenic shock due to acute myocarditis with no features of Kawasaki disease. Cardiogenic shock was refractory to fluids and inotropes. Later, this case was successfully managed with hydrocortisone and intravenous immunoglobulin. Therefore, this case report highlights keeping a lookout for such atypical presentations and early referral to a higher center for timely intervention and aggressive therapy specifically directed against the underlying inflammatory process to ameliorate the outcomes.