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Article ; Online: Dorsal Approach for Management of Complex Kaplans Dislocation.

Khanal, Siddhartha / Panthi, Sagar / Shrestha, Rishiswor / Neupane, Bikash / Pradhan, Jigyasu

Journal of Nepal Health Research Council

2023 Volume 21, Issue 2, Page(s) 342–344

Abstract: Complex metacarpophalangeal dislocation is an uncommon injury where the index is the most commonly involved finger. The most common mechanism involves hyperextension of digits at the metacarpophalangeal joint. Such dislocation needs open reduction as the ...

Abstract	Complex metacarpophalangeal dislocation is an uncommon injury where the index is the most commonly involved finger. The most common mechanism involves hyperextension of digits at the metacarpophalangeal joint. Such dislocation needs open reduction as the volar plate becomes entrapped between the metacarpal head and proximal phalanx making close reduction difficult. Approaches for open reduction can be dorsal, volar, and lateral. In our patient, we commenced a dorsal approach for reduction and additional stabilization done with K-wire. An early range of movement was initiated and resulted in good functional recovery. Keywords: Dislocation; metacarpophalangeal; plate; volar.
MeSH term(s)	Humans ; Nepal ; Fingers ; Upper Extremity
Language	English
Publishing date	2023-12-13
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2551251-1
ISSN	1999-6217 ; 1999-6217
ISSN (online)	1999-6217
ISSN	1999-6217
DOI	10.33314/jnhrc.v21i02.4309
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Article: Gastric antral vascular ectasia (Watermelon stomach); an unusual cause of upper gastrointestinal bleeding in elderly: A case report.

Lageju, Nimesh / Uprety, Pratik / Neupane, Durga / Bastola, Satish / Lama, Suhel / Panthi, Sagar / Gnawali, Arun

Annals of medicine and surgery (2012)

2022 Volume 82, Page(s) 104733

Abstract: Introduction: Gastric antral vascular ectasia (GAVE) is an unusual cause of upper gastrointestinal (GI) bleeding in an elderly patient.: Case presentation: A 73-year-old female with erosive gastritis, hypertension, and unstable angina arrived at the ... ...

Abstract	Introduction: Gastric antral vascular ectasia (GAVE) is an unusual cause of upper gastrointestinal (GI) bleeding in an elderly patient. Case presentation: A 73-year-old female with erosive gastritis, hypertension, and unstable angina arrived at the emergency department with shortness of breath, easy fatigability, and melaena. Physical examination indicated pallor but no signs of distress, with an unremarkable systemic examination. Routine blood testing indicated anemia. The patient underwent upper gastrointestinal endoscopy, which revealed linear red ectatic vessels radiating from the antrum towards the body. A diagnosis of GAVE was made. Blood transfusions and argon plasma coagulation were undertaken. Clinical discussion: This condition is an uncommon cause of upper GI bleeding with the antrum being the most prevalent site. The pathophysiology of GAVE is yet unknown, however, many hypotheses have been postulated. GAVE is frequently misdiagnosed as gastritis. GAVE treatment comprises initial resuscitation and symptomatic treatment with intravenous fluids and blood products. Endoscopy has increasingly been the first-line therapeutic option for GAVE in recent years, including argon plasma coagulation. Conclusion: The diagnosis of gastric antral vascular ectasia is frequently overlooked during upper GI endoscopy, despite the fact that it should always be explored, especially in cases of unexplained GI bleeding in the elderly.
Language	English
Publishing date	2022-09-22
Publishing country	England
Document type	Case Reports
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2022.104733
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Article: Baclofen overdose: A curious case of medical sales representative.

Gautam, Swotantra / Neupane, Aakash / Chamlagain, Mandita / Pokhrel, Sandip / Neupane, Durga / Acharya, Rochana / Panthi, Sagar

Clinical case reports

2022 Volume 10, Issue 8, Page(s) e6230

Abstract: In this case report, a medical sales representative consumed 250 mg of Baclofen out of curiosity. Baclofen has life-threatening complications like seizures, respiratory depression, and coma. A majority of patients recover on symptomatic treatment. ... ...

Abstract	In this case report, a medical sales representative consumed 250 mg of Baclofen out of curiosity. Baclofen has life-threatening complications like seizures, respiratory depression, and coma. A majority of patients recover on symptomatic treatment. Baclofen has a great potential for abuse and overdose; therefore, its use must be strictly monitored.
Language	English
Publishing date	2022-08-09
Publishing country	England
Document type	Case Reports
ZDB-ID	2740234-4
ISSN	2050-0904
ISSN	2050-0904
DOI	10.1002/ccr3.6230
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Article ; Online: Letter to Editor: Challenges in Neurosurgery in Nepal: Perspective from a Lower-Middle-Income Country.

Neupane, Durga / Lageju, Nimesh / Dahal, Alok / Jaiswal, Lokesh Shekher / Panthi, Sagar / Regmi, Swapnil

World neurosurgery

2022 Volume 164, Page(s) 453

MeSH term(s)	COVID-19 ; Humans ; Nepal ; Neurosurgery ; Neurosurgical Procedures ; Poverty
Language	English
Publishing date	2022-08-08
Publishing country	United States
Document type	Letter
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2022.05.007
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Article: Superior mesenteric artery syndrome mimicking gastric outlet obstruction: a case report and a literature review.

Khanal, Bhawani / Panthi, Sagar / Bhattarai, Raksha / Khatiwada, Pradeep / Acharya, Rochana / Neupane, Durga / Yadav, Padmini / Sharma, Ananta / Pokharel, Lenish / Basnet, Ujwal

Annals of medicine and surgery (2012)

2023 Volume 85, Issue 4, Page(s) 939–942

Abstract: Superior mesenteric artery (SMA) syndrome, an uncommon cause of intestinal obstruction, may present with clinical features mimicking gastric outlet obstruction.: Case presentation: The authors present a case of a 65-year-old gentleman who presented to ...

Abstract	Superior mesenteric artery (SMA) syndrome, an uncommon cause of intestinal obstruction, may present with clinical features mimicking gastric outlet obstruction. Case presentation: The authors present a case of a 65-year-old gentleman who presented to our institute with complaints of sudden onset abdominal distension and multiple episodes of bilious vomiting for 4 days. On examination, he was cachexic and dehydrated and was diagnosed later with SMA syndrome based on contrast-enhanced computed tomography abdomen findings. Discussion: After the diagnosis of SMA syndrome was made, the patient was planned for the operation. On exploration, a hugely distended stomach dilated first and the second part of the duodenum with SMA compressing the third part of the duodenum was found for which duodenojejunostomy was done. Conclusion: The high degree of suspicion is necessary for cachectic patients presenting with features of gastric outlet obstruction to diagnose SMA syndrome. Physical examination supported by radiological investigations can diagnose SMA syndrome to some extent. Treatment should be focused on relieving obstruction along with fluid and electrolyte resuscitation and nutritional supplementation. Some cases may require surgical correction.
Language	English
Publishing date	2023-03-25
Publishing country	England
Document type	Case Reports
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1097/MS9.0000000000000129
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Article ; Online: Open Reduction and Internal Fixation with Mini-plate and Screws for Management of Unstable Metacarpal Fracture among Hand Injuries in a Tertiary Care Center: A Descriptive Cross-sectional Study.

Panthi, Sagar / Shrestha, Rishiswor / Pradhan, Jigyasu / Neupane, Bikash / Khanal, Siddhartha / Karki, Angelica / Sharma, Deepa

JNMA; journal of the Nepal Medical Association

2021 Volume 59, Issue 239, Page(s) 653–656

Abstract: Introduction: Hand injuries metacarpal fractures are common and it accounts about 14 to 28%. Mini-plate fixation in unstable metacarpal fractures provides absolute stability and early mobilization of fingers to reduce complications. The purpose of this ... ...

Abstract	Introduction: Hand injuries metacarpal fractures are common and it accounts about 14 to 28%. Mini-plate fixation in unstable metacarpal fractures provides absolute stability and early mobilization of fingers to reduce complications. The purpose of this study is to find out the prevalence of open reduction and internal fixation with mini-plate and screws for management of unstable metacarpal fracture among hand injuries done in a tertiary care center. Methods: This was a descriptive cross-sectional study done from February 2019 and January 2021 in a tertiary care center with unstable isolated metacarpal fracture treated with mini-plate fixation and were followed up for six months duration. Ethical approval and informed written consent were taken from all patients. The outcome was assessed by the American Society for Surgery of the Hand Total Active Flexion Score. Convenient sampling method was used. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Statistical Package for Social Sciences used for analysis. Results: Out of 250 patients who underwent hand surgeries, open reduction and internal fixation with mini-plate and screws for unstable metacarpal fracture were done in 32 (12.8%) (8.66-16.94 at 95% Confidence Interval). The mean time of fracture union was 6.78±1.008 weeks. Functional outcome according to American Society for Surgery of the Hand Total Active Flexion score was excellent in 25 (78.2%), good in 6 (18.8%), and poor in 1 (3%) patient. Conclusions: Fixation of metacarpal fracture by mini-plate and screws was required in fewer patients. Mini-plate fixation provides better stability and early mobilization for unstable metacarpal fractures to achieve a good functional outcome.
MeSH term(s)	Bone Plates ; Bone Screws ; Cross-Sectional Studies ; Fracture Fixation, Internal ; Fractures, Bone/diagnostic imaging ; Fractures, Bone/surgery ; Hand Injuries/epidemiology ; Hand Injuries/surgery ; Humans ; Metacarpal Bones/diagnostic imaging ; Metacarpal Bones/injuries ; Metacarpal Bones/surgery ; Tertiary Care Centers ; Treatment Outcome
Language	English
Publishing date	2021-07-30
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2209910-4
ISSN	1815-672X ; 0028-2715
ISSN (online)	1815-672X
ISSN	0028-2715
DOI	10.31729/jnma.6846
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Article ; Online: Perception of Health Care Practitioners of Government Designated COVID-19 Hospitals of Nepal towards the Management of COVID-19 Pandemic: A Descriptive Cross-sectional Study.

Panthi, Sagar / Jaishi, Amrit Raj / Gautam, Swotantra / Bhandari, Siddhartha / Bhatt, Navin / Basnet, Lila Bahadur / Sharma, Sanjib Kumar

JNMA; journal of the Nepal Medical Association

2022 Volume 60, Issue 245, Page(s) 40–46

Abstract: Introduction: Amidst the chaos of COVID-19, health care practitioners are persistently providing services and experiencing many challenges. This study aimed to determine the perception of health care practitioners of government designated COVID-19 ... ...

Abstract	Introduction: Amidst the chaos of COVID-19, health care practitioners are persistently providing services and experiencing many challenges. This study aimed to determine the perception of health care practitioners of government designated COVID-19 hospitals of Nepal towards the management of COVID-19 pandemic. Methods: A descriptive cross-sectional study was conducted among the frontline health care practitioners working in the government designated COVID-19 hospitals in Nepal from 21st June, 2020 to 15th August, 2020. Ethical approval was obtained from the Ethical Review Board of the Nepal Health Research Council (Reference number: 347/2020 P). A total of 252 health care practitioners (doctors, nurses, and paramedics) working at the forefront in the emergency ward, general wards, intensive care units, isolation centers, fever clinics, laboratory, quarantine centers, help desks, etc. in the designated hospitals who consented to participate were included in the study. Convenience sampling was used. The data was analyzed using Statistical Package for the Social Sciences version 16.0. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Only 41 (16.3%) (11.73-20.86 at 95% Confidence Interval) of the health care practitioners were found to have satisfactory perception towards the management of COVID-19 pandemic in Nepal. Conclusions: The satisfactory perception of the health care practitioners in our study towards the management of COVID-19 pandemic in Nepal is lower as compared to the other studies in Nepal and abroad.
MeSH term(s)	COVID-19 ; Cross-Sectional Studies ; Delivery of Health Care ; Government ; Hospitals ; Humans ; Nepal/epidemiology ; Pandemics ; Perception ; SARS-CoV-2
Language	English
Publishing date	2022-01-15
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2209910-4
ISSN	1815-672X ; 0028-2715
ISSN (online)	1815-672X
ISSN	0028-2715
DOI	10.31729/jnma.7093
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Article ; Online: Atrial Fibrillation among Patients Admitted to the Department of Internal Medicine in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Shah, Surendra Prasad / Sah, Ram Pratap / Panthi, Sagar / Shah, Rakesh Kumar / Acharya, Rochana / Neupane, Durga / Puri, Reecha / Poudel, Sulaksha / Basnet, Lila Bahadur

JNMA; journal of the Nepal Medical Association

2022 Volume 60, Issue 253, Page(s) 756–760

Abstract: Introduction: Atrial fibrillation is one of the commonest arrhythmias with an overall prevalence estimated to be 0.4-1% in the general population. The objective of this study was to find out the prevalence of atrial fibrillation among patients admitted ... ...

Abstract	Introduction: Atrial fibrillation is one of the commonest arrhythmias with an overall prevalence estimated to be 0.4-1% in the general population. The objective of this study was to find out the prevalence of atrial fibrillation among patients admitted to the Department of Internal Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients admitted to the Department of Internal Medicine of a tertiary care centre from 01 March 2021 to 01 March 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: IRC-478/2021). Convenience sampling method was used. Data were collected from the hospital records using a semi-structured study proforma including demography, clinical presentation, laboratory investigations, electrocardiogram, 2-dimension echocardiography, and CHA2DS2VASc score. Point estimate and 95% Confidence Interval were calculated. Results: Among 27,980 patients, atrial fibrillation was found in 185 (0.66%) (0.58-0.77, 95% Confidence Interval). Among them 66 (35.67%) were in the age group of 61-70 years and 97 (52.43%) were females. Dyspnea was present in 149 (80.54%), palpitation in 137 (74.05%) and pedal edema in 117 (63.27%). Valvular atrial fibrillation was seen in 101 (54.59%) and non-valvular atrial fibrillation was seen in 84 (45.41%) patients. Conclusions: The prevalence of atrial fibrillation was found to be similar when compared to other studies conducted in similar settings.
MeSH term(s)	Female ; Humans ; Middle Aged ; Aged ; Male ; Atrial Fibrillation/epidemiology ; Cross-Sectional Studies ; Tertiary Care Centers ; Hospitalization ; Dyspnea
Language	English
Publishing date	2022-09-01
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2209910-4
ISSN	1815-672X ; 0028-2715
ISSN (online)	1815-672X
ISSN	0028-2715
DOI	10.31729/jnma.7858
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Article: Diffuse proliferative cerebral angiopathy: a case report and literature review on a very rare and misdiagnosed entity.

Panthi, Sagar / Khanal, Nimesh / Poudel, Sajana / Bhandari, Siddhartha / Khatiwada, Pradeep / Acharya, Rochana / Bhattarai, Raksha / Bhattarai, Bharosha / Khanal, Sandeep

Journal of surgical case reports

2022 Volume 2022, Issue 1, Page(s) rjab620

Abstract: Diffuse proliferative cerebral angiopathy (DPCA) is an uncommon type of cerebral vascular malformation, mostly diagnosed in young females. It is characteristically different from other cerebral arteriovenous malformations and can be differentiated by its ...

Abstract	Diffuse proliferative cerebral angiopathy (DPCA) is an uncommon type of cerebral vascular malformation, mostly diagnosed in young females. It is characteristically different from other cerebral arteriovenous malformations and can be differentiated by its peculiar imaging findings. A nidus of normal brain parenchyma is present between the abnormal vascular channels. Therefore, it is crucial to diagnose it as a separate entity because unnecessary treatment of DPCA increases the risk of damage to the normal parenchyma leading to neurological deficits. Here we describe a case of a 60-year-old male who presented with severe neurological deficits and was later diagnosed with DPCA. He was managed conservatively with antiepileptics and almost completely recovered to normal within 2 weeks. A rare case of DPCA confused with other hemorrhagic disorders is discussed here. Rare cases are often overlooked. Correct diagnosis helps to prevent tragic consequences.
Language	English
Publishing date	2022-01-18
Publishing country	England
Document type	Case Reports
ZDB-ID	2580919-2
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjab620
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Article ; Online: Dyslipidemia in Acute Non-cardioembolic Ischemic Stroke Patients at a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Shah, Surendra Prasad / Shrestha, Aashish / Pandey, Sirish Raj / Sigdel, Kaushal / Sah, Namrata / Panthi, Sagar / Basnet, Lila Bahadur

JNMA; journal of the Nepal Medical Association

2022 Volume 60, Issue 247, Page(s) 241–245

Abstract: Introduction: Acute ischemic stroke is the second most common cause of death after ischemic heart disease worldwide and Nepal's top five diseases based on Disability-Adjusted Life Years. Dyslipidemia is a major risk factor for coronary heart disease but ...

Abstract	Introduction: Acute ischemic stroke is the second most common cause of death after ischemic heart disease worldwide and Nepal's top five diseases based on Disability-Adjusted Life Years. Dyslipidemia is a major risk factor for coronary heart disease but has an unclear role in the pathogenesis of ischemic stroke. The objective of this study was to find the prevalence of dyslipidemia in acute non-cardioembolic ischemic stroke patients at a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among 76 patients with acute noncardioembolic ischemic stroke admitted in the Neuromedicine unit of a tertiary care centre from August 2017 to July 2018. Ethical approval was obtained from the Institutional Review Committee of the same institute (Reference number: 478/2020). Patients underwent baseline investigations, including fasting lipid profile and Computed Tomography Scan/Magnetic Resonance Imaging head. Data were analysed using Statistical Package for the Social Sciences version 21.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The prevalence of dyslipidemia among the acute non-cardioembolic ischemic stroke patients was 35 (46.05%) (35.05-57.05 at 95% Confidence Interval) where high total cholesterol was diagnosed in 11 (31.43%), high triglycerides in 25 (71.43%), high low-density-lipoprotein in 10 (28.57%), and low high-density-lipoprotein in 11 (31.43%) patients. Conclusions: The prevalence of dyslipidemia among acute non-cardioembolic ischemic stroke patients at our tertiary care centre is higher than the similar studies done in similar settings. Keywords: cardioembolic stroke; dyslipidemia; ischemic stroke; lipid; lipoprotein.
MeSH term(s)	Brain Ischemia/epidemiology ; Brain Ischemia/etiology ; Cross-Sectional Studies ; Dyslipidemias/complications ; Dyslipidemias/epidemiology ; Humans ; Ischemic Stroke/epidemiology ; Ischemic Stroke/etiology ; Nepal/epidemiology ; Tertiary Care Centers
Language	English
Publishing date	2022-03-11
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2209910-4
ISSN	1815-672X ; 0028-2715
ISSN (online)	1815-672X
ISSN	0028-2715
DOI	10.31729/jnma.7321
Database	MEDical Literature Analysis and Retrieval System OnLINE

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