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Article: A case report on recurrent area postrema syndrome in AQP4-IgG-positive NMOSD.

Shrestha, Ramesh / Kharel, Ghanshyam

2022 Volume 2022, Issue 10, Page(s) omac109

Abstract: Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory condition of the central nervous system caused by severe immune-mediated demyelination and axonal destruction, mainly affecting optic nerves and the spinal cord. We describe a 26-year-old ... ...

Abstract	Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory condition of the central nervous system caused by severe immune-mediated demyelination and axonal destruction, mainly affecting optic nerves and the spinal cord. We describe a 26-year-old Nepalese woman with recent onset of headache, nausea, vomiting and hiccups indicative of Area Postrema Syndrome (APS). The antibody test for aquaporin-4 was strongly positive. Brain magnetic resonance imaging (MRI) showed a bilateral hyperintense signal in the area postrema (AP). The patient started on methylprednisolone, and then azathioprine was added. However, the patient was readmitted because of tingling in her right upper extremity and sudden onset of tremors. An MRI scan showed an enlarged lesion in AP. Rituximab was started on top of the previous treatment, and a second dose was given after 2 weeks. The patient had been monitored regularly and symptom-free for 5 months. Hence, we emphasize the immediate need for a diagnostic approach for NMOSD management.
Language	English
Publishing date	2022-10-22
Publishing country	England
Document type	Case Reports
ZDB-ID	2766251-2
ISSN	2053-8855
ISSN	2053-8855
DOI	10.1093/omcr/omac109
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: A thalamic epidermoid cyst presenting with memory disturbances: a case report.

Paudel, Kumar / Shrestha, Ramesh / Karki, Sijan / Jha, Prabhat / Jha, Rajiv

Annals of medicine and surgery (2012)

2023 Volume 85, Issue 5, Page(s) 2089–2092

Abstract: Epidermoid cysts are benign, slow-growing tumors. They account for 0.2-1.8% of all intracranial tumors and rarely appear as intraparenchymal masses. The most prevalent symptom in people of middle age is an insidious-onset headache.: Case presentation: ...

Abstract	Epidermoid cysts are benign, slow-growing tumors. They account for 0.2-1.8% of all intracranial tumors and rarely appear as intraparenchymal masses. The most prevalent symptom in people of middle age is an insidious-onset headache. Case presentation: We present a 20-year-old college student who presented with memory disturbances. The imaging revealed a left thalamic mass. The tumor was excised and diagnosed histopathologically as an epidermoid cyst. Clinical discussion: Epidermoid cysts resemble epidermal skin cells in histology. The lesion of the thalamus involving the ventrolateral and anterior regions is involved with memory and language. Of note, to our knowledge, no cases of memory issues associated with thalamic epidermoid cysts have been reported in the literature. Conclusion: The ideal treatment is cystic component removal with complete capsule excision. Sometimes, in cases of incomplete excision, radiotherapy can be another option.
Language	English
Publishing date	2023-04-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1097/MS9.0000000000000557
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Article: Takayasu Arteritis Presenting As Epileptic Seizure: A Case Report.

Shrestha, Ramesh / Pandit, Abnish / Kharel, Ghanshyam

Cureus

2022 Volume 14, Issue 7, Page(s) e26520

Abstract: Takayasu's arteritis is a chronic granulomatous large-vessel vasculitis condition that affects the large and medium-sized arteries, primarily the heart and its major vessels. The first symptoms and indicators of Takayasu arteritis differ because the ... ...

Abstract	Takayasu's arteritis is a chronic granulomatous large-vessel vasculitis condition that affects the large and medium-sized arteries, primarily the heart and its major vessels. The first symptoms and indicators of Takayasu arteritis differ because the afflicted arteries are heterogeneous. Furthermore, vascular lesions might be difficult to identify at first, further complicating diagnosis. Takayasu arteritis presenting as epileptic seizures is rare. Here, we discuss a 20-year-old female who presented with a brief period of unresponsiveness, followed by a tonic stiffening, limb jerks, a postictal period of fatigue, and temporal memory loss. During the acute phase of Takayasu arteritis, high-dose glucocorticoid therapy and immunosuppressive therapy were used to control inflammatory reactions. Her symptoms gradually improved, and she was discharged from the hospital after serial monitoring; her follow-up visits revealed no recurrence.
Language	English
Publishing date	2022-07-02
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.26520
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Article ; Online: Anxiety among Pregnant Women Attending Obstetrics Unit of a Tertiary Care Centre during the COVID-19 Pandemic: A Descriptive Cross-sectional Study.

Rimal, Surya Prasad / Thapa, Kriti / Shrestha, Ramesh

JNMA; journal of the Nepal Medical Association

2022 Volume 60, Issue 251, Page(s) 621–624

Abstract: Introduction: The disastrous effect of COVID-19 pandemic on the mental health of vulnerable populations like pregnant women should not be neglected. The objective of the study was to find out the prevalence of anxiety among pregnant women attending the ... ...

Abstract	Introduction: The disastrous effect of COVID-19 pandemic on the mental health of vulnerable populations like pregnant women should not be neglected. The objective of the study was to find out the prevalence of anxiety among pregnant women attending the obstetrics unit of a tertiary care centre during the COVID-19 pandemic. Methods: A descriptive cross-sectional study was conducted from 16 May 2020 to 30 July 2020 among pregnant women attending obstetrics unit of a tertiary care centre. Ethical approval was obtained from the Institutional Review Committee (Reference number: 365/076/077-IRC). Convenience sampling method was used. Pregnancy-related anxiety questionnaires were used and semi-structured questionnaires were used for sociodemographic data. Point estimate and 95% Confidence Interval were calculated. Results: Out of 115 pregnant women, anxiety was found in 21 (18.26%) (11.20-25.32, 95% Confidence Interval). Conclusions: Anxiety among the pregnant women reported in this study was found to be lower than similar studies conducted in similar settings. Keywords: anxiety; COVID-19; pregnancy.
MeSH term(s)	Pregnancy ; Female ; Humans ; Cross-Sectional Studies ; Tertiary Care Centers ; Pandemics ; Pregnant Women ; COVID-19/epidemiology ; Anxiety/epidemiology
Language	English
Publishing date	2022-07-01
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.7259
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Article ; Online: Birth Defects among Newborns in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Khadka, Madan / Agarwal, Jyoti / Shrestha, Ramesh / Das, Dipti

JNMA; journal of the Nepal Medical Association

2022 Volume 60, Issue 251, Page(s) 588–591

Abstract: Introduction: The incidence of birth defects is 2-3% in the general population but it is increasing. An estimated 303,000 newborns die within 4 weeks of birth every year, worldwide, due to congenital anomalies. The objective of this study was to find ... ...

Abstract	Introduction: The incidence of birth defects is 2-3% in the general population but it is increasing. An estimated 303,000 newborns die within 4 weeks of birth every year, worldwide, due to congenital anomalies. The objective of this study was to find out the prevalence of birth defects among newborns in a tertiary care centre. Methods: A descriptive cross-sectional study was done in the Department of Obstetrics and Gynaecology and the Department of Paediatrics from 15 June 2016 and 14 June 2019. Ethical approval was obtained from the Institutional Review Committee (Reference number: 142/077/078-IRC). Data of newborns were collected from the hospital records. Convenience sampling method was used. Point estimate and 99% Confidence Interval were calculated. Results: Among 32,695 newborns, birth defects were seen in 169 (0.51%) (0.41-0.61, 99% Confidence Interval). The most common birth defect was musculoskeletal defects seen in 60 (35.50%) newborns followed by central nervous system defect seen in 30 (17.75%) newborns. Conclusions: The prevalence of birth defects among newborns was lower than in other studies done in a similar setting. Keywords: birth defect; congenital malformation; prevalence.
MeSH term(s)	Infant, Newborn ; Female ; Pregnancy ; Humans ; Child ; Cross-Sectional Studies ; Tertiary Care Centers ; Parturition ; Research Design
Language	English
Publishing date	2022-07-01
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.6610
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Article ; Online: Prevalence of Menstrual Abnormalities and its Effect among Undergraduate Students.

Muskan, Vitasta / Shrestha, Ramesh / Prasad, Pravin / Prasad, Archana

Journal of Nepal Health Research Council

2022 Volume 19, Issue 4, Page(s) 693–399

Abstract: Background: Menstrual abnormalities are menstrual problems that women face during their reproductive years. Globally, they are the most prevalent disorders affecting quality of life in females. This study aimed to assess the prevalence of menstrual ... ...

Abstract	Background: Menstrual abnormalities are menstrual problems that women face during their reproductive years. Globally, they are the most prevalent disorders affecting quality of life in females. This study aimed to assess the prevalence of menstrual abnormalities, its effects and health seeking behaviour of the respondents. Methods: A cross-sectional study of 30 days was conducted among the undergraduate female students of BP Koirila Institute of Health Sceince who were more than 18 years and had attained their menarche. Total number of responses recorded were 137. Data was collected online via google forms and descriptive analysis was done using SPSS 23. Results: Out of 137 participants, 94.89% had menstrual abnormalities. Among which, 75.38% females sought treatment. Dysmenorrhea and Pre-menstrual syndrome were found to be the most prevalent abnormality. The quality of life was affected in most of the females in terms of lack of concentration in study (91.54%), missing the opportunity for socialization (95.39%), inability to perform physical exercises (82.31%), extra hours of confinement to bed (38.46%) and unable to attend lectures (30%). Conclusions: The prevalence of menstrual abnormalities were high. Quality of life was affected in all the subjects with menstrual abnormality but only few of them were seeking treatment with a professional doctor.
MeSH term(s)	Cross-Sectional Studies ; Female ; Humans ; Male ; Nepal/epidemiology ; Prevalence ; Quality of Life ; Students ; Surveys and Questionnaires
Language	English
Publishing date	2022-03-13
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.v19i04.3635
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Article ; Online: Psychological Distress and Coping among Pregnant Women during the COVID 19 Pandemic.

Rimal, Surya Prasad / Thapa, Kriti / Shrestha, Ramesh

Journal of Nepal Health Research Council

2022 Volume 20, Issue 1, Page(s) 234–240

Abstract: Background: Mental health of pregnant individuals has been profoundly affected by the COVID-19 pandemic. Effective coping strategies are found to be associated with better psychological wellbeing during the COVID-19 pandemic. The objective of the ... ...

Abstract	Background: Mental health of pregnant individuals has been profoundly affected by the COVID-19 pandemic. Effective coping strategies are found to be associated with better psychological wellbeing during the COVID-19 pandemic. The objective of the present study is to assess psychological distress and coping among pregnant women during the COVID-19 pandemic. Methods: A descriptive cross sectional study was conducted from May 2020 to July 2020 among 115 pregnant women attending obstetric unit of a tertiary care centre using convenience sampling technique. Ethical approval was obtained from the Institutional Review Committee of the Institute. Covid-19 Peritraumatic Distress Index and Brief COPE inventory was used to collect the data. Data entry was done in Microsoft Office Excel 2007 and analysed in SPSS version 16. Results: Psychological distress was found in 2.6% of the participants. Psychological distress was significantly associated with occupation, fear of ANC visit, fear of visit to hospital for other health problems and fear of being alone or without help around delivery. Emotion focused coping was the most commonly used coping strategies among the pregnant women with the mean score of 21.37±3.130. Psychological distress and over all coping strategies had a positive correlation (<0.001). Conclusions: Psychological distress was found to be low among the pregnant women in this study. Fear of being without help and fear of contacting the virus during the visit to the hospital during the Covid-19 pandemic were the likely reasons of the psychological distress in the pregnant women.
MeSH term(s)	Adaptation, Psychological ; COVID-19/epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Nepal/epidemiology ; Pandemics ; Pregnancy ; Pregnant Women/psychology ; Psychological Distress ; Stress, Psychological/epidemiology ; Stress, Psychological/psychology
Language	English
Publishing date	2022-06-02
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.v20i01.4063
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Book ; Thesis: Effect of iodine and iron supplementation on physical, psychomotor and mental development in primary school children in Malawi

Shrestha, Ramesh Man

1994

Author's details	Ramesh M. Shrestha
Keywords	Malawi ; Grundschulkind ; Entwicklung ; Eisenmangel ; Prävention
Subject	Asiderose ; Sideropenie ; Eisen ; Eisenmangelkrankheit ; Ursprung ; Entwicklungsstadium ; Grundschüler ; Grundschulalter ; Kind ; Verhütung ; Vorbeugung ; Prophylaxe ; Vorsorge
Publishing country	Netherlands
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Wageningen, Landbouwuniv., Diss., 1994
Note	Zsfassung in niederländ. Sprache
HBZ-ID	HT006341999
ISBN	90-5485-234-8 ; 978-90-5485-234-6
Database	Catalogue ZB MED Nutrition, Environment, Agriculture

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Article: A case report: Lateral medullary syndrome with facial nerve palsy and hemiparesis.

Shrestha, Ramesh / Kharel, Ghanshyam / Acharya, Shraddha / Pandit, Rohit / Limbu, Nitu

Annals of medicine and surgery (2012)

2022 Volume 82, Page(s) 104722

Abstract: Lateral medullary syndrome (LMS) is the most common and severe neurological syndrome associated with atherothrombotic occlusion of the intracranial vertebral artery, followed by posterior inferior cerebellar artery and medullary artery occlusion. It ... ...

Abstract	Lateral medullary syndrome (LMS) is the most common and severe neurological syndrome associated with atherothrombotic occlusion of the intracranial vertebral artery, followed by posterior inferior cerebellar artery and medullary artery occlusion. It presents as a typical triad of oculosympathetic palsy (Horner's syndrome), ipsilateral gait ataxia, and hypoalgesia with ipsilateral thermoanesthesia of the face. In LMS, the upper motor neuron facial palsy is caused by the involvement of aberrant supranuclear fibers of the facial nerve. The caudal extension of the infarction to the pyramidal tracts may explain contralateral hemiparesis. Here, we have discussed a 42-year-old non-diabetic, hypertensive male with LMS, hemiparesis, and left UMN-type facial palsy. We reported this case because developing nations, have few tertiary level health facilities for neurological examination, and non-neurologists often miss the diagnosis; therefore, the characteristics must be known and understood.
Language	English
Publishing date	2022-09-17
Publishing country	England
Document type	Case Reports
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2022.104722
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Article: Peripheral Leukocytosis and Clinical Outcomes After Aneurysmal Subarachnoid Hemorrhage.

Shrestha, Ramesh / Rayamajhi, Sushil / Shrestha, Sunita / Thakali, Ajit / Bishokarma, Suresh

Cureus

2022 Volume 14, Issue 7, Page(s) e26778

Abstract: Background: Aneurysmal subarachnoid hemorrhage (SAH) has a high morbidity rate. Following SAH, a powerful systemic inflammatory response ensues contributing to delayed neurological deterioration and outcome. The aim of this study is to investigate if ... ...

Abstract	Background: Aneurysmal subarachnoid hemorrhage (SAH) has a high morbidity rate. Following SAH, a powerful systemic inflammatory response ensues contributing to delayed neurological deterioration and outcome. The aim of this study is to investigate if peripheral leukocytosis following SAH impacts clinical outcomes. Methods: This is a retrospective, observational, single tertiary center study of patients with SAH who underwent microsurgical clipping between 2017 and 2020. The study's inclusion criteria were aneurysmal SAH on baseline computerized tomography (CT), age above 18 years, and hospital admission within 72 hours of bleeding. Traumatic SAH, arteriovenous malformations, and mycotic aneurysms were all excluded. On admission, leukocyte counts were recorded. Demographic and clinical variables were compared between the two groups (TLC ≤12,000 and >12,000). The impact of peripheral leukocytes on clinical outcomes in terms of the Glasgow Outcome Score (GOS) was analyzed. Mann-Whitney U test for continuous variable and Fisher exact test or chi-square test for categorical variables were used for calculation of P-value. A P-value of 0.05 or less was considered statistically significant. Results: Among 90 patients who underwent clipping of ruptured aneurysms, 40 (44.4%) were anterior communicating artery (ACOMM) aneurysms, and 21 (23.3%) were middle cerebral artery(MCA), and 16 (17.8%) were posterior communicating artery (PCOMM). Clinically 57 patients (63.3%) had a World Federation of Neurosurgical Societies (WFNS) grade 1, 17 patients (18.9%) had a grade 2, four patients (4.4%) had a grade 3, and two patients (2.2%) had a grade 4. On radiological examination, six patients (6.7%) had fisher grade 1, 23 patients (25.6%) had grade 2, 22 patients (24.4%) had grade 3, and 39 (43.4%) had grade 4 SAH distribution. Clinical results were poor in 30 individuals (33.3 %), but good in 60 patients (66.7 %). On admission leukocytosis (>12,000) was seen among 34 (37.8%). Leukocytosis (>12,000) was associated with poor WFNS grade (>2); however, statistical significance was not seen with clinical outcome in terms of GOS. Conclusion: Poor clinical grade of patients following aneurysmal SAH is associated with peripheral leukocytosis; however, peripheral leukocytosis is not associated with poor outcomes.
Language	English
Publishing date	2022-07-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.26778
Database	MEDical Literature Analysis and Retrieval System OnLINE

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