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  1. Artikel ; Online: Eculizumab for paroxysmal nocturnal haemoglobinuria

    Sugat Adhikari / Surendra Sapkota / Suraj Shrestha / Kshitiz Karki / Anjan Shrestha

    Orphanet Journal of Rare Diseases, Vol 18, Iss 1, Pp 1-

    catastrophic health expenditure in Nepalese patients

    2023  Band 4

    Abstract: Abstract Paroxysmal nocturnal hemoglobinuria (PNH) results from a mutation in the phosphatidylinositol glycan class-A gene which causes uncontrolled complement activation with resultant intravascular hemolysis and its sequelae. Eculizumab is a terminal ... ...

    Abstract Abstract Paroxysmal nocturnal hemoglobinuria (PNH) results from a mutation in the phosphatidylinositol glycan class-A gene which causes uncontrolled complement activation with resultant intravascular hemolysis and its sequelae. Eculizumab is a terminal complement inhibitor that blocks this complement activation and has revolutionized the treatment of PNH but comes with an enormous price which can have catastrophic health expenditure in low-middle income countries (LMIC) like Nepal. Here, we discuss the potential way forwards in the treatment of PNH in Nepal and other LMICs.
    Schlagwörter Catastrophic health expenditure ; Eculizumab ; Low and middle-income countries ; Orphan drug ; Paroxysmal nocturnal hemoglobinuria ; Nepal ; Medicine ; R
    Sprache Englisch
    Erscheinungsdatum 2023-06-01T00:00:00Z
    Verlag BMC
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  2. Artikel ; Online: Eculizumab for paroxysmal nocturnal haemoglobinuria: catastrophic health expenditure in Nepalese patients.

    Adhikari, Sugat / Sapkota, Surendra / Shrestha, Suraj / Karki, Kshitiz / Shrestha, Anjan

    Orphanet journal of rare diseases

    2023  Band 18, Heft 1, Seite(n) 172

    Abstract: Paroxysmal nocturnal hemoglobinuria (PNH) results from a mutation in the phosphatidylinositol glycan class-A gene which causes uncontrolled complement activation with resultant intravascular hemolysis and its sequelae. Eculizumab is a terminal complement ...

    Abstract Paroxysmal nocturnal hemoglobinuria (PNH) results from a mutation in the phosphatidylinositol glycan class-A gene which causes uncontrolled complement activation with resultant intravascular hemolysis and its sequelae. Eculizumab is a terminal complement inhibitor that blocks this complement activation and has revolutionized the treatment of PNH but comes with an enormous price which can have catastrophic health expenditure in low-middle income countries (LMIC) like Nepal. Here, we discuss the potential way forwards in the treatment of PNH in Nepal and other LMICs.
    Mesh-Begriff(e) Humans ; Hemoglobinuria, Paroxysmal/drug therapy ; Health Expenditures ; Nepal ; Antibodies, Monoclonal, Humanized/therapeutic use
    Chemische Substanzen eculizumab (A3ULP0F556) ; Antibodies, Monoclonal, Humanized
    Sprache Englisch
    Erscheinungsdatum 2023-06-30
    Erscheinungsland England
    Dokumenttyp Letter
    ZDB-ID 2225857-7
    ISSN 1750-1172 ; 1750-1172
    ISSN (online) 1750-1172
    ISSN 1750-1172
    DOI 10.1186/s13023-023-02779-2
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel: Cytarabine-induced peripheral neuropathy in a young patient with acute myeloid leukemia: a case report.

    Karki, Kshitiz / Adhikari, Sugat / Shrestha, Suraj / Bhandari, Jenish / Baral, Bidisha / Baral, Aastha

    Annals of medicine and surgery (2012)

    2024  Band 86, Heft 5, Seite(n) 3082–3085

    Abstract: Introduction and importance: Cytarabine, a pyrimidine analogue, is commonly used to treat multiple haematological conditions, such as acute leukaemias and lymphomas. One of the rare and less reported complications of cytarabine is peripheral neuropathy, ...

    Abstract Introduction and importance: Cytarabine, a pyrimidine analogue, is commonly used to treat multiple haematological conditions, such as acute leukaemias and lymphomas. One of the rare and less reported complications of cytarabine is peripheral neuropathy, in which peripheral nerves are damaged, often causing weakness, numbness, and pain, usually in the hands and feet.
    Case presentation: The authors report the case of a 17-year-old male who developed a gradual onset of weakness and sensory loss in all four limbs during treatment with a conventional dose of cytarabine for acute myeloid leukaemia. Cytarabine was discontinued after the development of symptoms, and his motor and sensory functions gradually improved over the course of 3 months.
    Clinical discussion: Alongside some well-known side effects of cytarabine, including bone marrow suppression, cerebellar syndrome, and cardiotoxicity, peripheral neuropathy is one of the uncommon side effects of cytarabine. Diagnosis includes identifying and grading the severity of chemotherapy-induced peripheral neuropathy (CIPN) through clinical assessment and nerve conduction studies. Management includes withdrawing the chemotherapeutic agent and supportive treatment with drugs such as duloxetine. Recent studies also favour the use of acupuncture and sensorimotor-based exercise intervention for the management of CIPN.
    Methods: This case report has been prepared in line with the SCARE 2023 criteria.
    Conclusion: Although rare, even a conventional dosage of cytarabine can cause peripheral neuropathy, and routine neuromuscular examinations can help in the early diagnosis and intervention to limit further progression and reverse the course of the disease.
    Sprache Englisch
    Erscheinungsdatum 2024-03-12
    Erscheinungsland England
    Dokumenttyp Case Reports
    ZDB-ID 2745440-X
    ISSN 2049-0801
    ISSN 2049-0801
    DOI 10.1097/MS9.0000000000001937
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  4. Artikel: Hemophilic pseudotumor of the knee joint: Emphasizing prevention and early diagnosis in a rare disease.

    Devkota, Shritik / Adhikari, Sugat / Lamichhane, Samiksha / Adhikari, Dipendra / Bika, Bhola / Choudhary, Shayeri Roy / Bhalla, Tajinder

    Clinical case reports

    2024  Band 12, Heft 5, Seite(n) e8822

    Abstract: Key clinical message: Hemophilic pseudotumors are rare complications occurring in individuals with severe hemophilia, characterized by progressive cystic swellings in muscles and/or bones due to recurrent bleeding. Timely initiation of factor VIII ... ...

    Abstract Key clinical message: Hemophilic pseudotumors are rare complications occurring in individuals with severe hemophilia, characterized by progressive cystic swellings in muscles and/or bones due to recurrent bleeding. Timely initiation of factor VIII replacement is crucial.
    Abstract: Hemophilic pseudotumors are rare complications occurring in individuals with severe hemophilia, characterized by progressive cystic swellings in muscles and/or bones due to recurrent bleeding. Although their incidence has decreased with the advent of factor VIII replacement therapy, they still create challenges, particularly in regions with limited access to medical care. Here, we present a case report of a hemophilic pseudotumor of the knee joint in a 15-year-old male with hemophilia A. The patient presented with severe left knee pain, swelling, and restricted range of motion, prompting further investigation. Imaging studies revealed lytic lesions, and MRI bone signal changes consistent with hemophilic pseudotumors. Prompt initiation of factor VIII replacement therapy and supportive management led to a significant improvement in symptoms and joint functionality. Follow-up after 2 months showed that the swelling had significantly reduced in size, with marked improvement in the functionality of the knee joint. This case confirms what is already known in the hemophilia literature: how important it is to prevent, diagnose, and treat pseudotumors early in hemophilia. However, longer clinical and imaging follow-up of this case is necessary to determine whether the complaints associated with pseudotumors resolve with hematologic treatment or will require surgical treatment.
    Sprache Englisch
    Erscheinungsdatum 2024-04-30
    Erscheinungsland England
    Dokumenttyp Case Reports
    ZDB-ID 2740234-4
    ISSN 2050-0904
    ISSN 2050-0904
    DOI 10.1002/ccr3.8822
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel: Parasitic mature cystic ovarian teratoma: A rare case of autoimplantation of a twisted dermoid cyst.

    Shrestha, Suraj / Adhikari, Sugat / Yadav, Chandra Narayan / Poddar, Elisha / Bhatta, Shekhar / Sapkota, Surendra / Khadayat, Ramesh / Neupane, Garima / Kunwar, Simin / Regmi, Pradeep Raj

    Clinical case reports

    2023  Band 11, Heft 9, Seite(n) e7764

    Abstract: Extragonadal parasitic dermoid cysts are rare. Diagnosis of such extragonadal parasitic teratoma is often done intraoperatively during surgical exploration of abdominal mass. ...

    Abstract Extragonadal parasitic dermoid cysts are rare. Diagnosis of such extragonadal parasitic teratoma is often done intraoperatively during surgical exploration of abdominal mass.
    Sprache Englisch
    Erscheinungsdatum 2023-09-20
    Erscheinungsland England
    Dokumenttyp Case Reports
    ZDB-ID 2740234-4
    ISSN 2050-0904
    ISSN 2050-0904
    DOI 10.1002/ccr3.7764
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  6. Artikel: Pontine and bilateral cerebellar lesion in osmotic demyelination syndrome associated with uncontrolled type II diabetes mellitus: a case report.

    Shrestha, Suraj / Kharel, Sanjeev / Gautam, Sandesh / Poddar, Elisha / Adhikari, Sugat / Acharya, Suman / Pant, Samriddha Raj / Jha, Anamika / Ojha, Rajeev

    Annals of medicine and surgery (2012)

    2023  Band 85, Heft 3, Seite(n) 477–480

    Abstract: Osmotic demyelination syndrome (ODS) as a result of the hyperosmolar hyperglycemic state is rare and can present with variable neurological manifestation due to lysis of myelin sheath.: Case presentation: A 44-year diabetic male presented with ... ...

    Abstract Osmotic demyelination syndrome (ODS) as a result of the hyperosmolar hyperglycemic state is rare and can present with variable neurological manifestation due to lysis of myelin sheath.
    Case presentation: A 44-year diabetic male presented with complaints of sudden onset, progressive bilateral weakness in lower limbs, and slurring of speech for the past 1.5 months. Cerebellar examination showed a bilaterally impaired finger nose test, dysdiadochokinesia, impaired heel shin test, and an impaired tandem gait. MRI brain (T2 and fluid-attenuated inversion recovery sequences) showed high signal intensity in the central pons and bilateral cerebellum. With a diagnosis of ODS with poorly controlled diabetes, he was treated with insulin, metformin, and supportive measures following which his symptoms subsided gradually.
    Clinical discussion: A rapid correction of hyponatremia is considered the most common cause of ODS. Variations in plasma glucose levels, a rare cause of ODS, can cause an abrupt osmolality change causing pontine and extrapontine myelinolysis. Prevention of rapid correction of hyponatremia and rapid changes in plasma osmolality in vulnerable patients is the mainstay of treatment.
    Conclusions: Clinical features, imaging studies, and monitoring of serum osmolality, serum glucose, and electrolytes aid in diagnosis and favorable outcomes for the patient.
    Sprache Englisch
    Erscheinungsdatum 2023-02-17
    Erscheinungsland England
    Dokumenttyp Case Reports
    ZDB-ID 2745440-X
    ISSN 2049-0801
    ISSN 2049-0801
    DOI 10.1097/MS9.0000000000000230
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel: Remdesivir in COVID-19 management: availability and relevance to low- and middle-income countries.

    Adhikari, Sugat / Khadka, Sitaram / Dahal, Sadhana / Shrestha, Dhan Bahadur / Shahi, Janak / Bajgain, Yogesh

    Drugs & therapy perspectives : for rational drug selection and use

    2020  Band 37, Heft 1, Seite(n) 26–28

    Schlagwörter covid19
    Sprache Englisch
    Erscheinungsdatum 2020-10-28
    Erscheinungsland New Zealand
    Dokumenttyp Journal Article
    ZDB-ID 1197107-1
    ISSN 1179-1977 ; 1172-0360
    ISSN (online) 1179-1977
    ISSN 1172-0360
    DOI 10.1007/s40267-020-00791-1
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  8. Artikel ; Online: Association of geographic distribution and birth weight with sociodemographic factors of the maternal and newborn child of hilly and mountain regions of eastern Nepal: a cross-sectional study.

    Bhattarai, Bharosha / Panthi, Sagar / Yadav, Gopal Kumar / Gautam, Swotantra / Acharya, Rochana / Neupane, Durga / Khanal, Nimesh / Khatri, Bharat / Neupane, Krishna / Adhikari, Sugat / Lageju, Nimesh / Basnet, Lila Bahadur / Pyakurel, Prajjwal / Yadav, Shankar Prasad

    BMJ paediatrics open

    2023  Band 6, Heft 1

    Abstract: Objectives: To determine the association of geographic distribution, and birth weight with sociodemographic factors of the maternal and newborn child of hilly region (lower altitude) and mountain region (high altitude) of eastern Nepal as well as the ... ...

    Abstract Objectives: To determine the association of geographic distribution, and birth weight with sociodemographic factors of the maternal and newborn child of hilly region (lower altitude) and mountain region (high altitude) of eastern Nepal as well as the prevalence of low birth weight (LBW) and large for gestational age (LGA) among term singleton deliveries in eastern Nepal.
    Methodology: A cross-sectional study was conducted in the district-level hospitals of Dhankuta, Tehrathum, Solukhumbu and Taplejung districts of eastern Nepal of Province 1. Mothers with preterm or post-term delivery, multiple pregnancies, stillbirth/intrauterine fetal death and incomplete records were excluded from the study with only 1386 term pregnancies (37-42 weeks) delivered at the respective facilities between 17 July 2019 and 16 July 2020 were included. The appropriate data were entered in Microsoft Excel 2019 V.16.0 and statistical analysis was performed by using the statistical package for social sciences, IBM SPSS V.29.
    Results: The low maternal age, Dalit ethnic group, low gravidity, low parity, higher antenatal care (ANC) visits (≥4), incomplete deworming and dT vaccination status, breech deliveries and LBW newborns were significantly attributed to hilly region (lower altitude) (p value <0.05). Similarly, the hilly region, lower and/or no ANC visits and early term gestation had significant negative association with birth weight at the lower quantiles only. Meanwhile, the female newborn had significant and negative association with birth weight distribution at all seven quantiles. The prevalence of the LBW, average for gestational age and LGA newborn child among term singleton deliveries in Eastern Nepal is 6.6%, 85.8% and 7.6%, respectively.
    Conclusions: The local organisations should focus on adequate antenatal care visits in mountain region and coverage of dT vaccine and deworming medications in hilly region. Appropriate measures and programmes should be initiated to bring down LBW in hilly region.
    Mesh-Begriff(e) Infant, Newborn ; Humans ; Female ; Pregnancy ; Birth Weight ; Cross-Sectional Studies ; Nepal/epidemiology ; Sociodemographic Factors ; Risk Factors ; Stillbirth/epidemiology
    Sprache Englisch
    Erscheinungsdatum 2023-01-16
    Erscheinungsland England
    Dokumenttyp Journal Article
    ISSN 2399-9772
    ISSN (online) 2399-9772
    DOI 10.1136/bmjpo-2022-001579
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  9. Artikel: Remdesivir in COVID-19 management: availability and relevance to low- and middle-income countries

    Adhikari, Sugat / Khadka, Sitaram / Dahal, Sadhana / Shrestha, Dhan Bahadur / Shahi, Janak / Bajgain, Yogesh

    Drugs Ther Perspect

    Schlagwörter covid19
    Verlag WHO
    Dokumenttyp Artikel
    Anmerkung WHO #Covidence: #898182
    Datenquelle COVID19

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  10. Artikel: New-onset diabetes in COVID-19 and clinical outcomes: A systematic review and meta-analysis.

    Shrestha, Dhan Bahadur / Budhathoki, Pravash / Raut, Sumit / Adhikari, Sugat / Ghimire, Prinska / Thapaliya, Sabin / Rabaan, Ali A / Karki, Bibodh Jung

    World journal of virology

    2021  Band 10, Heft 5, Seite(n) 275–287

    Abstract: Background: Diabetes mellitus (DM) is associated with adverse clinical outcomes and high mortality in patients with coronavirus disease 2019 (COVID-19). The relationship between diabetes and COVID-19 is known to be bidirectional.: Aim: To analyze the ...

    Abstract Background: Diabetes mellitus (DM) is associated with adverse clinical outcomes and high mortality in patients with coronavirus disease 2019 (COVID-19). The relationship between diabetes and COVID-19 is known to be bidirectional.
    Aim: To analyze the rate of new-onset diabetes in COVID-19 patients and compare the clinical outcomes of new-onset diabetes, pre-existing diabetes, hyperglycemic, and non-diabetes among COVID-19 patients.
    Methods: We used the Meta-analysis of Observational Studies in Epidemiology statement for the present meta-analysis. Online databases were searched for all peer-reviewed articles published until November 6, 2020. Articles were screened using Covidence and data extracted. Further analysis was done using comprehensive meta-analysis. Among the 128 studies detected after thorough database searching, seven were included in the quantitative analysis. The proportion was reported with 95% confidence interval (CI) and heterogeneity was assessed using
    Results: Analysis showed that 19.70% (CI: 10.93-32.91) of COVID-19 patients had associated DM, and 25.23% (CI: 19.07-32.58) had associated hyperglycemia. The overall mortality rate was 15.36% (CI: 12.57-18.68) of all COVID-19 cases, irrespective of their DM status. The mortality rate was 9.26% among non-diabetic patients, 10.59% among patients with COVID-19 associated hyperglycemia, 16.03% among known DM patients, and 24.96% among COVID-19 associated DM patients. The overall occurrence of adverse events was 20.52% (CI: 14.21-28.70) among COVID-19 patients in the included studies, 15.29% among non-diabetic patients, 20.41% among patients with COVID-19 associated hyperglycemia, 20.69% among known DM patients, and 45.85% among new-onset DM. Meta-regression showed an increasing rate of mortality among new hyperglycemic patients, known diabetics, and new-onset DM patients in comparison to those without diabetes.
    Conclusion: A significantly higher rate of new onset DM and hyperglycemia was observed. Higher mortality rates and adverse events were seen in patients with new-onset DM and hyperglycemia than in the non-diabetic population.
    Sprache Englisch
    Erscheinungsdatum 2021-09-19
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2829019-7
    ISSN 2220-3249
    ISSN 2220-3249
    DOI 10.5501/wjv.v10.i5.275
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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