Publications by authors named "Amrit Bhusal"

This case report discusses a compelling case involving acrania, exencephaly, and spinal myeloschisis in a 22-year-old pregnant woman from rural Nepal. The delayed diagnosis due to limited healthcare access underscores the importance of early prenatal care and screening. The case sheds light on the complexity of congenital anomalies and their implications.

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Corticosteroid-induced psychosis is rare and less reported in children compared to adults. However, psychosis is considered a severe adverse effect of corticosteroids in pediatric nephrotic syndrome. Steroid-induced psychosis is dose-dependent and should be treated by tapering the dose of steroids and usually initiating an atypical antipsychotic.

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Poland syndrome (PS) is a rare congenital condition characterized by the developmental anomaly of the chest wall, and classically presents with ipsilateral agenesis/hypoplasia of sternocostal head of pectoralis major which remains as the essential feature of the condition. It may or may not be associated with ipsilateral limb abnormalities. Diagnosis is mainly clinical.

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Injuries to blood vessels occur in 0.8% of the cases following laparoscopic cholecystectomy. They may result from direct penetration while insertion of trocar or by thermal injury (electrocautery).

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Article Synopsis
  • Gastroepiploic artery aneurysms (GEAAs) are a rare type of splanchnic artery aneurysms, with a prevalence of only 0.4% among all SAAs, and are most commonly caused by factors like atherosclerosis, trauma, and infections.
  • A case study detailed a 35-year-old female with no significant medical history who experienced shock due to a spontaneously ruptured right gastroepiploic artery aneurysm, detected via a CECT scan.
  • GEAAs are more common in males and tend to rupture after age 50, making spontaneous ruptures in younger females extremely rare, necessitating urgent surgical treatment due to associated high risks of mortality
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Introduction And Importance: Poly-orchidism is a rare congenital anomaly of the genitourinary system, which is characterized by the presence of more than two testicles, also being termed as "supernumerary testis". Tri-orchidism is the most frequently encountered form of poly-orchidism, which is defined as the presence of more than two intra- or extra-scrotal testicles.

Case Presentation: The authors present a case of a 16-year-old male who presented with a complaint of an empty left scrotal sac, and was later diagnosed as a case of tri-orchidism with each testis in bilateral hemipelvis confirmed by ultrasound with Doppler and MRI.

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  • Acute gastric volvulus is a rare and serious condition that can be hard to diagnose because it shows unusual symptoms.
  • A unique case involved a 38-year-old male with a nonincarcerated organo-axial gastric volvulus linked to a para-esophageal hiatus hernia, diagnosed primarily through CT imaging.
  • Successful open surgery treated this complex case, underscoring the need for a better understanding and customized management strategies to improve patient outcomes.
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  • - Intussusception occurs when one part of the bowel folds into another, commonly seen in infants and toddlers, often without a specific cause due to lymphoid tissue growth after viral infections.
  • - A rare case involved an 11-year-old girl with multiple bowel telescoping episodes caused by several polyps, presenting with abdominal pain and blood in the stool.
  • - Imaging techniques reveal distinctive signs of intussusception, like "target sign" and "pseudo-kidney sign," indicating the presence of multiple polyps as potential lead points for this condition in children.
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Hepatolithiasis is a rare condition requiring multidisciplinary treatment approach. In this case report we present a case of multiple hepatolithiasis successfully treated with right hepatectomy. A 54 years-old asymptomatic female with previous history of hepaticojejunostomy for recurrent CBD stone was diagnosed with hepatolithiasis during routine follow-up.

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Introduction: Healthcare during pregnancy and childbirth and after delivery is important for the survival and well-being of both the mother and the neonate. Maternal healthcare in Nepal faces challenges due to various causes. However, providing proper knowledge on maternal healthcare to mothers and promoting a positive attitude towards it can have a significant impact on maternal and child health outcomes.

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  • - Subarachnoid hemorrhage is a serious neurological emergency where blood leaks into the space surrounding the brain, most often due to a ruptured cerebral aneurysm, with high mortality rates between 8% to 67%.
  • - It can be misdiagnosed as it may present similarly to chronic migraine, but distinct symptoms like sudden severe headache, neck stiffness, and nausea can help differentiate between the two.
  • - A case study highlighted a 37-year-old woman with a history of migraines who experienced a sudden, intense headache, and imaging revealed a ruptured aneurysm, underscoring the need for careful evaluation in patients with similar symptoms.
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Introduction: Portal vein thrombosis (PVT) is a rare medical condition that obstructs blood flow in the portal vein, with cirrhosis as a common predisposing factor. However, its association with oral contraceptive pills (OCPs), particularly with progestins, remains inadequately explored. This case report aims to contribute to this understanding, focusing on the rare presentation of PVT-induced intestinal obstruction in a female on prolonged OCP therapy.

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Pericardial hydatid cysts, although rare, present unique diagnostic challenges and require a multidisciplinary approach for effective management. This parasitic infection, caused by larvae, typically affects the liver and lungs but can manifest in the pericardium, leading to potentially life-threatening complications if untreated. The 22-year-old female's escalating dyspnea posed diagnostic challenges despite inconclusive echocardiography.

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Multiple pregnancies are infrequently encountered, with the incidence of spontaneous triplet pregnancies estimated at approximately 1 in 7000 pregnancies. Triplet gestations are recognized for their propensity to bring about a spectrum of pregnancy related complexities, encompassing fetal structural abnormalities, neurological anomalies, disturbances in amniotic fluid levels, preterm labor, and suboptimal neonatal outcomes. Anencephaly is a serious congenital defect where the brain and skull do not fully develop, often leading to a poor prognosis.

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Introduction And Importance: PHACE syndrome is a rare neurocutaneous disorder characterized by large segmental hemangiomas on the face and is associated with multiple developmental defects. PHACE stands for posterior fossa malformations, hemangiomas, arterial abnormalities, cardiac defects, and eye anomalies, with the most common manifestation being hemangioma in the cervico-facial region in early childhood.

Case Presentation: The authors report a case of a 15-year-female with complaints of facial hemangioma which on multisystemic imaging showed features of central nervous system (CNS) anomalies that led to the diagnosis of PHACE syndrome.

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Introduction And Importance: Lipoma arborescens is a rare synovial disorder, typically affecting the knee joint, with limited reports of atypical presentations. The study emphasizes the need for a multidisciplinary diagnostic approach and discusses the genetic and signalling factors associated with its pathogenesis.

Case Presentation: A 50-year-old male presented with a painless swelling in the dorsum of the right hand, a rare extra-articular manifestation of Lipoma arborescens.

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This case report presents a 21-year-old male with recurrent seizures attributed to isolated temporal lobe closed-lip schizencephaly coexisting with septo-optic dysplasia. Despite adult-onset seizures, the patient lacked motor deficits, maintaining normal developmental milestones. Comprehensive diagnostic modalities, including MRI revealing temporal lobe atrophy and associated abnormalities, contributed to the unique identification of schizencephaly.

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Key Clinical Message: Although it is very uncommon, SLE may initially present with recurrent episodes of EM-like rash. Despite the various possibilities underlying their association, prompt identification, and treatment of SLE in patients presenting with EM is important to prevent death or serious organ damage.

Abstract: Rowell's syndrome (RS) is an uncommon presentation of systemic lupus erythematosus (SLE) with erythema multiforme (EM)-like lesions associated with specific serological changes, including positive rheumatoid factor (RF), speckled antinuclear antibody (ANA), positive rheumatoid factor, or anti-La antibodies in the serum.

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Pulmonary sequestration (PS) is a rare congenital anomaly characterized by noncommunicative lung tissue supplied by an abnormal systemic vessel. We present a case of a 30-year-old male with intralobar PS, receiving arterial supply from the celiac artery, manifesting as massive hemoptysis. After urgent stabilization, endovascular embolization using polyvinyl alcohol particles was successfully employed.

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Introduction And Importance: Neonatal supraventricular tachycardia (SVT) poses unique challenges in diagnosis and management, with refractory cases requiring synchronized cardioversion being exceptionally rare. This case report explores the presentation and management of refractory SVT in a neonate, emphasizing the significance of sharing such clinical scenarios.

Case Presentation: A 16-day-old neonate, born via emergency caesarean section, presented with respiratory distress, poor feeding, and vomiting.

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Foreign body ingestion and its natural elimination are common in children. However, this is uncommon for long foreign bodies. Here, we report the spontaneous removal of an ingested pencil in an asymptomatic child.

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Blunt trauma abdomen with abdominal wall herniation with bowel perforation is an acute emergency condition. Road traffic accidents causing blunt trauma are common in a youngster like in our case. Once the patient is resuscitated, ultrasonography and Computed tomography must be done.

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Article Synopsis
  • Gastrointestinal stromal tumors (GISTs) are the most common type of mesenchymal tumors in the gastrointestinal tract, making up about 1% of all GI tumors, with rectal GISTs being particularly rare at only 5% of GIST cases.
  • A 46-year-old male was diagnosed with a rectal GIST that had spread to the liver and lungs, and he was treated with Imatinib Mesylate, a targeted therapy.
  • Rectal GISTs should be considered as a possible cause for patients experiencing defecation issues, bleeding, or pain in the rectal area, despite their rarity.
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AA is a frequent surgical condition that demands urgent intervention. It accounts for approximately 6% of all emergency department visits. Situs inversus is a rare condition in which the orientation of asymmetric organs is a mirror image of normal anatomy.

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