Publications by authors named "Gautam Rijal"

Visual loss following a spine surgery in a prone position is a disastrous and irreversible complication. Moreover, the recommended treatment for such visual loss is lacking and the outcome is not so satisfactory. A 38-year-old gentleman developed profound right sided visual loss after an uneventful cervical spine surgery in a prone position that lasted approximately two and half hours.

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Tuberous sclerosis is an uncommon neurocutaneous syndrome characterized by hamartomatous growths with unpredictable progression. Diagnosing and managing neonatal tuberous sclerosis can be challenging. We report a rare case of a 30-day-old male born out of a non-consanguineous marriage who presented with poor suckling and persistent abnormal body movement, required prolonged intensive care, and was diagnosed with tuberous sclerosis with multisystem involvement.

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Background: Larval source management is an effective measure to control mosquito-borne diseases. Bacillus thuringiensis produces specific insecticidal crystal proteins toxic to mosquito larvae. In many parts of the South East Asian region, Bacillus thuringiensis is used for larval source management.

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Introduction: Spinal cord injury usually results in disabling conditions. The incidence of spinal trauma is region-specific due to unique geography and demography. The epidemiology of spinal trauma changes with economic and social factors even in different periods.

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Background: Participatory policy analysis (PPA) as a method in health policy and system research remains underexplored. Using our experiences of conducting PPA workshops in Nepal to explore the impact of the country's move to federalism on its health system, we reflect on the method's strengths and challenges. We provide an account of the study context, the design and implementation of the workshops, and our reflections on the approach's strengths and challenges.

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Background: Pleural effusions are most commonly classified as transudative or exudative based on Light's criteria which has shown misclassification in 10%-20% of cases. Studies have demonstrated lesser misclassification with pleural fluid cholesterol criteria. Thus, this study aimed to find the diagnostic properties of pleural fluid cholesterol in differentiating the type of effusion.

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Background: The Preschool Anxiety Scale (PAS)-Parent version scale is a 28-item measure designed to assess anxiety symptoms in preschoolers aged 3-6 years. The aim of this study was to assess the psychometric properties of the Nepali translated version of the PAS-Parent version.

Methods: A descriptive cross-sectional design was used to collect data from 680 mothers among seven conveniently selected schools in Kathmandu.

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Background: Tuberculosis is a common respiratory disease imposing significant health burden. Directly observed treatment short course strategy ensures patient compliance in tuberculosis treatment. The aim of this study was to assess pattern of tuberculosis, trend and outcome of patients registered at Directly observed treatment short course centre of Tribhuvan University Teaching Hospital.

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Anchored fallopian tube through the drain tube is rare. We present a case of a 27-year-old female patient who underwent right salpingectomy with the fenestrated drain tube in the pelvic cavity. Postoperatively, the drain could not be removed.

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The Coronavirus 2019 disease (COVID-19) originated in Wuhan in China in December 2019 has evolved over the past year in terms of its pathophysiology, clinical presentation, imaging manifestations and management strategies. Though COVID-19 is predominantly a pulmonary illness, it is now established to show widespread extra pulmonary involvement. Gastrointestinal manifestations of COVID-19 are also well known.

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Nepal suffers from high burden of antimicrobial resistance (AMR) due to inappropriate use of antibiotics. The main objective of this study was to explore knowledge, attitude and practices of antibiotics uses among patients, healthcare workers, laboratories, drug sellers and farmers in eight districts of Nepal. A cross-sectional survey was conducted between April and July 2017.

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Article Synopsis
  • Diabetic maculopathy is a significant cause of blindness, and this study aimed to evaluate microaneurysms using various noninvasive imaging techniques.
  • The study involved 18 patients and found that 71.8% of the microaneurysms were detectable across all imaging methods, with a majority being high-flow types located primarily in the deep capillary plexus.
  • Results highlighted correlations between high-flow microaneurysms and retinal thickening, while low-flow microaneurysms were associated with areas of reduced capillary density, suggesting these features could threaten vision.
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Chronic kidney disease (CKD/uremia) remains vexing because it increases the risk of atherothrombosis and is also associated with bleeding complications on standard antithrombotic/antiplatelet therapies. Although the associations of indolic uremic solutes and vascular wall proteins [such as tissue factor (TF) and aryl hydrocarbon receptor (AHR)] are being defined, the specific mechanisms that drive the thrombotic and bleeding risks are not fully understood. We now present an indolic solute-specific animal model, which focuses on solute-protein interactions and shows that indolic solutes mediate the hyperthrombotic phenotype across all CKD stages in an AHR- and TF-dependent manner.

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A medical order is a medical and legal document and careful writing of this document is necessary. In Nepal the medical order in the admitted patients is written on a cardex which is utilised by the nurses to dispense medicines and to follow the doctor's orders. However, with the dawn of the electronic age this is being replaced by a computerized system, which is suggested to be better.

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Background: Urinary tract infections (UTI) are common. It causes severe morbidity and mortality, and it is important to know the causative organisms in the hospital and community for optimum management of UTI.

Methods: This is a prospective hospital based study to identify the organisms causing UTI and their antibiotic susceptibility.

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This was a prospective study done in Nepal Medical College Teaching Hospital, Kathmandu, Nepal to find out the relationship between BPH and BPH associated with prostatitis as regards their symptoms and histopathology. We looked at the symptoms of both disease processes and tried to establish whether we could differentiate between the two entities on a clinical basis. Our study included thirty six patients who were operated for symptoms suggestive of LUTS due to BPH.

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Spinal tuberculosis is usually secondary to lung or abdominal involvement and may also be the first manifestation of tuberculosis. Spinal tuberculosis (often called Pott's disease) is by definition, an advanced disease, requiring meticulous assessment and aggressive systemic therapy. Physicians should keep the diagnosis in mind, especially in a patient from a group with a high rate of tuberculosis infection.

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