Publications by authors named "Khatiwada A"

Spontaneous urinomas are rare, encapsulated urine collections in the retroperitoneum that occur without prior trauma or obstruction. It often presents with nonspecific abdominal symptoms, mimicking various acute abdominal pathologies. This case report describes a rare and unique instance of spontaneous urinoma secondary to pyeloureteritis, presenting with atypical clinical features that mimic acute bowel obstruction.

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Introduction: Phyllodes tumors (PTs) of the breast are rare fibroepithelial neoplasms, accounting for less than 1% of all breast tumors. The WHO classifies PTs into benign, borderline, or malignant categories based on histological features. While benign PTs generally have a favorable prognosis, they carry a risk of transformation into malignant variants, particularly in cases of recurrence.

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Introduction: Stump appendicitis is a rare complication of appendectomy in which residual appendiceal tissue becomes inflamed, mimicking acute appendicitis. This case report highlights the classic clinical presentation, diagnosis, and management of stump appendicitis.

Case Presentation: A 61-year-old male presented with abdominal pain and a past history of open appendectomy performed 4 years prior.

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Article Synopsis
  • - Diabetes Mellitus poses a significant public health challenge globally, particularly in low- and middle-income countries like Nepal, where medication costs hinder patient access to necessary treatments.
  • - A study investigated price variations in oral hypoglycaemic medicines (OHMs) across Nepal, finding a dramatic maximum variation of 484.82%, with many medicine categories surpassing 100% price differences despite the local production of these drugs.
  • - The findings highlight a lack of cost-effective alternatives and suggest a need for better drug policies to make OHMs more affordable, ensuring patients have access without financial strain.
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  • This systematic review investigates the cost-effectiveness of brexu-cel, a treatment for mantle cell lymphoma and acute lymphoblastic leukemia, across different countries.
  • A thorough search was conducted, leading to the review of 149 records, of which 22 were fully analyzed, resulting in five articles and seven health technology assessment (HTA) reports meeting the criteria.
  • The findings indicate that brexu-cel is deemed cost-effective in several studies, particularly in Scotland, but some HTA agencies expressed doubts about its cost-effectiveness for certain conditions.
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Treacher Collins syndrome, also known as mandibulofacial dysostosis, is a rare congenital disorder affecting craniofacial development. It is caused by an autosomal dominant mutation, primarily in the TCOF1 gene, which impacts the development of the first and second branchial arches. We present the case of a 12-year-old male with bilateral conductive hearing loss and deformed ears, whose clinical and imaging findings were consistent with Treacher Collins syndrome.

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Septo-optic dysplasia (SOD), also known as de Morsier syndrome, is a rare congenital disorder characterized by a combination of optic nerve hypoplasia, hypothalamic-pituitary dysfunction, and midline brain abnormalities, such as the absence of the septum pellucidum or thinning/agenesis of the corpus callosum. Although bilateral optic nerve hypoplasia is more common, unilateral involvement occurs less frequently. When SOD is associated with cortical malformations, such as schizencephaly, it is referred to as Septo-optic dysplasia plus.

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Ovarian dermoid cysts are usually asymptomatic and detected incidentally. However, they can have variable presentation especially when they are associated with complications. Spontaneous rupture of ovarian dermoid cyst is a rarely encountered complication as dermoid cyst usually have a thick capsule.

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Article Synopsis
  • - A healthy ecosystem requires a balanced relationship between carnivores and their prey, which this study explores through the predator-prey power law equation in Nepal's lowland protected areas.
  • - The study found that predator biomass density increases about three times for every five times the increase in prey biomass density, creating a lopsided biomass pyramid that supports the idea of predator reliance on prey.
  • - By examining competition between predators, the research suggests that maintaining the power law exponent can help scientists better understand the growth patterns in ecological communities, leading to new research opportunities.
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Choriocarcinoma is a type of gestational trophoblastic disease that occurs as a complication of pregnancy-related events. The gestational trophoblastic disease includes both benign and malignant conditions including complete and partial mole, invasive mole, choriocarcinoma, and placental site trophoblastic disease. Choriocarcinoma generally presents with pervaginal bleeding, symptoms of anemia, and symptoms of its metastatic lesion.

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Introduction: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. While only a few of those born with this anomaly survive into adulthood, it becomes an extremely rare diagnosis in adults.

Case Presentation: Here, the authors present a case of ALCAPA in a symptomatic adult female with angina and palpitations that was repeatedly missed on transthoracic echocardiogram.

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Kawasaki disease is an acute, self-limiting, systemic vasculitis of small and medium-sized arteries. It predominantly occurs in children under 4 years of age, though rarely older children can also be affected. This disease is the leading cause of acquired heart disease in children, with coronary aneurysms being a hallmark finding.

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  • Acute appendicitis and adnexal torsion are common causes of abdominal pain in women but occur together very rarely.
  • A unique case is presented where a woman was diagnosed with both ovarian dermoid torsion and acute appendicitis using imaging techniques.
  • The case highlights the importance of thorough investigation by radiologists, as two serious conditions can coexist, requiring collaborative surgical intervention for proper treatment.
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Ovarian vein thrombosis (OVT), while uncommon, is a serious complication that can arise from pregnancy, pelvic inflammatory disease, oncological conditions, and pelvic surgeries. Here we discuss a case of a 37-year-old woman who, during her postpartum period, experienced lower abdominal pain and fever. Utilizing imaging findings, she was ultimately diagnosed with right ovarian vein thrombosis.

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Early recognition and prompt surgical intervention are crucial in managing giant arachnoid cysts causing obstructive hydrocephalus, as illustrated in this case of a 17-year-old male. Timely treatment can alleviate symptoms and prevent neurologic complications, ensuring favorable outcomes in affected patients.

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Gliomatosis peritonei is an extremely rare condition usually associated with either immature teratoma or, less commonly, mature teratoma. We present a case of a young female with long-standing progressive abdominal distension, who was diagnosed with mature ovarian teratoma with gliomatosis peritonei and gross ascites. The final diagnosis in this case was determined through the correlation of imaging, operative, and histopathological findings.

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Identifying the constituting materials of concealed objects is crucial in a wide range of sectors, such as medical imaging, geophysics, nonproliferation, national security investigations, and so on. Existing methods face limitations, particularly when multiple materials are involved or when there are challenges posed by scattered radiation and large areal mass. Here we introduce a novel brute-force statistical approach for material identification using high spectral resolution detectors, such as HPGe.

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  • * A case study of a 45-year-old woman revealed she had swelled lymph nodes and back pain; her MRI showed lesions that initially appeared to be cancerous but were later identified as schwannomas through detailed examination.
  • * The case emphasizes the need to accurately differentiate schwannomatosis from other similar tumors to ensure proper treatment, as having multiple schwannomas can indicate either schwannomatosis or neurofibromatosis type 2.
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Central nervous system tuberculosis accounts for approximately 1% of all tuberculosis cases. Transverse myelitis is an extremely rare manifestation of central nervous system tuberculosis, involving 1 or more vertebral segments of the spinal cord. However, it may extend to involve 3 or more segments of the cord, which would then be designated as longitudinally extensive transverse myelitis.

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Female genital tract tuberculosis presents a diagnostic challenge because of its variable clinical presentation and radiological manifestation. Most patients are present with history of infertility, pain in the abdomen, vaginal discharge, and bleeding. These symptoms mimic those of gynecological cancer, such as endometrial carcinoma.

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Asthma and allergic rhinitis are pathologically interlinked conditions. Despite skin testing (ST) being pivotal for evaluating allergic sensitization, U.S.

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  • The study aimed to identify factors that predict improvement in chronic rhinosinusitis symptoms, measured by the SNOT-22, after initiating highly effective modulator therapy in adults with cystic fibrosis.
  • Data from 184 participants showed that worse initial SNOT-22 scores, having the F508del mutation, and not having prior modulator therapy were linked to greater symptom improvement post-therapy.
  • The minimal clinically important difference (MCID) for the SNOT-22 in this population was determined to be 8.5 points, indicating significant symptom improvement, and the test demonstrated strong internal consistency.
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Excitatory amino acid transporters (EAATs) are essential CNS proteins that regulate glutamate levels. Excess glutamate release and alteration in EAAT expression are associated with several CNS disorders. Previously, we identified positive allosteric modulators (PAM) of EAAT2, the main CNS transporter, and have demonstrated their neuroprotective properties .

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