Publications by authors named "Shashank Neupane"

Article Synopsis
  • Tolosa-Hunt syndrome is a rare condition characterized by unilateral orbital pain and ophthalmoplegia, often necessitating a diagnosis of exclusion and responding well to steroid treatment.
  • A 38-year-old male experienced symptoms including diplopia and blurry vision, which were treated successfully with Prednisolone and later with IV methylprednisolone after recurrence.
  • The diagnosis relies on typical clinical presentations, significant steroid response, and the exclusion of other conditions, emphasizing the need for patient awareness regarding potential symptom recurrence and the importance of follow-up care.
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Unlabelled: Protein S is a vitamin K-dependent protein that acts as a break in secondary hemostasis by inactivating activated factor V and activated factor VIII. We report a case of a 40 years old male who had the first episode of deep vein thrombosis of the left lower limb 10 years back, which despite treatment, reoccurred 3 months later in the bilateral lower limb. Thrombophilic screening showed severe protein S deficiency.

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Article Synopsis
  • Portal hypertension can be a rare complication of liver metastases, and clinicians need to differentiate it from conditions that mimic cirrhosis based on clinical and imaging similarities.
  • A case study involving a 29-year-old woman with progressive abdominal distension and jaundice revealed liver metastases from breast cancer leading to portal hypertension, ultimately resulting in her death before treatment could be initiated.
  • This case emphasizes the unusual presentation of liver metastases as portal hypertension, contrasting with typical presentations linked to chemotherapy-induced pseudocirrhosis.
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Introduction: Amyotrophic lateral sclerosis is a rare progressive neurodegenerative disease that affects the brain and spinal cord nerve cells. The study highlights the role of early diagnosis and prognosis of bulbar onset ALS.

Case Presentation: We present a case of 60 years old female who presented with slurring of speech with a deviation of tongue and progressive dysphagia.

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Ciprofloxacin, among the many Fluoroquinolones, has been widely used as a broad-spectrum antibiotic due to its wide range of action and relatively safe adverse effect profile. However, among the cutaneous adverse drug reactions due to Ciprofloxacin, toxic epidermal necrolysis occurring along with cholestatic hepatitis is a rare one. Here, we present a case of a 22-year-old male patient who was diagnosed with toxic epidermal necrolysis with cholestatic hepatitis secondary to Ciprofloxacin.

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Hemophagocytic Lymphohistiocytosis (HLH) is a rare life-threatening condition characterized by widespread activation of the immune system leading to tissue damage all over the body. It is divided into primary HLH due to inborn error in lymphocytes, T cells, and macrophages and secondary HLH which is mostly due to infections, systemic connective tissue diseases, and lymphoid malignancies. Here, we report a 34-year-old man with a history of high-grade fever, chills, and rigor, eschar, splenomegaly with the laboratory findings of thrombocytopenia, hypochromic RBCs with anisocytosis and basophilic stippling, elevated transaminases, and a positive Weil Felix test along with positive PCR results for Orientia tsutsugamushi and the presence of IgG and IgM antibodies.

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The study aimed to determine the level of self-reported adherence to antihypertensive drug(s) and its associated factors among patient with hypertension at a tertiary care center. The authors performed hospital based observational cross-sectional study using semi-structured questionnaires, WHO STEP tool and Hill and Bone high blood pressure compliance scale from December 1, 2021 to February 28, 2022. Descriptive statistics, Chi-square/Fisher's exact test and non-parametric tests were used for statistical analysis.

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Unlabelled: Minimal change disease is an important cause of nephrotic syndrome in children, however, few cases are seen among adults. There is very little literature regarding the occurrence of minimal change disease in adults. We reported a case of a 63-year-old male who presented with the complaint of swelling around the eyes mostly during the morning for 18 days and frothing of urine for 7 days.

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