Publications by authors named "Shambhu Khanal"

6 Publications

  • Page 1 of 1

Extensive bilateral intracranial calcifications and seizure in iatrogenic hypoparathyroidism: A case report.

Clin Case Rep 2021 Nov 12;9(11):e05076. Epub 2021 Nov 12.

Department of Endocrinology Tribhuvan University Teaching Hospital Kathmandu Nepal.

Postoperative permanent hypoparathyroidism can exhibit extensive intracranial calcifications involving basal ganglia, thalamus, cerebellum, and cerebral cortex.
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http://dx.doi.org/10.1002/ccr3.5076DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8587699PMC
November 2021

Endogenous endophthalmitis and multifocal brain abscess-An interesting case.

Clin Case Rep 2021 Oct 6;9(10):e04913. Epub 2021 Oct 6.

Department of Neurology Maharajgunj Medical Campus Tribhuvan University Institute of Medicine Kathmandu Nepal.

We present an unusual case that staphylococcal brain abscess can present in an immunocompetent with endogenous endophthalmitis secondary to a septic foci and early prevention of dissemination with appropriate management to prevent its complications.
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http://dx.doi.org/10.1002/ccr3.4913DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8493369PMC
October 2021

Pituitary Apoplexy Complicated by Cerebral Infarction: A Case Report.

JNMA J Nepal Med Assoc 2021 Jul 30;59(239):723-726. Epub 2021 Jul 30.

Department of Neurosurgery, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.

Cerebral infarction is a rare complication of pituitary apoplexy, which can result in significant morbidity if not treated on time. Pituitary apoplexy mostly occurs in pre-existing adenoma, which can remain undiagnosed until symptoms arise. Here, we present a case of a 26-year-old man with undiagnosed acromegaly who presented with left retro-orbital pain, diminished vision of the left eye, and right hemiparesis. Neuroimaging revealed large hemorrhagic sellar mass and ischemic infarction in the left middle cerebral artery territory. Emergency transcranial tumor excision was done, which resulted in significant neurological recovery.
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http://dx.doi.org/10.31729/jnma.6120DOI Listing
July 2021

A Rare and Misdiagnosed Entity Paroxysmal Nocturnal Hemoglobinuria: A Case Report.

Cureus 2021 May 8;13(5):e14902. Epub 2021 May 8.

Internal Medicine, Tribhuvan University, Institute of Medicine, Maharajgunj Medical Campus, Kathmandu, NPL.

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired stem cell disorder manifesting as non-immunological hemolytic anemia, hemoglobinuria, unusual thrombosis, and renal impairment due to deficiency of glycosylphosphatidylinositol (GPI) linked proteins in red blood cells. Patients present with features of chronic non-immune intravascular hemolysis, unexplained anemia, and thrombosis at unusual sites. It is often misdiagnosed and treated as anemia due to a low degree of suspicion. In resource-limited settings, the low degree of suspicion and paucity of investigations are the major diagnostic challenges. The even bigger challenge remains in the affordability of definitive treatment after a diagnosis has been made. Herein, we present a case of PNH in a 26-year man from rural Nepal who went undetected during the initial presentation of hemolytic anemia and later presented to us with hemolytic anemia and gastrointestinal symptoms. We made the provisional diagnosis based on the clinical presentations. However, we faced challenges in reaching the final diagnosis and providing the definitive treatment due to financial constraints and limited resources. Any patient presenting with features of chronic non-immune intravascular hemolysis, unexplained anemia, and unusual thrombosis should prompt the consideration of PNH.
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http://dx.doi.org/10.7759/cureus.14902DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183308PMC
May 2021

Tuberculosis with Evans syndrome: A case report.

Clin Case Rep 2021 May 6;9(5):e04113. Epub 2021 May 6.

Department of Internal Medicine Institute of Medicine Tribhuvan University Teaching Hospital Kathmandu Nepal.

Evans syndrome and tuberculosis could be predisposing factors for one another, or there may be a common pathophysiological denominator for the co-occurrence. Further research is needed for a better understanding of pathophysiology and treatment.
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http://dx.doi.org/10.1002/ccr3.4113DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8122135PMC
May 2021

Hemochromatosis in a β-thalassemia minor patient with H63D homozygous mutation: A case report.

Clin Case Rep 2020 Dec 12;8(12):2341-2345. Epub 2020 Jul 12.

Department of Hemato-Oncology Tribhuvan University Institute of Medicine Kathmandu Nepal.

β-thalassemia heterozygosity can cause significant iron overload when accompanied by gene mutations and inappropriate iron supplementation.
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http://dx.doi.org/10.1002/ccr3.3096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752352PMC
December 2020
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