Publications by authors named "Shivani Thapa"

7 Publications

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Impact of COVID19 on resident physicians of a community hospital in New York city.

J Community Hosp Intern Med Perspect 2021 Jan 26;11(1):4-8. Epub 2021 Jan 26.

Department of Pulmonary Medicine, Interfaith Medical Center, Brooklyn, NY, USA.

Novel Corona Virus Disease 19 has created unforeseen burden on health care. New York city is one of the epicenters of pandemic and here we explore physical, mental and social impact of COVID 19 on Resident Physicians (RP) working within the center of this epicenter. This is a single-center cross-sectional web-based survey involving RP of a community hospital in Brooklyn, New York. Questionnaire was formulated in online platform. We used a convenient sampling method. Univariate analysis was conducted and presented the distribution of qualitative responses as frequency and percentages. COVID19 related symptoms were reported by 39.8% RP. COVID19 IgG and IgM antibodies, both negative were reported by 34.9%, while only 6% RPs were IgG antibody positive. Symptomatic RP tested for COVID19-PCR was positive in 42.42%. Self-isolation from family during the pandemic was reported by only 14.5%. Financial constraints, lack of accommodation, and emotional reasons were main reasons of not being able to self isolate. Being bothered by 'Anxiety' and 'Nervousness' were reported by 8.5% on 'Almost every day' while 46.3% reported on 'several days in the two weeks duration'. 'Uncontrollable worrying', 'Feeling down', 'Depressed,' or 'Hopeless' was reported as 'Not at all' by 78.8% and 3.7% reported it to 'occur nearly every day for the last two weeks'. Aftermath of fight against pandemic has left RP with significant physical, mental, and social impact. Appropriate stress management and safety interventions are urgently needed. Further studies are needed to explore the detailed impact of COIV19 on RP.
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http://dx.doi.org/10.1080/20009666.2020.1834670DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7850354PMC
January 2021

Polysomnographic variables in Alternate overlap syndrome: data from sleep heart health study.

J Community Hosp Intern Med Perspect 2019 Apr 12;9(2):108-112. Epub 2019 Apr 12.

Department of Pulmonary Medicine, Interfaith Medical Centre, Brooklyn, NY, USA.

: To evaluate influence of asthma on polysomnographic variables of patients with obstructive sleep apnea (OSA).: A longitudinal retrospective study using data collected from the Sleep Heart Health Study (SHHS).: All 2822 patients included had OSA, 2599 were non-asthmatic whereas 223 were asthmatics. Average BMI for non-asthmatics was 28.8 kg/m whereas asthmatics had 29.5 kg/m. Median pack-years of smoking was 1.42 vs. 1.98 in non-asthmatic and asthmatic groups, respectively. Sex distribution, age (in years), BMI, FEV, FVC, AHI ≥ 4% (all apneas, hypopneas with ≥4% oxygen desaturation or arousal per hour of sleep), RDI ≥ 3% (overall respiratory distribution index at ≥3% oxygen desaturation or arousal), sleep latency, percentage of sleep time in apnea/hypopnea and Epworth sleep scale score were all statistically significant. Non-asthmatics had greater AHI (12.63/hr) compared to asthmatics (11.34/hour), = 0.0015. RDI in non-asthmatics and asthmatics was (23.07 vs 20.53; = 0.009). Sleep latency was found to be longer in asthmatics 19.8 minutes vs. 16 minutes ( = 0.008). Epworth sleepiness scale score was high in asthmatics (9 vs. 8, = 0.002).: OSA was found more severe in non-asthmatic subgroup, but asthmatics had statistically significant higher Epworth sleepiness scale score and sleep latency. Clinicians should be vigilant and keep low threshold to rule out OSA particularly on patients with difficult to control asthma, smoker, GERD, obese and nasal disease.
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http://dx.doi.org/10.1080/20009666.2019.1595951DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484460PMC
April 2019

A Rare Case of Systemic Lupus Erythematosus with Gastric Ulcer and Acute Pancreatitis: A Case Report and Literature Review.

Gastroenterology Res 2018 Aug 8;11(4):321-325. Epub 2018 Feb 8.

Department of Medicine, Interfaith Medical Center, Brooklyn, NY, USA.

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease which can manifest in many different organ systems. Gastrointestinal (GI) involvement is common in SLE, but the symptoms are usually mild. More severe GI complications including acute pancreatitis and peptic ulcer bleeding are rare but represent a significant risk of morbidity and mortality. We present a case of a 25-year-old Hispanic female with a severe SLE flare. The initial presentation included symptoms of hematemesis and epigastric abdominal pain secondary to both gastric ulceration and acute pancreatitis, an atypical presentation of an SLE flare. The non-specific symptom of abdominal pain makes both acute pancreatitis and gastric ulcer disease a clinical challenge; however, clinicians need to have a high suspicion for these conditions co-existing at the same time due to higher mortality rates.
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http://dx.doi.org/10.14740/gr1048wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089583PMC
August 2018

Metachronous Granular Cell Tumor of the Descending Colon.

Gastroenterology Res 2018 Aug 8;11(4):317-320. Epub 2018 Feb 8.

Department of Medicine, Interfaith Medical Center, Brooklyn, NY, USA.

Granular cell tumors (GCTs) are uncommon tumors. They are believed to be neuronal in origin and are usually found in the head and/or neck area of the body. They have also been reported in various locations of the gastrointestinal (GI) system, usually discovered during routine screening colonoscopy. We report a case of GCT in a 58-year-old asymptomatic African American female as a metachronous tumor of a well-differentiated adenocarcinoma of the sigmoid colon, which was an incidental finding in screening colonoscopy. To our knowledge, this is the first case with GCT identified as a metachronous tumor following an adenocarcinoma of the colon.
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http://dx.doi.org/10.14740/gr1045wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089591PMC
August 2018

Intramuscular Epinephrine-Induced Transient ST-Elevation Myocardial Infarction.

J Investig Med High Impact Case Rep 2018 Jan-Dec;6:2324709618785651. Epub 2018 Jul 6.

Interfaith Medical Center, Brooklyn, NY, USA.

Myocardial infarction in the setting of anaphylaxis may result from the anaphylaxis itself or from the epinephrine used to treat the anaphylaxis. While cases of myocardial infarction due to large doses of intravenous epinephrine have previously been reported, myocardial infarction after therapeutic doses of intramuscular epinephrine is rarely reported. A 23-year-old male presented with sudden onset of difficulty in swallowing and speech after eating takeout food. He was treated with intramuscular epinephrine for presumed angioedema following which he immediately developed chest tightness associated with ST elevation on electrocardiogram and elevated serum troponin. His symptoms and electrocardiogram findings were transient and resolved within the next 10 minutes. . Epinephrine is lifesaving during anaphylaxis and should be promptly used. Health care providers, however, need to be aware and vigilant of this rare complication of epinephrine.
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http://dx.doi.org/10.1177/2324709618785651DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069038PMC
July 2018

Spinal gout causing reversible quadriparesis: a case report and literature review.

J Community Hosp Intern Med Perspect 2018 12;8(3):111-114. Epub 2018 Jun 12.

Department of Medicine, Interfaith Medical Center, Brooklyn, USA.

Gout commonly affects peripheral joints and is rarely found in axial joints, such as the spine and sacroiliac joints. We report a case of a patient that presented with quadriparesis who was empirically treated for spinal gout and a review of relevant literature. A 77-year-old male presented with new-onset quadriparesis that developed over 3 days. MRI imaging was suggestive of tophaceous gout of the cervical spine, but our patient refused a spinal biopsy. He was empirically treated with high-dose steroids and his upper and lower extremities weakness started improving within 3 days and resolved completely. Although spinal gout is uncommon, this case indirectly suggests that gout should be kept as a differential diagnosis when faced with back pain or quadriparesis. This case implies that empiric treatment should be considered when radiographic evidence is suggestive of tophaceous gout of the spine.
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http://dx.doi.org/10.1080/20009666.2018.1472515DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5998288PMC
June 2018

Scleredema Diabeticorum with Superimposed Cellulitis and Abscess Formation.

Case Rep Endocrinol 2018 16;2018:9513768. Epub 2018 Apr 16.

Interfaith Medical Center, Brooklyn, NY, USA.

Scleredema diabeticorum is a rare cutaneous manifestation of diabetes mellitus. We present a case of an obese male with poorly controlled diabetes who came to the hospital with upper back pain and subsequently developed sepsis due to a small deep-seated abscess in his back that was drained and treated with antibiotics. He was also found to have extensive induration of the skin over his back and neck. Skin biopsy confirmed the diagnosis of scleredema diabeticorum.
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http://dx.doi.org/10.1155/2018/9513768DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5926487PMC
April 2018