Prevalence of helicobacter pylori infection & pattern of gastrointestinal involvement in patients undergoing upper gastrointestinal endoscopy in Sikkim Mona Dhakal, OP Dhakal Indian Journal of Medical Research, 2018 Helicobacter pylori infection of stomach induces chronic inflammation1. Production of ammonia by this urease-producing bacteria and release of biochemicals such as proteases, vacuolating cytotoxin A and phospholipases contribute significantly to its inflammatory and carcinogenic potential2. Inflammation induced due to these bacteria causes duodenal ulcer, gastric ulcer as well as cancers3. Mode of transmission of H. pylori is the faecal-oral or orooral route4. Around 50 per cent of world’s population harbours this pathogen in upper gastrointestinal (GI) tract5, but the prevalence of this infection varies worldwide, being as low as 10 per cent in developed Western nations to as high as 80 per cent in developing countries including India6,7. Clinical manifestations occur only in approximately 20 per cent8,9.
Domperidone-induced dystonia: A rare and troublesome complication O. P. Dhakal, M. Dhakal, D. Bhandari BMJ Case Reports, 2014 Domperidone is a commonly prescribed antiemetic drug but its side effects are rarely seen. Extrapyramidal side effects are a very rare complication of the drug occurring in 1/10 000 population. They usually occur in infants and very young children due to a poorly developed blood–brain barrier. We report a case of acute dystonia in a 13-year-old boy induced by domperidone. The boy was treated for viral fever and was started on domperidone 30 mg/day, sustained release form (0.7 mg/kg/day), for persistent vomiting along with other supportive treatment. On the fourth day of treatment, although the fever and vomiting subsided, the child developed oromandibular dystonia despite giving the drug in the recommended dose. Fortunately, drug-induced dystonias are a reversible condition and the child improved in 7–8 days after discontinuation of the drug. There was no recurrence at 1 month follow-up. Usually, dystonic reactions do not threaten life but are troublesome and life altering, so judicious use of the drug is advised.
Phytobezoar leading to gastric outlet obstruction in a patient with diabetes O. P. Dhakal, M. Dhakal, D. Bhandari BMJ Case Reports, 2014 Gastroparesis is a condition which results in delayed gastric emptying without gastric outflow tract obstruction. Gastrointestinal involvement in diabetes can present in various forms such as oesophageal dysmotility, gastro-oesophageal reflux disease, gastroparesis, enteropathy, non-alcoholic fatty liver disease and glycogenic hepatopathy. Gastroparesis is the most common gastric motility disorder complicating long-standing diabetes. It can sometimes lead to mechanical obstruction as a result of formation of bezoars. Phytobezoars are the most common type of bezoar and are composed of indigestible food, vegetable fibre or seeds. Poor pyloric function and decreased acid formation predisposes phytobezoars formation in patients with diabetic gastroparesis. An 80-year-old patient with diabetes in our presentation developed gastric outlet obstruction due to impaction of phytobezoar over the pylorus.
Pancreatitis in Scrub typhus: A rare complication M. Dhakal, O. P. Dhakal, D. Bhandari BMJ Case Reports, 2014 Scrub typhus is a zoonosis transmitted by a trombiculid mite which introduces bacteria of Orientia tsutsugamushi by its bite. The acute febrile illness is characterised by eschar at the site of the bite with maculopapular rashes and local and/or generalised lymphadenopathy. The disease is endemic in the tsutsugamushi triangle. Sikkim, a small Himalayan north-eastern state, is also not unaffected where outbreaks of the disease have been reported. The clinical spectrum of the disease ranges from mild to fatal depending on the virulence of the bacterial strain, susceptibility of the host and promptness of the treatment. In severe cases, there can be multiple organ involvement. Pancreatitis is a serious and unusual complication of this disease, which was seen in our presentation. A 22-year-old man, diagnosed to have scrub typhus, developed pancreatitis in the second week of the illness and responded well to medical treatment.
Polycystic kidney disease and chronic renal failure in tuberous sclerosis M. Dhakal, O. P. Dhakal, D. Bhandari BMJ Case Reports, 2013 Tuberous sclerosis is a rare genetic disease which leads to formation of benign tumours in the brain and other organs of the body. It is a multisystem disease with various clinical manifestations. Renal angiomyolipomas are the most common renal manifestations whereas renal cell carcinoma is the least. Renal cysts are found in around 20% of the patients but polycystic kidney disease is present in less than 2% cases and is relatively rare manifestation of the disease. We present a case of tuberous sclerosis in a 60-year-old man who presented to the medicine outpatient department for routine evaluation of his hypertension. He was diagnosed as tuberous sclerosis. His ultrasound and CT scan of abdomen revealed polycystic kidney disease. His kidney function test and urine analysis were suggestive of chronic kidney disease.
Gastric xanthelasma: an unusual endoscopic finding M. Dhakal, O. P. Dhakal, D. Bhandari, A. Gupta BMJ Case Reports, 2013 Gastric xanthelasma is a rarely encountered finding in upper gastrointestinal (GI) endoscopy. It is characterised by yellowish-white plaque in the stomach especially in the antrum or the pyloric region. Histologically it consists of foamy macrophages in the lamina propria. It is a benign condition but its appearance mimics malignancy and it is found to be associated with various conditions, some of which are considered premalignant so, histological confirmation is necessary. We present a case of a 44-year-old man who presented to the medicine outpatient department for intermittent pain in epigastrium for the last 2 years. His physical examination was normal. His haematological and biochemical investigations were also normal. His upper GI endoscopy revealed yellowish-white plaque in fundus of the stomach, which was diagnosed as gastric xanthelasma by histological examination with associated chronic gastritis.
Large gastric lipoma Barun Kumar Sharma, OP Dhakal Kathmandu University Medical Journal, 2012 Gastric lipoma is a rare benign tumor and seen in five percent of gastro-intestinal lipomas and accounts for less than one percent of all gastric tumors. Gastric lipomas are located submucosally and usually in antral region of Stomach. Computed tomography is considered as valuable tool in the diagnosis of gastrointestinal lipomas. Due to their relative rarity, gastric lipomas are often left out of the differential diagnosis for upper gastro-intestinal submucosal masses. We report a case of 70 year female that presented with upper abdominal pain since last two years. Abdominal Computed tomography revealed a large gastric lipoma in antral region. Patient refused for any surgical intervention due to old age. Patient was provided symptomatic treatment and was under regular follow-up. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 70-72 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8024
RECENT SCHOLAR PUBLICATIONS
Dabigatran-induced gastrointestinal bleed treated by 4-factor prothrombin complex concentrate in a tertiary care hospital in Sikkim. Dhakal M, Dhakal OP Dhakal, NILAY Journal of the Association of Physicians of India, 74 (3), 20–22. , 2026 2026
Evaluation of the relationship between procalcitonin and total leukocyte count, neutrophil and neutrophil/lymphocyte ratio in patients with systemic inflammatory response … OP Dhakal, M Dhakal, N Dhakal J Assoc Physicians India 73 (2), 31-34 , 2025 2025 Citations: 3
Prevalence of Helicobacter Pylori Infection in Chronic Liver Disease in Sikkim ND OP DHAKAL, MONA DHAKAL Journal of The Association of Physicians of India, Volume 73 Issue 1 … , 2025 2025
Molecular characterization of extended-spectrum beta-lactamases and carbapenemases producing Enterobacteriaceae isolated from North Eastern region of India OPD a Thounaojam Salvia1 , Laishram Shantikumar Singh2 , Rachana Khati1 ... Journal of Laboratory Physicians , 2024 2024 Citations: 6
Phenotypic detection of ESBL, AmpC, MBL, and their co-occurrence among MDR Enterobacteriaceae isolates T Salvia, KG Dolma, OP Dhakal, B Khandelwal, LS Singh Journal of Laboratory Physicians 14 (03), 329-335 , 2022 2022 Citations: 42
Antibody response following exposure to SARS- CoV-2:Is it a reliable marker of immunity? DB Mona Dhakal, Om Prakash Dhakal Journal of Clinical and Diagnostic Research 16, 36-39 , 2022 2022
Chapter 15: Neprilysin inhibitors in Hypertension OPD Mona Dhakal Hypertension: An evidence based treatise for clinicians, 143 - 146 , 2022 2022
Chapter 23 - Enhancement of foveolar architectural changes in gastric endoscopic biopsies GA Gupta M, Dhakal O P Recent trends in computational intelligence enabled research, theoretical … , 2021 2021
Eradication of Helicobacter Pylori Infection Using Triple Drug Therapy: A Hospital Based Observational Study in Sikkim DB Mona Dhakal, O P Dhakal Indian Journal Of Public Health Research &Development 11 (May 2020), 225 - 228 , 2020 2020
Dabigatran induced hepatic bleed.(First case report) O Dhakal, M Dhakal Journal of Gastroenterology and Hepatology 34, 708-708 , 2019 2019
Prevalence of Helicobacter pylori infection & pattern of gastrointestinal involvement in patients undergoing upper gastrointestinal endoscopy in Sikkim OP Dhakal, M Dhakal Indian Journal of Medical Research 147 (5), 517-520 , 2018 2018 Citations: 29
Fundus Image Classification using Convolutional Neural Network with Quantization PK Jha, A Verma, OP Dhakal 2018
Study of CYPIA1 and GSTM1 gene polymorphism in gastric cancer in Sikkim, northeastern region of India M Sherpa, OP Dhakal JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 32, 97-97 , 2017 2017
A hospital based cross sectional study to evaluate awareness of lifestyle interventions among hypertensive patients in Sikkim (North-Eastern State of India) M Dhakal, OP Dhakal International Journal of Medical Research and Review 5 (4), 421-428 , 2017 2017 Citations: 5
Correlation of Helicobacter pylori infections in patients of dyspepsia with or without ulcer with endoscopic findings TSK Singh, OP Dhakal, D Gautam, B Khandelwal, M Dhakal, OT Lepcha, ... International Journal of Medical Research and Review 4 (04) , 2016 2016
Hyperglycemia in critically ill patients and its association with increased mortality. A hospital based observational study M Dhakal, OP Dhakal, D Bhandari Int J Med Res Rev 4 (4), 525-30 , 2016 2016 Citations: 5
Domperidone-induced dystonia: a rare and troublesome complication OP Dhakal, M Dhakal, D Bhandari BMJ case reports 2014, bcr2013200282 , 2014 2014 Citations: 25
Phytobezoar leading to gastric outlet obstruction in a patient with diabetes OP Dhakal, M Dhakal, D Bhandari Case Reports 2014, bcr2013200661 , 2014 2014 Citations: 17
Pancreatitis in scrub typhus: a rare complication M Dhakal, OP Dhakal, D Bhandari BMJ Case Reports CP 2014, bcr2013201849 , 2014 2014 Citations: 13
Ademetionine in patients with chronic alcoholic liver disease: Results of a multicentre observational study in Indian patients G Choudhuri, T Singh Int J Res Health Sci 2 (3), 831-41 , 2014 2014 Citations: 13
MOST CITED SCHOLAR PUBLICATIONS
Phenotypic detection of ESBL, AmpC, MBL, and their co-occurrence among MDR Enterobacteriaceae isolates T Salvia, KG Dolma, OP Dhakal, B Khandelwal, LS Singh Journal of Laboratory Physicians 14 (03), 329-335 , 2022 2022 Citations: 42
Prevalence of Helicobacter pylori infection & pattern of gastrointestinal involvement in patients undergoing upper gastrointestinal endoscopy in Sikkim OP Dhakal, M Dhakal Indian Journal of Medical Research 147 (5), 517-520 , 2018 2018 Citations: 29
Domperidone-induced dystonia: a rare and troublesome complication OP Dhakal, M Dhakal, D Bhandari BMJ case reports 2014, bcr2013200282 , 2014 2014 Citations: 25
Gastric xanthelasma: an unusual endoscopic finding M Dhakal, OP Dhakal, D Bhandari, A Gupta Case Reports 2013, bcr2013201017 , 2013 2013 Citations: 23
Phytobezoar leading to gastric outlet obstruction in a patient with diabetes OP Dhakal, M Dhakal, D Bhandari Case Reports 2014, bcr2013200661 , 2014 2014 Citations: 17
Pancreatitis in scrub typhus: a rare complication M Dhakal, OP Dhakal, D Bhandari BMJ Case Reports CP 2014, bcr2013201849 , 2014 2014 Citations: 13
Ademetionine in patients with chronic alcoholic liver disease: Results of a multicentre observational study in Indian patients G Choudhuri, T Singh Int J Res Health Sci 2 (3), 831-41 , 2014 2014 Citations: 13
Polycystic kidney disease and chronic renal failure in tuberous sclerosis M Dhakal, OP Dhakal, D Bhandari BMJ Case Reports CP 2013, bcr2013200711 , 2013 2013 Citations: 13
Molecular characterization of extended-spectrum beta-lactamases and carbapenemases producing Enterobacteriaceae isolated from North Eastern region of India OPD a Thounaojam Salvia1 , Laishram Shantikumar Singh2 , Rachana Khati1 ... Journal of Laboratory Physicians , 2024 2024 Citations: 6
Clinical presentation, etiology and outcome of upper gastrointestinal bleed from a tertiary care hospital of east sikkim: an observational study M Dhakal Journal of Evolution of medical and Dental Sciences , 2013 2013 Citations: 6
A hospital based cross sectional study to evaluate awareness of lifestyle interventions among hypertensive patients in Sikkim (North-Eastern State of India) M Dhakal, OP Dhakal International Journal of Medical Research and Review 5 (4), 421-428 , 2017 2017 Citations: 5
Hyperglycemia in critically ill patients and its association with increased mortality. A hospital based observational study M Dhakal, OP Dhakal, D Bhandari Int J Med Res Rev 4 (4), 525-30 , 2016 2016 Citations: 5
Sporadic case of visceral leishmaniasis in Sikkim, India L Adhikari, TSK Singh, D Tsering, OP Dhakal, A Gupta Journal of Global Infectious Diseases 2 (2), 196-197 , 2010 2010 Citations: 5
Epidemiology and clinical presentation of patients with atrial fibrillation from a tertiary care hospital of east Sikkim: an observational study M Dhakal, OP Dhakal, P Nandy, M Dhakal JEMDS 2 (20), 3554-60 , 2013 2013 Citations: 4
Evaluation of the relationship between procalcitonin and total leukocyte count, neutrophil and neutrophil/lymphocyte ratio in patients with systemic inflammatory response … OP Dhakal, M Dhakal, N Dhakal J Assoc Physicians India 73 (2), 31-34 , 2025 2025 Citations: 3
Large gastric lipoma BK Sharma, OP Dhakal Kathmandu University Medical Journal 10 (3), 70-72 , 2012 2012 Citations: 3
Acute filarial infection presenting with fits and altered sensorium-rare presentation. A case report M Dhakal, OP Dhakal J Evol Med Dent Sci 2, 3182-3184 , 2013 2013 Citations: 2
Large gastric ulcer: Result of foreign body-induced giant cell reaction M Dhakal, OP Dhakal, M Sherpa, A Gupta, D Bhandari Journal of Digestive Endoscopy 4 (03), 078-081 , 2013 2013 Citations: 1
Kala-azar mimicking chronic liver disease-a rare presentation. A case from Sikkim (North-Eastern state) DROP DHAKAL Journal of Evolution of medical and Dental Sciences , 2013 2013 Citations: 1
Dabigatran-induced gastrointestinal bleed treated by 4-factor prothrombin complex concentrate in a tertiary care hospital in Sikkim. Dhakal M, Dhakal OP Dhakal, NILAY Journal of the Association of Physicians of India, 74 (3), 20–22. , 2026 2026
