Ayush Anand


MBBS Student
B. P. Koirala Institute of Health Sciences, Dharan, Nepal




Ayush is interested in doing research in Medicine, Medical Education, Biomedical Ethics, Public Health, and Mental Health.


Scopus Publications

Scopus Publications

  • Kyasanur Forest Disease: Clinical manifestations and molecular dynamics in a zoonotic landscape
    Amogh Verma, Ayush Anand, Ajeet Singh, Abhinav Khare, Ahmad Neyazi, Sarvesh Rustagi, Neelima Kukreti, Abhay M Gaidhane, Quazi Syed Zahiruddin, and Prakasini Satapathy

    Elsevier BV

  • The Emerging Concern of Chronic Wasting Disease (CWD) in Humans
    Amogh Verma, Ayush Anand, Prakasini Satapathy, Abhay M. Gaidhane, Quazi Syed Zahiruddin, and Vivek Sanker

    SAGE Publications

  • Addressing the Multifaceted Challenge of Salmonella: Comprehensive Analysis of a Recent Outbreak and Future Strategies
    Amogh Verma, Ayush Anand, Sai Gautham Kanagala, Prakasini Satapathy, Abhay M. Gaidhane, and Quazi Syed Zahiruddin

    SAGE Publications

  • Addressing the Widespread Anthrax Outbreak in Zambia: A Call for Integrated Public Health Action
    Amogh Verma, Ayush Anand, Parshant Yadav, Parth Gupta, and Prakasini Satapathy

    SAGE Publications

  • Immune thrombocytopenic purpura after influenza vaccine administration; a systematic review and meta-analysis
    Mohamed Elsaid, Arvind Nune, Aml M. Brakat, Ayush Anand, Mahmoud Alashwah, Ahmed Maher, Nitu Lama, and Criselle Angeline C. Peñamante

    Springer Science and Business Media LLC
    Abstract Background The American Society of Haematology defines immune thrombocytopenic purpura (ITP) as a common hematologic disorder characterized by a transient or long-term decrease in platelet counts (< 100 × 109/L.), purpura, and haemorrhagic episodes caused by antiplatelet autoantibodies, with the exclusion of other clinical conditions. We aimed to systematically determine the incidence of ITP in adults and children following influenza vaccination, the duration between vaccination and the occurrence of ITP, and to identify predictors of ITP after the vaccine. Methods We searched PubMed, Cochrane Library, Google Scholar, Web of Science, Scopus, and Science Direct. We included primary studies that assessed the occurrence of immune thrombocytopenia in individuals who had received any influenza vaccine (primary or booster dose), regardless of the dosage, preparation, time of administration, or age of the participants. We excluded studies that were (a) Narrative, scoping, and umbrella reviews ;(b) studies with no accessible full text, abstract-only studies, or (c) Overlapping or unreliable data. The risk of bias in the included studies was assessed using the Joanna Briggs Institute (JBI) tool. We categorized studies for qualitative analysis based on study design. Descriptive statistics were used to summarize quantitative data, including the incidence of ITP after influenza vaccination. Results Out of 729 articles retrieved from the database search, we included 24 studies. All patients identified and included in this systematic review presented with immune thrombocytopenia, determined by their platelet count. The period between vaccination and the occurrence of ITP ranged from (2:35 days). The mean duration was 13.5 days. The analysis revealed a statistically significant incidence rate ratio (IRR) = 1.85,95% CI [1.03–3.32] of ITP occurrence after 42 days. Conclusions Influenza-associated ITP is uncommon, self-limiting, non-life-threatening, and curable. None of the patients reported having severe adverse events or death. Further studies are required to confirm the exact incidence of the ITP to better understand the pathophysiology of ITP development post-influenza vaccination.

  • Nephrotic syndrome following COVID-19 vaccination: a systematic review
    Charmy Parikh, Henil Upadhyay, Suyog Patel, Ramaswamy Sundararajan, Dhairya Shah, Ayush Anand, Bhavana Baraskar, Tulsi Bhatt, Deepak Verma, Shubham Agrawal,et al.

    Springer Science and Business Media LLC

  • Management of calcified right atrial myxoma extending into the inferior vena cava: A case report
    Mohammad Qaiser Aziz Khan, Amna Zaheer, Sarib Bin Yasir, Ramsha Fatima, and Ayush Anand

    Oxford University Press (OUP)
    Abstract Cardiac myxomas can rarely involve the right atrium, get calcified and involve the inferior vena cava (IVC). Early surgical intervention is critical to prevent life-threatening complications. We presented the case of a 39-year-old male with fever, cough and shortness of breath for 1 week. Initial laboratory investigations revealed leucocytosis and thrombocytopenia. His electrocardiogram was normal, and his chest X-ray showed bilateral infiltrates. Based on the findings of a high-resolution chest computed tomography scan, echocardiography and cardiac magnetic resonance imaging, we made a provisional diagnosis of calcified right atrial myxoma extending up to the IVC. We managed the case with cardiopulmonary bypass via aortic cannulation followed by a right atriotomy. Post-operatively, the patient’s condition improved and was doing well on monthly follow-ups.

  • Cardiovascular Disease Outcomes Associated with Obstructive Sleep Apnea in Diabetics: A Systematic Review and Meta-Analysis
    Ganesh Bushi, Bijaya Kumar Padhi, Muhammed Shabil, Prakasini Satapathy, Sarvesh Rustagi, Keerti Bhusan Pradhan, Zahraa Haleem Al-qaim, Jagdish Khubchandani, Ranjit Sah, Sanjit Sah,et al.

    Background: There is significant pathogenic and epidemiological overlap between diabetes and obstructive sleep apnea (OSA). This systematic review aimed to ascertain the association between OSA and cardiovascular disease (CVD) in a diabetic population. Methods: The study protocol was registered with PROSPERO (CRD42023404126). On 15 July 2023, a comprehensive search of the literature was performed in PubMed, EBSCO, Scopus, ProQuest, and Web of Science, using keywords and synonyms of OSA, diabetes, and CVD, coupled with specific terms for different CVDs. Only observational studies that reported CVD events in diabetics (with and without OSA) were included. The quality of the studies included in the analysis was assessed using the Newcastle–Ottawa Scale. Results: In the primary literature search, 8795 studies were identified, of which 9 met the inclusion criteria and included 17,796 participants. Eight studies were eligible for meta-analysis, and a pooled risk ratio (RR) of 1.29 (95% CI = 0.91–1.83) was found for developing CVD in diabetics with OSA at a 95% prediction interval of 0.30–5.60. The included studies showed significant heterogeneity with an I2 value of 91%. Conclusion: These findings show the possible association between OSA and diabetes and their impact on CVDs. Identifying and managing OSA in individuals with diabetes at an early phase could potentially reduce the risk of CVDs and its related complications.

  • Severe homozygous HbE disease: the first case report from Nepal
    Urza Bhattarai, Dibasha Adhikari, Arun Gautam, Ayush Anand, Bhupendra Shah, and Sanjib Kumar Sharma

    Oxford University Press (OUP)
    Abstract Hemoglobin E (HbE) is the most prevalent hemoglobinopathy in the eastern Indian subcontinent. We presented the case of a 53-year-old male from Nepal with a history of multiple blood transfusions who presented with abdominal fullness for 15 years and easy fatigability for 2 months. He had pallor and massive splenomegaly. Laboratory parameters showed pancytopenia with microcytic anemia, indirect hyperbilirubinemia, target cells in the peripheral smear and iron overload. A computed tomography scan of the abdomen showed multiple splenic infarcts. Hemoglobin electrophoresis was suggestive of HbE homozygous disease. Based on these findings, we made a diagnosis of HbE homozygous disease. We provided symptomatic treatment and folic acid supplementation and counseled him for splenectomy and genetic screening. Our case highlighted the uncommon presentation of Hb E disease.

  • Health-related quality of life measured by SF-36 among postdelivery mothers attending maternal and child health clinic in Eastern Nepal: a cross-sectional study
    Pratiksha Chapagain, Prajjwal Pyakurel, Ayush Anand, Ashwini Gupta, and Durga Subedi

    Ovid Technologies (Wolters Kluwer Health)
    Objectives: Assessing health-related quality of life (HRQoL) and its associated factors is essential for providing adequate healthcare and developing necessary interventions in women postdelivery. This study intended to find out the HRQoL score and related factors among women postdelivery in Nepal. Methodology: This was a cross-sectional study using nonprobability sampling conducted at a Maternal and Child Health (MCH) Clinic in Nepal. The study participants were 129 women postdelivery to 12 months who visited the MCH Clinic from 2 September 2018 to 28 September 2018. Outcome measures were sociodemographic, clinical indicators, obstetric indicators, and their relation with the overall HRQoL score of postdelivery mothers using the Short Form Health Survey (SF-36) Version 1. Results: Of 129 respondents, 68.22% were in the 21–30 age group, 36.43% were upper caste, 88.37% were Hindu, 87.60% were literate, 81.39% were homemakers, 53.49% with income less than 12 months, 88.37% had family support, and 50.39% with vaginal deliveries. HRQoL was significantly more in employed women (P=0.037), those with family support (P=0.003), and those who had a cesarean section (P=0.02) and wanted pregnancy (P=0.040). Conclusion: HRQoL in women postdelivery can be influenced by employment status, family support, type of delivery, and desirability of pregnancy.

  • Effectiveness of artificial intelligence-assisted colonoscopy in early diagnosis of colorectal cancer: a systematic review
    Aashna Mehta, Harendra Kumar, Katia Yazji, Andrew A. Wireko, Jai Sivanandan Nagarajan, Bikona Ghosh, Ahmad Nahas, Luis Morales Ojeda, Ayush Anand, Medha Sharath,et al.

    Ovid Technologies (Wolters Kluwer Health)
    INTRODUCTION As AI-assisted diagnosis gained immense popularity, it is imperative to consider its utility and efficiency in the early diagnosis of colorectal cancer, responsible for over 1.8 million cases and 881,000 deaths globally, as reported in 2018. Improved adenoma detection rate, as well as better characterizations of polyps, are significant advantages of AIC. This systematic review investigates the effectiveness of AIC in the early diagnosis of CRC as compared to conventional colonoscopy. METHODS Electronic databases such as PubMed/Medline, SCOPUS, and Web of Science (WOS) were reviewed for original studies (randomized controlled trials, observational studies), systematic reviews, and meta-analysis between 2017-2022 utilizing MESH terminology in a broad search strategy. All searches were performed and analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology and were conducted from November,2022. A data extraction form based on the Cochrane Consumers and Communication Review group's extraction template for quality assessment and evidence synthesis was used for data extraction. All included studies considered for bias and ethical criteria and provided valuable evidence to answer the research question. RESULTS The database search identified 218 studies, including 87 from PubMed, 60 from SCOPUS, and 71 from Web of Science databases. The retrieved studies from the databases were imported to Rayyan software and a duplicate article check was performed, all duplicate articles were removed after careful evaluation of the data. The abstract and full-text screening was performed in accordance with the following eligibility criteria: STROBE for observational studies; PRISMA for review articles, ENTREQ for narrative studies; and modified JADAD for randomized controlled trials (RCT). This yielded 15 studies that met the requirements for our systematic review and were finally included in the review. CONCLUSION AIC is a safe, highly effective screening tool that can increase the detection rate of adenomas, and polyps resulting in early diagnosis of colorectal cancer in adults when compared to conventional colonoscopy. The results of this systematic review prompt further large-scale research to investigate the effectiveness in accordance with gender, race, and socioeconomic status as well as its influence on prognosis and survival rate.

  • Immunological and inflammatory effects of infectious diseases in circadian rhythm disruption and future therapeutic directions
    Helen Huang, Aashna Mehta, Jacob Kalmanovich, Ayush Anand, Maria Chilo Bejarano, Tulika Garg, Nida Khan, Gauvain Kankeu Tonpouwo, Anastasiia D. Shkodina, and Mainak Bardhan

    Springer Science and Business Media LLC

  • Gender representation in surgery: progress and challenges in recent years
    Aashna Mehta, Andrew A. Wireko, Favour Tope Adebusoye, Pearl Ohenawaa Tenkorang, Muhammad J. Zahid, Anushka Pujari, Heli Patel, Zoya Morani, Luis Morales Ojeda, Ayush Anand,et al.

    Ovid Technologies (Wolters Kluwer Health)

  • Global population surpasses eight billion: Are we ready for the next billion?
    Nityanand Jain, Islam Kourampi, Tungki Pratama Umar, Zahra Rose Almansoor, Ayush Anand, Mohammad Ebad Ur Rehman, Shivani Jain, and Aigars Reinis

    American Institute of Mathematical Sciences (AIMS)
    <abstract> <p>In November 2022, the global population had officially crossed eight billion. It has long been recognized that socioeconomic or health-related problems in the community always accompany an uncontrolled population expansion. International calls have been made regarding lack of universal health coverage, an insufficient supply of healthcare providers, the burden of noncommunicable disease, population aging and the difficulty in obtaining safe drinking water and food. The present health policy paper discusses how to conquer these crowded world issues, including (1) promoting government and international organization participation in providing appropriate infrastructure, funding and distribution to assist people's health and well-being; (2) shifting health program towards a more preventive approach and (3) reducing inequalities, particularly for the marginalized, isolated and underrepresented population. These fundamental principles of health policy delivery as a response to an increasingly crowded world and its challenges are crucial for reducing the burden associated with excessive healthcare costs, decreased productivity and deteriorating environmental quality.</p> </abstract>

  • Knowledge and attitude regarding the COVID-19 pandemic among undergraduate health science students of Nepal: An online survey
    Ayush Anand, Ashwini Gupta, Sweta Singh, Sulav Pyakurel, Rajendra Karkee, and Prajjwal Pyakurel

    SAGE Publications
    Objectives: This study aims to assess health science students’ knowledge and attitude about COVID-19 epidemiology, management, and prevention; and the association of knowledge and attitude with various sociodemographic characteristics. Methods: An online survey was done among 524 undergraduate health science students using a pre-tested questionnaire across 19 health science institutions in Nepal from 30 June to 11 August 2021. All subjects were enrolled in the study after informed consent. Outcomes were Knowledge level, attitude level, and predictors of knowledge level and attitude level. Bivariate analysis was done to determine the association between variables. Results: Of 524 students, 42.9% were male, and 57.1% were female. More than half (54.6%) and the majority (85.1%) participants had good knowledge and attitude, respectively. Approximately three-fifths (59.4%) of the participants were from the B. P. Koirala Institute of Health Sciences (BPKIHS). Students in BPKIHS (odds ratio = 1.774; 95% confidence interval = 1.243–2.533), junior years (odds ratio = 8.892; 95% confidence interval = 5.814–13.599), age less than 23 years (odds ratio = 2.985; 95% confidence interval = 2.089–4.266) were more likely to have good knowledge. Students under 23 years (odds ratio = 24.160; 95% confidence interval: 9.570–60.992) and those in junior years (odds ratio = 4.460; 95% confidence interval = 3.753–5.300) were likely to have a good attitude level. Students in BPKIHS (odds ratio = 0.443; 95% confidence interval = 0.272–0.722) were less likely to have a good attitude. Conclusions: Overall, health science students had adequate knowledge and a good attitude regarding COVID-19. However, students lacked knowledge regarding infectiousness, transmission, post-vaccination observation period, remdesivir use, convalescent plasma therapy, and awake-prone positioning. Knowledge and attitude scores were associated with age, stream, and study institution.

  • Computational Grafting of Epitopes
    Manish Manish, Smriti Mishra, Monika Pahuja, Ayush Anand, Naidu Subbarao, and Ram Samudrala

    Springer US

  • Clinical Manifestations of Monkeypox
    Haneen Abaza, Kuchalambal Agadi, Ayush Anand, and Mohamed Elsaid

    Springer Nature Switzerland

  • Progressive Cerebral Venous Thrombosis with Cranial Nerve Palsies in an Adolescent African Girl & Associated Diagnostic Pitfalls: A Rare Case Report
    Yonathan Aliye Asfaw, Helen Huang, Muhammad Taimur, Ayush Anand, Sujan Poudel, Tulika Garg, Bethlehem Aliye Asfaw, Befekadu Molalegn Abebe, Hanieh Akbariromani, Gavrilo Lazovic,et al.

    Informa UK Limited
    Abstract Cerebral venous thrombosis (CVT) is a cerebrovascular disorder caused by complete or partial occlusion of the cerebral venous and sinus system. The etiology has been attributed to hypercoagulability and pro-thrombotic states, leading to raised intracranial pressures that often manifest as headaches and focal neurological deficits. However, the multifactorial nature of CVT can create a diagnostic conundrum for clinicians. We describe a unique case of a 16-year-old female who presented with convulsions, postictal confusion, and drowsiness followed by residual weakness of her extremities. She initially presented to the primary care center with headache, high-grade fever, and altered mental status and was empirically treated for pyogenic meningitis. The patient failed to improve with a week of antibiotics and was referred to the tertiary care center for urgent attention. On presentation, the patient developed VI and VII cranial nerve palsy. Subsequently, MRI images showed filling defects in the superior sagittal, right transverse, and sigmoid sinuses with right parietal gyral T1 hyperintensity and T2 hypo-intensity. She was diagnosed with septic CVT based on sinus venous thrombosis and venous infarction, probably secondary to meningococcal pneumonia. It can be challenging to distinguish between both conditions as their presentations overlap. Moreover, cranial nerve palsy is an infrequent manifestation of CVT, with unclear pathogenesis. We highlight the role of neuro-imaging in the early detection of CVT and bring to light the unfamiliar symptoms and a more varied clinical spectrum that may hinder the diagnosis in a limited-resource setting. Future research should be explicitly modeled to improve the diagnostic efficiency of CVT and improve outcomes in younger patient populations.

  • Management of snake bite during third trimester of pregnancy with coagulopathy and delivery of a live baby in resource-limited setting in Nepal: a case report
    Ashwini Gupta, Sudeep Bhandari, Ayush Anand, Sanjib Kumar Sharma, Arun Gautam, K C Priyanka, Neeraj Acharya, and Sweta Singh

    Oxford University Press (OUP)
    ABSTRACT We reported a case of snakebite in an 18-year-old woman, Gravida 2 Para 1+0 in the third trimester of pregnancy who presented with pain and swelling over the left hand and forearm and vaginal spotting. The laboratory investigations revealed coagulopathy attributed to green pit viper envenomation. On the fourth day of admission, the patient developed sudden abdominal pain and massive per vaginal bleeding with haemorrhagic shock, most likely abruptio placentae. In Nepal, no anti-snake venom has been developed for green pit-viper. So, she was managed conservatively, including blood transfusion, and delivered a single live female baby without any foetal complications. The patient was discharged along with the baby after 8 days of hospitalization. This case demonstrated that vigilant observation and appropriate resuscitation with fluids and blood products could save mother and baby in pit viper envenomation cases in settings where specific anti-snake venom is unavailable.

  • Multiple endocrine neoplasia type 1 with suspicion of Zollinger Ellison syndrome in a family with history of renal stones and hypercalcemia in a limited resource setting: a case report
    Kamran Hussain, Jebun Nahar, Fakhar Abbas, Jasir Nawar, and Ayush Anand

    Oxford University Press (OUP)
    ABSTRACT Multiple endocrine neoplasia type 1 (MEN 1) syndrome is a rare autosomal dominant endocrine tumour syndrome, which can be diagnosed clinically based on family history and the existence of MEN 1-associated tumours or molecularly based on genetic testing. We described the case of a Hispanic 55-year-old male presenting with dysphagia, chest pain and diarrhoea for three months with a family history of hypercalcaemia and nephrolithiasis in first-degree relatives. Primary hyperparathyroidism was suggested by hypercalcaemia, elevated parathyroid hormone level, hypercalciuria, nephrolithiasis on abdominal computed tomography scan and enlarged parathyroid gland on computed tomography pulmonary angiogram. Also, patient had hypergastrinemia and a hypodense lesion in the pancreas on computed tomography scan of abdomen. These findings suggested MEN 1 syndrome with high suspicion of associated Zollinger Ellison syndrome. Our case highlights the importance of family history and high clinical suspicion in patients presenting with primary hyperparathyroidism and hypergastrinemia.

  • Management of Psychosis Associated with Graves' Disease: A Rare Case Report
    Ozge Ceren Amuk Williams, Mouad Abdulrahim, Victoria Davis, Charles Jenson, Ayush Anand, and Anil Krishna Bachu

    Hindawi Limited
    Graves’ disease is an autoimmune disease in which patients can rarely present with psychiatric symptoms. In these patients, detailed history with psychiatric evaluation using a mental status examination is crucial for the early identification of psychiatric manifestations. Early intervention with medical and surgical therapy can help effectively treat the condition and prevent adverse outcomes such as catatonia. We reported the case of a 25-year-old African American female with Graves’ disease who had significant stressors and presented with auditory hallucinations. She was diagnosed with psychosis secondary to Graves’ disease and was managed medically using antithyroid drugs and beta-blockers. On failure of medical therapy, a surgical approach was employed. The patient was managed successfully, and her condition improved. Our case highlights that the importance of early intervention in these cases can lead to successful outcomes in patients with Graves’ disease-induced psychosis.

  • Olanzapine-induced restless leg syndrome (Willis–Ekbom disease): A case report
    Soumitra Das, Sakshi Prasad, Ayush Anand, Arghadip Das, Gibson Obinna Anugwom, and Funso Oladunjoye

    SAGE Publications
    Restless leg syndrome, also known as Willis–Ekbom disease, is a neurological sensorimotor disorder accompanied by an irresistible urge to move the legs with a fluctuating course of symptoms. It is a common disorder affecting all ages, with existing comorbidities and positive family history being associated with increased prevalence. Herein, we present a case of a 51-year-old female diagnosed with the bipolar affective disorder who developed restless leg syndrome following the use of olanzapine. Olanzapine is a second-generation antipsychotic which can cause restless leg syndrome due to its anti-dopaminergic action on the nervous system, particularly the spinal cord. Existing literature on olanzapine-induced restless leg syndrome has suggested managing this disorder by reducing the dose or replacing olanzapine with other drugs such as clonazepam, quetiapine, and aripiprazole. In our case, olanzapine was not replaced with other medications as the patient showed a significant improvement in bipolar affective disorder symptoms using olanzapine. Instead, clonazepam was added to the treatment regimen which was scheduled to be taken before olanzapine.

  • Management of scleroderma renal crisis with left ventricular diastolic dysfunction in a resource-limited setting: A rare case report
    Yonathan Aliye Asfaw, Helen Huang, Ayush Anand, Muhammad Taimur, Asad Ali Khan, Sangam Shah, Sujan Poudel, Jack Michel, and George Michel

    SAGE Publications
    Scleroderma renal crisis with left ventricular diastolic dysfunction can lead to significant mortality. We presented the case of a 32-year-old female with anuria for 2 days. On further inquiry, she had joint pain, difficulty turning her head sidewise, and associated difficulty in finger movement. Also, hyperpigmentation with superimposed hypopigmentation was reported, which reduced during her pregnancy and worsened post-partum. Her family history suggested similar complaints in her mother. In addition, she had a blurring of vision. She had hypertension, microangiopathic hemolytic anemia, deranged renal function, and retinopathy on ophthalmologic examination. Radiological investigations revealed pulmonary edema, pleural effusion, and left ventricular diastolic dysfunction. Hence, a diagnosis of scleroderma renal crisis complicated by left ventricular diastolic dysfunction was made. She was managed conservatively using anti-hypertensive medications and hemodialysis, which resulted in gradual improvement. Our case highlighted the management approach to this rare presentation with anti-hypertensives and hemodialysis in a resource-limited setting.