Brihaspati.Sigdel

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Brihaspati.Sigdel 👨‍⚕️ Prof Dr. Brihaspati Sigdel | ENT & Head-Neck Surgeon
🔬 Expertise: Thyroid & HN Cancer Surgery | Endoscopic Sinus Surgery | Rhinoplasty

27/08/2026

For people who choose to drink, U.S. guidance commonly defines moderate drinking as:

* Men: up to 2 standard drinks/day
* Women: up to 1 standard drink/day

One standard drink ≈ 12 oz (355 mL) of 5% beer.

21/08/2026
Cervical cancer screening
20/08/2026

Cervical cancer screening

18/08/2026

Posterior epistaxis मा TESPAL को सफलता दर 90% रहेको देखिन्छ।
Hypertension, antiplatelet/anticoagulant प्रयोग तथा previous nasal surgery ले surgical success मा उल्लेखनीय प्रभाव पार्दैन।
त्यसैले uncontrolled posterior epistaxis मा TESPAL प्रभावकारी र भरपर्दो उपचार विकल्प हो।

14/08/2026

SHOCK + AST/ALT >1000 = Ischemic hepatitis

14/08/2026

Anti-HBs + only → 💉 Vaccinated
* Anti-HBs + Anti-HBc + → 🦠 Past infection → Resolved
* HBsAg + → 🦠 Current infection

Exam trick:
👉 Core antibody positive = vaccine होइन।

3 मुख्य marker मात्र सम्झिनुस्:

1. HBsAg = Virus छ?

* + → Current infection
* − → No current infection / resolved

2. Anti-HBs = Immunity छ?

* + → Immune
* Vaccine वा previous infection बाट आउन सक्छ।

3. Anti-HBc = Virus सँग exposure भएको थियो?

* + → Natural infection भएको छ
* ❌ Vaccine ले Anti-HBc बनाउँदैन

14/08/2026

1️⃣ SAAG = “Pressure कि Peritoneum?”

SAAG = Serum albumin − Ascites albumin

* ≥ 1.1 → Portal hypertension → “PRESSURE”
* Cirrhosis
* Heart failure
* Budd-Chiari
* < 1.1 → No portal hypertension → “PERITONEUM”
* Malignancy
* TB
* pancreatitis


Ascitic Total Protein = “Liver vs Heart”

14/08/2026

Epigastric pain relieved by leaning forward =Chronic pancreatitis - do CT Scan to see calcification and structural change

13/08/2026

Errectile dysfunction

Sudden + situational + nocturnal erections present = PSYCHOGENIC
Gradual + vascular risk = VASCULAR
Neuro disease + absent reflex = NEUROLOGIC
Low libido + low T = HYPOGONADISM
New drug → MEDICATION

12/08/2026

Alcohol use disorder treatment:

* Naltrexone → ↓ craving/reward; good if goal is reduced drinking
* Acamprosate → maintains abstinence, especially after detox
* Disulfiram → deterrent; requires highly motivated patient
* Benzodiazepines → withdrawal, not maintenance

Address

Gandaki Medical College, Metrocity Hospital

33700

Opening Hours

Monday 08:00 - 09:00
16:00 - 18:00
Tuesday 08:00 - 09:00
16:00 - 18:00
Wednesday 08:00 - 09:00
16:00 - 18:00
Thursday 08:00 - 09:00
16:00 - 18:00
Friday 08:00 - 09:00
16:00 - 18:00
Sunday 08:00 - 09:00
16:00 - 18:00

Website

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