Browsing by Author "Acharya, Kunjan"
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Publication Aspiration of a Row of Artificial Dentures in an Adult: A Case Report(Nepal Medical Association, 2022) Dulal, Malati; Tripathi, Prashant; Shrestha, Amit; Acharya, Kunjan; Niroula, SaileshAbstract: Clinical findings of foreign body aspiration, generally, are subtle. Scrutinous clinical suspicion is always recommended. Here, we present a rare case of an adult male, who under the influence of alcohol had aspirated a row of his artificial denture without his conscience of where his denture got missing and presented to our outpatient department with non-specific symptoms. With clinical examination and advanced diagnostics, he was successfully managed with rigid bronchoscopy. With the advancement in diagnostic techniques and our widened knowledge of the condition, utmost early detection has been possible and our case report reinforces the need for a low threshold for foreign body aspiration suspicion, especially in adults with dentures, and the use of rigid bronchoscopy as a plausible tool for the prompt management of the aspiration.Publication Aspiration of a Row of Artificial Dentures in an Adult: A Case Report(Nepal Medical Association, 2022) Dulal, Malati; Tripathi, Prashant; Shrestha, Amit; Acharya, Kunjan; Niroula, SaileshAbstract Clinical findings of foreign body aspiration, generally, are subtle. Scrutinous clinical suspicion is always recommended. Here, we present a rare case of an adult male, who under the influence of alcohol had aspirated a row of his artificial denture without his conscience of where his denture got missing and presented to our outpatient department with non-specific symptoms. With clinical examination and advanced diagnostics, he was successfully managed with rigid bronchoscopy. With the advancement in diagnostic techniques and our widened knowledge of the condition, utmost early detection has been possible and our case report reinforces the need for a low threshold for foreign body aspiration suspicion, especially in adults with dentures, and the use of rigid bronchoscopy as a plausible tool for the prompt management of the aspiration.Publication Diagnostic Accuracy of Fine Needle Aspiration Cytology as Compared to Histopathology in Parotid Gland Swelling(Nepal Health Research Council, 2023) Tripathi, Prashant; Acharya, Kunjan; Shrivastav, Shreya; Gyawali, Bigyan RajAbstract Background: The diagnosis of parotid swelling is challenging and investigations like imaging and needle aspiration cytology are helpful. The objective of this study was to determine the diagnostic accuracy of fine needle aspiration cytology (FNAC) as compared to the histopathology in parotid gland swelling. Methods: It was a descriptive cross sectional study carried out in the Department of ENT-Head & Neck Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu by reviewing the medical record charts of the patients who had undergone surgery for parotid lesions during the study period of seven and half years. All patients whose fine needle aspiration cytology and histopathology reports were available were included in the study. The data were presented as mean, standard deviation, ratio and percentages. Microsoft excel was used for data analysis. Results: There were 75 patients included in the study. The age ranged from nine years to 78 years and the mean age being 38.3± 17.42 years. The male to female ratio was 1:1.78. The concordance rate between fine needle aspiration cytology and histopathology was 82.7%. The sensitivity and specificity of the fine needle aspiration cytology were 80% and 95% respectively. Similarly, the positive predictive and negative predictive values were 84% and 93% respectively. The diagnostic accuracy of the fine needle aspiration cytology was 91% for the parotid swelling in our study. Conclusions: The diagnostic accuracy of fine needle aspiration cytology for parotid swellings in our study was excellent. The result of fine needle aspiration cytology is helpful in deciding management plan for parotid lesions. Keywords: Benign; cytology; histopathology; malignant; parotid.Publication Microbiological Profile and Drug Sensitivity Pattern in Persistently Discharging Ears: A Tertiary Level Hospital Based Retrospective Study(Institute of Medicine, 2020) Gyawali, Bigyan R; Pradhanaga, Rabindra B; Rayamjhi, Pabina; Dongol, Kripa; Gupta, Mudit; Shrestha, Lava; Acharya, KunjanABSTRACT Introduction: Antimicrobial resistance is an emerging issue resulting from the misuse of antibiotics in today’s world. As an effect of it, cases with persistent ear discharge not responding to the conventional oral antibiotics prescribed in ear pathologies are seen increasing in our day to-day practice. This study aims to review the microbiological growth and the pattern of their antibiotic sensitivity in this group of population. Methods: This was a retrospective study which was conducted at the Department of ENT-HNS of Tribhuvan University Teaching Hospital. Record files of all cases who presented with persistently discharging ear for more than 2 weeks and not responding to oral antibiotics, between January 2017 to March 2020 were assessed. Cases of chronic otitis media (COM) squamous with persistent discharge were excluded as most of the times it is the disease process rather than type of organism which causes the persistence of ear discharge despite the use of antibiotics. Results: COM mucosal and cavity infection following modified radical mastoidectomy (MRM) were the commonest pathologies. Pseudomonas aeruginosa (PA) and Coagulase negative Staphylococcus (CoNS) were the commonest bacterial isolates. Pseudomonas aeruginosa showed a good sensitivity to antibiotics like Tazobactam and Piperacillin and resistance to conventionally used antibiotics like Ciprofloxacin and Levofloxacin. Similarly, CoNS had good sensitivity to antibiotics like Oxacillin and Levofloxacin and resistance to conventionally used antibiotics like Amoxicillin. Conclusion: COM mucosal and post MRM cavity infection are the commonest pathologies presenting with persistent ear discharge with PA and CoNS as the predominant isolates. Pseudomonas aeruginosa holds a good sensitivity to drugs like Tazobactam and Piperacillin; and CoNS to drugs like Oxacillin and Levofloxacin. Keywords: Drug sensitivity, ear discharge, microbiological, persistentPublication Prevalence of Post Tonsillectomy Haemorrhage at a Tertiary Care Centre in Nepal(Nepal Medical Association, 2021) Tripathi, Prashant; Bajracharya, Rohita; Acharya, Kunjan; Kharel, Bijaya; Neupane, Yogesh; Dutta, Heempali; Dongol, Kripa; Gurung, UrmilaAbstract: Introduction: Tonsillectomy is one of the common ENT surgical procedures. Post-tonsillectomy haemorrhage remains a frequent complication which can be potentially life-threatening. The objective of the present study was to calculate the prevalence of haemorrhage following a tonsillectomy at a tertiary care centre. Methods: It was a descriptive cross-sectional study performed by medical chart review of the patients who underwent tonsillectomy from January 2018 to December 2019 at the department of ENT- Head and Neck Surgery of Tribhuvan University Teaching Hospital. Ethical approval was obtained from the institutional review committee (Ref:-282(6-11) E2 076/077). Convenient sampling method was used. All patients of any age who had tonsillectomy for recurrent tonsillitis or tonsillar hypertrophy with or without obstructive sleep apnoea and no missing information on chart review were included in the study. Data were entered in MS-Excel 2007 and analyzed in rate and percentage. Results: Ten (5.18%) out of a total of 193 patients who underwent tonsillectomy had a post tonsillectomy haemorrhage. All 10 (100%) were adults patients, operated for recurrent tonsillitis, and used electrocautery. It was common in male patients 7 (70%). All of the haemorrhages was between a third and sixth postoperative day and were mild in severity. Conclusions: The prevalence of post-tonsillectomy haemorrhage was high at our centre during the study period of two years. It was common in adults, males and surgery done for recurrent tonsillitis using electrocauterization.