NepMed Repository :: Browsing by Author "Bastola, Priska"

Browsing by Author "Bastola, Priska"

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Case Report on Pseudoaneurysm of Brachial Artery: A Rare Complication of Paediatric Supracondylar Humerus Fracture Pinning
(Institute of Medicine, 2019) Bhandari, Prawesh S; Bastola, Priska; Gurung, Dinesh
ABSTRACT Pseudoaneurysm (PA) of the brachial artery in pediatric supracondylar humerus fracture who have undergone closed reduction and percutaneous pinning is a rare complication. A few cases have been reported in medical literature. This case report sheds some insight into early identification and management outcome of such complication. Rapidly progressive swelling in antecubital fossa in cases of supracondylar fracture who have undergone pinning should arouse suspicion of vascular lesion. It should be timely intervened. Surgical intervention of pseudoaneurysm with reversed saphenous venous graft has shown to have no early vascular complication. Keywords: Case report, supracondylar fracture, pseudoaneurysm, supracondylar fracture
Comparison of Sevoflurane and Isoflurane for Myocardial Protection During Coronary Artery Bypass Surgery in a Tertiary Care Center in Nepal
(Institute of Medicine, 2019) Bastola, Priska; Bishwas Pradhan,; Basnet, Madindra
ABSTRACT Introduction Myocardial protection during Coronary Artery Bypass Graft (CABG) has always been an area of concern so we aimed to evaluate the level of release of Creatine Phosphokinase (CPK-MB) and Troponin I (cTnI) at various time intervals in the first 24 hours after on pump CABG in patients receiving either Sevoflurane or Isoflurane. Furthermore clinically relevant patient outcomes were also evaluated in patients undergoing on pump coronary artery bypass grafting. Methods This was a prospective randomized trial in patients undergoing on pump coronary artery bypass graft surgery, which was conducted from January 2016 till June 2017. A total of 105 patients were enrolled out of which there were 53 in Isoflurane and 52 in Sevoflurane group who received the respective volatile anesthetic agents throughout the surgery except during bypass at 1-1.5 MAC. The primary outcome was comparison of the CPK MB and cTnI levels at 0 hr, 6 hr, 12 hr and 24 hr after surgery from baseline, whereas the secondary outcomes were duration of intensive care unit stay, usage of vasopressors and inotropes, renal dysfunction, stroke. Results No significant difference in CPK MB and cTnI levels at all time intervals in both the groups, the other secondary outcome parameters were comparable. Conclusion The study found no difference in the cardiac markers between the two anesthetics. Based on the data, Sevoflurane and Isoflurane might be used equivalently in patients undergoing coronary artery bypass graft surgery with extracorporeal circulation without any difference in their myocardial protection function. Keywords: Coronary artery bypass graft, isoflurane, myocardial injury, myocardial protection, sevoflurane
Comparison of EuroSCORE II with EuroSCORE in Cardiac Surgical Patients in a Tertiary Level Teaching Hospital in Nepal
(Institute of Medicine, 2020) Pradhan, Bishwas; Bastola, Priska; Basnet, Madindra B; Shrestha, Bibhush; Sigdel, Shailendra; Gurung, Arjun
ABSTRACT Introduction: European System for Cardiac Operative Risk Evaluation (EuroSCORE) is the standard tool for risk stratification of patients undergoing cardiac surgery. Its relevance has been validated in European, Asian countries and also in Nepal. Its limitations led to development of EuroSCORE II. This study was carried out to compare EuroSCORE II with EuroSCORE in Nepalese cardiac surgical patients. Methods: A retrospective analytical cohort study of 3 years duration in 972 adult cardiac surgeries was conducted. Scores obtained from EuroSCORE (Logistic and Additive) and EuroSCORE II was compared with the observed mortality. Calibration was calculated by Hosmer- Lemeshow (H-L) test (Chi Square test) and discrimination by calculating the area under the curve (AUC) of receiver operating characteristics (ROC) curve. Results: Observed mortality was 4.11%. EuroSCORE additive, logistic and EuroSCORE II predicted mortality were 4.32%, 4.55% and 2.13% respectively. H-L chi square calculation for EuroSCORE additive model could not hold as all observed and expected frequencies match exactly. Hence it can be considered as a good fit. EuroSCORE logistic model (H-L, Chi-square 7.743, p<0.001) and EuroSCORE II (H-L, Chi-square 11.631, p = 0.168) also showed good fit i.e. both can predict mortality satisfactorily. AUC of ROC curve of EuroSCORE additive, logistic and EuroSCORE II were 0.632, 0.636 and 0.616 respectively, which showed fair discrimination power. Conclusion: Mortality prediction of adult cardiac surgical patients by EuroSCORE (additive and logistic) and EuroSCORE II was satisfactory. Keywords: Additive, cardiac surgical, EuroSCORE, logistic
Prevalence of Surgical Glove Perforation in Orthopedic Surgery at Tribhuvan University Teaching Hospital: An Observational Study
(Nepal Medical Association, 2025) Bhandari, Prawesh Singh; Adhikari, Shirish; Deo, Nitish Bikram; Uprety, Suresh; Bastola, Priska
Abstract Introduction: Gloves provide a physical barrier preventing cross-infection between the operating team members and the patient. However, there is always a chance of the gloves perforating and breaching this barrier. This study attempts to understand the prevalence of perforation of surgical gloves in orthopedic surgery at Tribhuvan University Teaching Hospital. Methods: This was an observational cross-sectional study carried out over three months. Gloves from the chief and first assistant surgeons were checked for visible perforation and occult perforation by water leak test. The type of surgery, hand dominance, duration of surgery, time during surgery when perforation occurred, and area of glove perforation were noted. Operative perforation rate, Overall glove perforation, and Operative perforation based on type of surgery, and duration of surgery were calculated. The categorical variables obtained were summarized with frequency and percentage. Results: A total of 166 cases were included in the study. The operative perforation rate was 79 (47.59%; 95% CI: 39.80-55.47%) and the overall glove perforation was 117 (8.81%). Trauma surgery was the most common surgery performed during this study 111 (66.86%) and 56 (50.45%) of trauma surgery cases had glove perforation. Glove perforation was noticed by 25 (43.85%) of chief surgeon during surgery, out of which 11 (44%) of it was between 0.5 to 1 hour. Similarly, 20 (50%) of assistant surgeon noticed glove perforation during surgery, out of which 9 (45%) of it was between 1 to 1.5 hour after starting the surgery. Conclusions: Perforations of the surgical gloves was comparable to other published literature. Trauma surgery was the most common

Browsing by Author "Bastola, Priska"

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