Browsing by Author "Dongol, Kripa"
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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 Foreign Body Aspiration in Children in a Tertiary Care Hospital(Nepal Medical Association, 2021) Dongol, Kripa; Neupane, Yogesh; Dutta, Heempali Das; Gyawali, Bigyan Raj; Kharel, BijayaAbstract: Introduction: Foreign body aspiration is a common problem in children with signifi cant mortality and morbidity. This study aims to determine the prevalence of foreign body aspiration in children in a tertiary care hospital of Nepal. Methods: A descriptive cross-sectional study was conducted at Tribhuvan University Teaching Hospital from April 2010 to March 2016 after obtaining ethical approval from Institutional Review Committee (Reference number- 08(6-11)E277/78). All children of age up to 15 years with suspected foreign body aspiration were included. The data was collected from the medical record section and entered in Microsoft Excel. The descriptive statistical analysis was performed. Results: A total of 26,294 patients were included in the study. The prevalence of foreign body aspiration in children was found to be 98 (0.37%). On rigid bronchoscopy, 82 patients (83.6%) were confirmed to have a foreign body in the airway. The peak incidence of foreign body aspiration was seen in patients of age group one to two years. The commonest foreign body in the airway was a peanut. Conclusions: The prevalence of foreign body aspiration in children was low, which is similar to other studies. Foreign body aspiration may lead to dreadful complications. Therefore, both the clinicians and the public need to be cautious about it.Publication 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.Publication Pyogenic Granuloma of External Auditory Canal: A Case Report(Institute of Medicine, 2023) Karki, Utsav R; Dongol, Kripa; Pradhananga, Rabindra B; Shah, Bikash KABSTRACT The external auditory canal is an atypical location for pyogenic granuloma (PG) to originate. We report a case of PG in a 15-year-old boy's external auditory canal. He experienced reduced hearing and occasional blood-tinged ear discharge for 8 months. Examination revealed a pinkish-soft mass occluding the canal lumen. Pure tone audiogram showed 42 dB moderate conductive hearing loss in the right ear. High-resolution computed tomography showed a well-defined, homogenously enhancing soft tissue density lesion in the canal. The mass was completely excised, and post-operative histopathology confirmed the diagnosis of PG. No recurrence was observed during the six-month follow-up period. PG should be considered in the differential diagnosis of external auditory canal lesions. Keywords: External auditory canal, lobular capillary hemangioma, pyogenic granulomaPublication Tracheostomy among Children Admitted in the Pediatric Intensive Care Unit of a Tertiary Care Centre(Nepal Medical Association, 2023) Bathwal, Rahul; Dongol, Kripa; Dutta, Heempali; Neupane, YogeshAbstract Introduction: Tracheostomy is commonly performed for upper airway obstruction, prolonged mechanical ventilation and tracheo-bronchial toileting. Pediatric tracheostomy differs from adult tracheostomy in terms of surgical procedure, post-operative care and recovery. The tracheostomized patients may either be decannulated, discharged with tube-in-situ or the patient may expire. The aim of this study was to find out the prevalence of tracheostomy in patients admitted to the Pediatric intensive care unit of a tertiary care centre. Methods: A descriptive cross-sectional study was performed among children admitted to the Pediatric intensive care unit of a tertiary care centre from 1 May 2017 to 31 August 2022 after obtaining ethical approval from the Institutional Review Committee. A convenience sampling method was used. The point estimate was calculated at 95% Confidence Interval. Results: Among 1472 patients, tracheostomy was done in 65 (4.41%) (3.37-5.47, 95% Confidence Interval). A total of 33 (50.76%) underwent tracheostomy for prolonged ventilation whereas 32 (49.23%) were tracheostomized for airway obstruction. Among them, 41 (63.07%) patients were successfully decannulated, 9 (13.84%) were discharged with tracheostomy tubes in situ whereas 15 (23.07%) patients deceased. The most common complication was tracheostomy tube blockage reported in 5 (7.69%). Conclusions: The prevalence of tracheostomy among the children of the pediatric intensive care unit was found to be lower than in other studies.