Browsing by Author "Ghimire, Madhu"
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Publication Diagnostic Yield of Upper Gastrointestinal Endoscopy in Children: A Three Years Experience(Nepal Paediatric Society (JNPS), 2020) Joshi, Binita Gurubacharya; Ghimire, MadhuAbstract: Introduction: Gastrointestinal disorders are very common in paediatric population. Upper Gastrointestinal Endoscopy procedures have increased dramatically worldwide and have contributed in identification of various gastrointestinal disorders along with therapeutic benefits. However, it is recently being established in paediatric population in Nepal and proper data is scarce. This study was aimed to assess upper gastrointestinal endoscopy with respect to its indications and diagnostic yield at a tertiary centre over a three years period. Methods: This is a retrospective observational study where data of all paediatric patients between the age group 0 - 15 years having various gastrointestinal problems who underwent upper gastrointestinal endoscopy from March 2013 - Feb 2016 in our centre were analysed. Results: Among 270 patients, males comprised 60% and females comprised 40%. Age range was 0 - 15 years and majority were from the age group between 10 to 15 years (66.2%). Most common indications for endoscopy were chronic abdominal pain (58.8%), acute epigastric pain (18.5%), followed by failure to thrive (7%). Abnormal findings were detected in 250 patients (92.5%); gastroduodenitis (28.14%), antral gastritis (18.51%), erosive gastritis (15.92%), duodenitis (9.25%), hiatus hernia (7.4%), varices (5.5%) were common findings. Histopathologically, chronic gastritis and duodenitis (72%) were common findings followed by acute gastritis and giardiasis. Among 80 patients who underwent RUT, 50% each had positive and negative results. Conclusion: Chronic abdominal pain remains common gastrointestinal problem in children. With the advent of upper gastrointestinal endoscopy various gastrointestinal problems can be identified and managed accordingly. Along with the facility of histopathology, diagnostic yield and outcome is further enhanced.Publication Esophageal Stricture Post Accidental Corrosive Ingestion: A Case Report(Nepal Paediatric Society (JNPS), 2016) Joshi, Binita Gurubacharya; Lamichhane, Ritu; Ghimire, MadhuAbstract: Corrosive substance ingestion is a seriouspublic health hazard. Mostly, children are victim due to accidental ingestion occurring commonly in less than five years. Whether acid or alkali, the ingestion may have catastrophic effects and the outcomes can vary from minimal injury to perforation and death. Esophagogastroduodenoscopy should be done 12-24 hours of ingestion in order to assess the extent of mucosal injury. Esophageal stricture remains one of the major sequel usually seen after three weeks of ingestion. Endoluminal dilatation is current recommendation for initial treatment of stricture and surgery should follow for strictures refractory to dilatation. We here present a case of a five year old child with accidental corrosive ingestion at her school which led to esophageal stricture. She underwent multiple dilatation of stricture followed by esophageal corrective surgery which again led to post-surgical stricture requiring further dilatations.