Browsing by Author "Giri, Piyush"
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Publication Outcomes of Finger Replantation in Western Nepal: An Observational Study(Nepal Medical Association, 2025) Giri, Piyush; Shakya, SujanAbstract Introduction: Hand injuries involving finger amputations prevalent in young working populations. This study evaluated the demographics and clinical outcomes of finger replantation procedures performed at a regional referral center in Western Nepal. Methods: This retrospective,observational, cross-sectional study was conducted at the Department of Burns, Plastic and Reconstructive Surgery, Charak Memorial Hospital, Pokhara, from January 2023 to December 2024. Ethical approval was obtained from National Health Research Council on 16 February 2025 (Reference no:1840). All patients who underwent finger replantation procedure with successful artery and venous flow restoration were included. Data on demographics, injury characteristics, surgical techniques, and outcomes were collected. Survival was defined as digit viability for a minimum of 21 days. Functional outcomes were assessed using the Chen functional scoring system at 6 months. Results: A total of 10 finger replantation procedures were performed in 10 patients with mean age of 34.6 ±13.60 years. All patients were male and right-handed. Six(60.00%) patients were employed in blue-collar occupations. The thumb was commonly affected digit accounting for 6(60.00%) cases. The principal mechanism of injury was crush amputation observed in 7(70.00%) cases.Five (50.00%) replanted fingers were categorized as Tamai level III. Successful replantation was achieved in 8(80.00%) fingers. Functional assessment revealed Grade I outcomes in 6(75.00%) cases and Grade III in 2(25.00%) cases. Conclusions: Finger replantation in a resource-limited setting achieved survival rates comparable to international standards. Success was attributed to younger patient age, shorter ischemia time, and appropriate surgical techniques.Publication Rare presentation of Eccrine Porocarcinoma Authors(Nepal Health Research Council, 2024) Giri, Piyush; Pokhrel, Shrinkhala; Pandey, Pratishtha; Khadka, Karuna; Kunwar, Sushma; Banstola, Laxman; Gurung, Narendra VikramEccrine porocarcinoma is a tumor of the sweat gland that mostly develops from an existing benign eccrine poroma. It is a rare cutaneous malignancy with a high risk of metastasis and recurrence. Known to affect the elderly population in general with no gender discrepancy, it presents as an ulcerative mass commonly in the trunk or head/neck region. Definitive diagnosis is made by histopathological findings of peculiar pleomorphic cells with nuclear hyperchromasia and mitotic activity, surrounded by ductal lumen. The standard treatment is complete surgical excision with appropriate surgical margins; adequate work-ups to look for metastasis and timely follow ups for chances of recurrence. Here we report a case of an 82-year-old patient who presented at our department with a long-standing exophytic lesion in the head that rapidly started growing in the past few weeks. After excisional biopsy and histopathology, the diagnosis of Eccrine porocarcinoma was made. Keywords: Cutaneous; eccrine porocarcinoma; malignancy; rare.