Browsing by Author "Gurung, Urmila"
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Publication A Large Follicular Adenomatoid Odontogenic Tumor Occupying the Maxillary Sinus: A Case Report(Nepal Medical Association, 2023) Maharjan, Leison; Gurung, Urmila; Pradhan, BibhuAbstract Adenomatoid odontogenic tumour is a rare benign, odontogenic tumour with uncertain histogenesis. Whether it is a hamartoma or a neoplasm is still a controversial topic. It is usually associated with an unerupted maxillary canine. Here, we discuss a follicular adenomatoid odontogenic tumour in a young girl with uncommon features such as it arose from two unerupted teeth and partial resorption of the roots of other normal teeth. The tumour was large enough to completely occupy the maxillary sinus. It was treated with enucleation and curettage by lateral rhinotomy approach.Publication Intranasal Corticosteroid Spray Usage in Patients with Allergic Rhinitis: Correctness in Technique and Compliance(Institute of Medicine, Tribhuvan University, 2024) Gurung, Urmila; Khadgi, SajishAbstract: Introduction Intranasal corticosteroid spray (INCS) needs to be administered correctly and regularly for it to be effective in treating allergic rhinitis. This study aimed to assess the correctness of technique and compliance of intranasal corticosteroid spray usage in patients with allergic rhinitis. Methods It was a cross-sectional study conducted in the Dept of ENT-Head and Neck surgery, Tribhuvan University Teaching Hospital from April to September 2023. Patients aged 18 or more with allergic rhinitis on INCS or had been on INCS in the past three months were assessed for INCS administration technique based on EPOS 2020 checklist and their compliance asked. Factors that could hinder the correct techniques and compliance were assessed. Results A total of 138 patients, 71 males and 67 females, aged 18 to 55 years were included. Most of them (60/138; 43.5%) had completed secondary level education. 97.1% (134/138) had been prescribed INCS spray by ENT doctor and 89.13% (124/ 138) had received verbal instructions mostly by ENT doctor (91.1%). 7.2% (10/138) completed all the steps as per EPOS 2020 checklist whilst 25/138 (18.1%) completed five essential steps. The correctness of the INCS administration technique however did not differ with age, gender, academic qualification, prescriber or whether instructions were given or not. 119/138 (86.2%) patients reported being compliant. Conclusion INCS spray was scarcely administered with the correct technique although the compliance was good. This study emphasizes the need for effective patient and healthcare worker education pertaining to correct INCS technique.Publication Ringer’s Lactate versus Isotonic Saline: The Nasal Irrigation Solution of Choice in Chronic Rhinosinusitis(Institute of Medicine, Tribhuvan University, 2024) Gurung, Urmila; Devkota, Anuj; Pokhrel, Shishir; Pradhan, BibhuAbstract: Introduction Nasal douching is a simple and highly effective treatment option for chronic rhinosinusitis. This study aimed to compare the efficacy of Ringer’s lactate versus isotonic saline for nasal irrigation in treating chronic rhinosinusitis (CRS) with or without polyposis using the SNOT-22 score. Methods This quasi-experimental study was conducted at the Department of ENT and Head & Neck Surgery, Tribhuvan University Teaching Hospital, from September 2020 to November 2021. Seventy-eight patients aged ≥ 16 years with CRS were included in the study. Patients were grouped into either isotonic saline or Ringer’s lactate groups based on the clinician’s preference. Nasal irrigation was prescribed for four weeks. Pre and post-irrigation SNOT-22 scores were analyzed using paired t-test and Student’s t-test. Results A significant improvement in the SNOT-22 scores before and after nasal irrigation was observed in both the Ringer’s lactate (26.76±14.07 vs 14.41±7.92, p<0.001) and isotonic saline groups (24.64±11.12 vs 12.58±6.62, p<0.001). However, the difference in post-nasal irrigation SNOT-22 scores between these groups remained statistically insignificant (p=0.27). Common symptoms such as nasal blockage and thick nasal discharge showed substantial improvement. The most common side effect was fluid pooling in the paranasal sinuses. Conclusion Both isotonic saline and Ringer’s lactate were effective for nasal irrigation in patients suffering from chronic rhinosinusitis, with no significant difference in their efficacy, making either solution a suitable choice for nasal irrigation in the management of the CRS.