Browsing by Author "Gyawali, Bigyan Raj"
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Publication Diagnostic Accuracy of Fine Needle Aspiration Cytology as Compared to Histopathology in Parotid Gland Swelling(Nepal Health Research Council, 2023) Tripathi, Prashant; Acharya, Kunjan; Shrivastav, Shreya; Gyawali, Bigyan RajAbstract Background: The diagnosis of parotid swelling is challenging and investigations like imaging and needle aspiration cytology are helpful. The objective of this study was to determine the diagnostic accuracy of fine needle aspiration cytology (FNAC) as compared to the histopathology in parotid gland swelling. Methods: It was a descriptive cross sectional study carried out in the Department of ENT-Head & Neck Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu by reviewing the medical record charts of the patients who had undergone surgery for parotid lesions during the study period of seven and half years. All patients whose fine needle aspiration cytology and histopathology reports were available were included in the study. The data were presented as mean, standard deviation, ratio and percentages. Microsoft excel was used for data analysis. Results: There were 75 patients included in the study. The age ranged from nine years to 78 years and the mean age being 38.3± 17.42 years. The male to female ratio was 1:1.78. The concordance rate between fine needle aspiration cytology and histopathology was 82.7%. The sensitivity and specificity of the fine needle aspiration cytology were 80% and 95% respectively. Similarly, the positive predictive and negative predictive values were 84% and 93% respectively. The diagnostic accuracy of the fine needle aspiration cytology was 91% for the parotid swelling in our study. Conclusions: The diagnostic accuracy of fine needle aspiration cytology for parotid swellings in our study was excellent. The result of fine needle aspiration cytology is helpful in deciding management plan for parotid lesions. Keywords: Benign; cytology; histopathology; malignant; parotid.Publication Prevalence of Bilateral Vocal Fold Palsy in Cases with Perinatal Hypoxia(Institute of Medicine, 2025) Gyawali, Bigyan Raj; Dutta, Heempali; Neupane, Yogesh; Pokhrel, Sishir; Guragain, Rajendra; Shrestha, Laxman; Basnet, Srijana; Balakrishnan, Karthik; Sidel, DouglasABSTRACT Introduction: There is a notable gap concerning the potential impact of perinatal hypoxia on laryngeal innervation and its role as a causative factor for bilateral vocal fold palsy (BVFP) in children. This study aims to assess the prevalence of BVFP in cases with perinatal hypoxia. Methods: This cross-sectional study took place at the Department of Ear, Nose, and Throat (ENT) and the Department of Pediatrics of Institute of Medicine, Kathmandu, Nepal. Institutional Review Board approval was obtained. From November 2019 to March 2023, all children under 2 years of age with documented perinatal hypoxia were included. Exclusion criteria comprised cases without parental consent, identification of another identifiable cause of BVFP, or the child being on oxygen support during examination, preventing laryngoscopy. Additionally, a retrospective cohort analysis included all BVFP patients at the department between January 2013 and November 2019 to validate our findings. Results: The study included 21 cases, and none of those with perinatal hypoxia exhibited BVFP. Furthermore, the retrospective cohort of BVFP cases presenting at our department did not reveal a significant history of perinatal hypoxia. Conclusion: Our study did not yield compelling evidence linking perinatal hypoxia with BVFP however, considering the constraints of our study, insights from existing literature and absence of prior research in this area, the hypothesis of perinatal hypoxia's impact on laryngeal innervation merits further, more comprehensive research in this area. Keywords: Hypoxic injury; perinatal hypoxia; vocal fold palsyPublication 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.