Browsing by Author "Kayastha, R"
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Publication Adrenal Ganglioneuroma(Kathmandu University, 2020) Kayastha, R; Acharya, R; Pradhan, S; Tuladhar, AS; Shrestha, AABSTRACT Adrenal ganglioneuromas are rare sympathetic differentiated tumors which originate from neural crest cells. These lesions are usually discovered incidentally on imaging and tend to be hormonally silent. Preoperative diagnosis of adrenal ganglioneuroma remains extremely challenging and the gold standard treatment is adrenalectomy. There is good prognosis after surgery without recurrence. We herein report a case of adrenal ganglioneuroma in a 15 year old female who presented with complaint of abdominal discomfort. Contrast Enhanced Computed Tomography abdomen showed a large septated hypodense right suprarenal mass which was echogenic on Ultrasonography. It showed T1 hypointense and T2 hyperintense signal on Magnetic Resonance Imaging of abdomen and pelvis. Excisional biopsy and histological examination of the mass was suggestive of adrenal ganglioneuroma. This report presents the clinical and radiological data for the rare tumor which would share some experience to facililate the diagnosis of adrenal ganglioneuroma. KEY WORDS Adrenal mass, Computed tomography, Ganglioneuroma, Magnetic resonance imaging, UltrasonographyPublication Post-Operative Pain and Associated Factors in Patients Undergoing Single Visit Root Canal Treatment on Teeth with Vital Pulp(Kathmandu University, 2018) Shresha, R; Shrestha, D; Kayastha, RABSTRACT Background Pain after root canal therapy is unwanted yet common experience for the patient and unpleasant for the dentist so it is always desirable to predict such pain. Objective To evaluate the frequency, intensity and associated factors of post-operative pain after single visit endodontic therapy on teeth with vital pulps. Method A total of 418 single visit root canal treatments were performed on patients of age 18 years and above by two endodontists. Canals were shaped with rotary Pro- Taper files. After the canal preparation, the canals were obturated, using lateral compaction technique, with ProTaper universal gutta-percha and AH-Plus sealer. Independent factors were recorded during the treatment and characteristics of post- operative pain were later surveyed through questionnaires. The severity of pain was recorded on a visual analogue scale (VAS) of 0-5. The data were analyzed using logistic regression models. Result The prevalence of post-operative pain within first six hours after treatment was high (79.2%) which decreased to 22% at the end of 72 hours however majority (70%) of the patients had mild to moderate pain (VAS 1-2). The factors that significantly influenced post-obturation pain experience were: gender (OR=0.55, 95%CI=0.32- 0.93; p=0.03), tooth type (OR-0.67; 95% CI=10.56-0.81, p=0.00), history of pre- operative pain (OR=1.26; 95% CI= 1.04-1.51; p=0.02) and number of canals (OR=2.03; 95% CI=1.40-2.95; p=0.00). Conclusion The prevalence of some level of post -operative pain after single visit root canal therapy was high and was significantly influenced by female gender, increased number of canals, posterior tooth type and positive history of pre-operative pain. KEY WORDS Pain, Post-operative pain, Root canal treatment, Single visit