Browsing by Author "Koirala, Dinesh P"
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Publication Emergency Transport, Diagnosis and Resuscitation of Penetrating Injury Caused by Iron Rod: A Case Report(Institute of Medicine, 2021) Shrestha, Jukel; Bastola, Hemanta; Koirala, Dinesh P; Shakya, Jasmine; Bom, Rabin; Maharjan, Ramesh K; Shakya, Yogendra M; Prasad, Pratap NABSTRACTForeign bodies with their long edges that penetrate the body are potentially life-threatening, owing to the resulting hemorrhagic shock and visceral damage. In an under-resourced environment, the outcome after major impalement injury can be improved by (a) rapid transport with the impaled object in situ (b) quick assessment and resuscitation in the emergency room (c) transport to operating room for definitive care. We report here the successful management of penetrating long iron rod injury from the perineum to the loin of pediatric patient, including transport from rural to tertiary hospital, diagnosis and, resuscitation. Keywords: Fall injury, iron rod, penetrating injury, perineal impalement injury, prehospital carePublication Three Week or One Week Bladder Catheterization in Reducing Urethrocutaneous Fistula for Hypospadias Repair: A Randomized Controlled Trial(Institute of Medicine, 2021) Shrestha, Sandesh; Shrestha, Gyaneswhor; Verma, Rupesh; Koirala, Dinesh P; Chapagain, Suman; Dahal, Geha RABSTRACT Introduction: Surgical correction is the only treatment for hypospadias. Complication rate is usually high. Indwelling catheter is kept postoperatively for urinary diversion and proper healing. There is no consensus regarding the duration of catheterization. This study was conducted to compare urethrocutaneous fistula (UCF) rate between one and three weeks of catheterization. Methods: This study was a randomized control trial, conducted at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. All children undergoing urethroplasty for hypospadias were randomized into two groups. After surgery, urinary catheter was kept for one and three weeks in group 1 and group 2 respectively. Occurrence of UCF and other complications were noted and compared between the groups. Results: A total of 32 patients were randomized in to 2 groups having 16 in each group. Fourteen (43.8%) developed UCF. In one week group, 8 (50%) and in three week group 6(37.5%) developed UCF. It was not statistical different (p = 0.48). Occurrence of UCF was not different in different age of children, type of hypospadias and single or staged procedure. Meatal stenosis was not different in both groups. Conclusion: Incidence of UCF was not different in one week or three week of urinary catheterization after surgery for hypospadias. Keywords: Catheter duration,hypospadias surgery, meatal stenosis, urethrocutaneous fistula