Browsing by Author "Koirala, N"
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Publication Demographic and Clinical Profile of Women Attending Genetic Clinic for Prenatal Invasive Testing at a Tertiary Referral Center, India(Kathmandu university, 2021) Koirala, N; Kafle, SPABSTRACT Background The Prenatal Invasive Tests (PIT) are used during pregnancy for the detection of genetic anomalies. Studies addressing the profile of women who come to seek prenatal invasive testing are scarce. Objective To assess the socio-demographic characteristics and clinical profile of women who are referred for prenatal invasive testing in a tertiary referral center in India. Method A descriptive, cross-sectional study was undertaken in 60 women who came to the genetic clinic at a tertiary referral center, New Delhi, India following counseling regarding prenatal invasive testing. Data was collected using a self-developed and validated semi-structured questionnaire, administered after the counseling for the test by the counselor. Data were analyzed using mean, percentage, standard deviation and range. Result The majority of the women were from urban residences and all of them were literate. Nearly half of the women were in the age group 21-30 years. Mean gestational age was 19.24 ± 2.63 weeks and most were pregnant for the second time. The main reasons for referral were advanced maternal age and abnormal obstetric ultrasonography. The participant’s understanding of the test was still incomplete despite the counseling and there was a need for additional counseling/information. One-third of them preferred additional counseling whereas, the remaining two- thirds preferred booklets and pamphlets. Conclusion The profiles of pregnant women referred to genetic clinic provide better insight about their background for the health personnel and this study emphasizes rechecking the understanding regarding invasive tests following counseling; which eventually helps for appropriate decision making regarding the tests. KEY WORDS Awareness, Decision making, CounselingPublication Outcome of Uretero Renoscopic Lithotripsy (URSL) with Holmium LASER Vs Pneumatic Lithotripter for Lower Ureteric Stones, Experience from University Hospital of Nepal(Kathmandu University, 2020) Joshi, HN; Singh, AK; Koirala, N; Karmacharya, RMABSTRACT Background There are various methods of endoluminal ureteral stone fragmentation. Among various modalities Laser lithotripsy and Pneumatic lithotripsy are commonly used and have shown comparable outcomes. Objective To compare the efficacy and outcome of laser and pneumatic lithotripsy in a patient with lower ureteric calculi. The comparison will be done in stone free rate, migration of stone and complication of the procedure. Method This is a prospective comparative study in a cohort of patients at University Hospital with Lower Ureteric stone. Ninety patients were randomized in to two groups (Laser Lithotripsy Vs Pneumatic Lithotripsy) during the study period. The purpose of this study was to measure the immediate stone free rate, intra-operative complications, mean operative time, post-operative complication and if any stone retention after six weeks follow up. Result Both the groups were similar in Age and Gender. Immediate stone free rate was slightly higher in Laser lithotripsy group (97.77%) in comparison to Pneumatic lithotripter group (84.44%) with p=0.507 which is not statistically significant. There was statistical difference in terms of stone migration rate, mean operation time in favor of Laser Lithotripsy group (p<0.01, in both parameters). There were no immediate complications in both the group however there were three cases of short segment ureteric strictures (6.66%) in case of Pneumatic lithotripsy on six weeks follow up which was managed conservatively. Conclusion Both LASER lithotripter and Pneumatic lithotripter are equally efficacious modality of endoluminal URSL in lower ureteric stone with similar Stone Free Rate. Laser lithotripsy showed lower frequency of stone migration and had shorter procedure time. KEY WORDS Laser lithotripsy, Lower ureteric calculus, Pneumatic lithotripsy