Browsing by Author "Maharjan, DK"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Publication Hospital based analytic study of peptic ulcer disease in patients with dyspeptic symptoms(Kathmandu University, 2009) Sharma, S; Maharjan, DK; Thapa, PBAbstract Background: Peptic ulcer disease is one of the most common diseases prevalent in developing country like Nepal and with availability of endoscopy there have been increase in diagnosis and therapeutic use of endoscopy. Objective: The aim of this study is to investigate the prevalence of peptic ulcer disease in patient who came for upper gastrointestinal endoscopy in Kathmandu Medical College Teaching Hospital. Materials and methods: All patients who were referred to department of endoscopy from outpatient department (OPD) and inpatient department with symptoms like dyspepsia, upper GI bleeding were included from August 2004 to August 2008. Results: A total of 2761 patient were evaluated, with mean age group of 40.57 years (range 8- 95 years) and with sex distribution of male 1353 (49%) and female 1408 (51%) and racial difference into Aryan 2050 (74.2%) and Mongoloid 771 (25.8%). There were 983 patients (35.60%) with peptic disease which includes erosive gastritis, non erosive gastritis, duodenitis and gastroduodenitis without obvious ulcer. The prevalence of peptic disease with or without ulcer was more common in age group of 20- 49 years (n= 764, 27.67 %) with 70 patient with gastric ulcer (2.5%) and 50 patient with duodenal ulcer (1.8%). There was no significant racial difference among incidence of peptic ulcer (P value= 0.527). Conclusions: Peptic ulcer disease is a significant cause of morbidity in urban population of Nepal with more prevalent of erosive diseases in productive age group (20-49 years). However both male and female have equal incidence of peptic ulcer disease and there was no significant racial difference in its incidence. Key words: Peptic ulcer diseases, Oesophago-gastroduodenoscopy, H. pyloriPublication Influence of duration of symptoms over perioperative outcomes during emergency laparoscopic cholecystectomy(Kathmandu University, 2009) Sharma, SK; Thapa, PB; Maharjan, DK; Dhakal, A; Baral, NAbstract Background: Laparoscopic cholecystectomy is a gold standard treatment for gall stone diseases. Early surgical intervention in acute calculus cholecystitis is feasible and duration of onset of symptoms does not influence the conversion rate. Objective: To compare the safety and feasibility between urgent and delayed laparoscopic cholecystectomy in patients with acute calculus cholecystitis. Materials and methods: This is a comparative study conducted in Department of Surgery, Kathmandu Medical College, during the period of January 2006 to January 2008. Alltogether, 436 patients were analysed out of which 55 were selected as urgent laparoscopic cholecystectomy and were included in the study. Among 55 patients presented with acute calculus cholecystitis were divided into two groups. Group 1 underwent laparoscopic cholecystectomy within 72 hours of onset of pain abdomen and Group 2 after 72 hours of onset of pain abdomen. Results: Conversion rate in Group 1 was 19.44% whereas it was 263% in Group 2 (p = .693). There was no statistically significant difference in mean operating time (p = .412), total hospital stay (p = .626), bile duct injury and postoperative complications. Conclusion: Urgent laparoscopic cholecystectomy is safe and duration of onset of pain abdomen does not influence conversion rate. Key words: Urgent laparoscopic cholecystectomy, Conversion rate, acute calculus cholecystitisPublication Modified Limberg Flap for Pilonidal Sinus(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2017) Thapa, Prabin Bikram; Maharjan, DK; Ghimire, R; Shrestha, SKAbstract: Background: Pilonidal sinus disease is a common condition usually seen in young adults. Although several methods of treatment have been described, but all have been associated with high recurrence rates. This study was carried out to evaluate the advantages and results of rhomboid excision and Limberg flap reconstruction in the management of pilonidal sinus disease. Objective: To evaluate the advantages and results of rhomboid excision and Limberg flap reconstruction in the management of pilonidal sinus disease Material and Methods: This was prospective descriptive study conducted in Unit III, Department of Surgery, Kathmandu Medical College Teaching Hospital from August 2013 to August 2015. First 50 patients with diagnosis of pilonidal sinus were included .Exclusion criteria was patients with pilonidal abscess. Results: Total 50 patient were included in 2 years time. Mean age was 23.48 ± 3.9 years with all male patients only. Median duration of surgery was 32 ± 4.4 minutes .Median time for normal activities was 21± 3.9 days and median follow up time was 18±8.5 months. No recurrence was noted till then. Post surgery, patient applied hair removal cream: 44%, hair shaving: 34% and laser therapy for hair follicles: 22%. Conclusion: Modified Limberg flap is better option for pilonidal sinus with least recurrence. However, post surgical counseling for hair removal is very important in order to prevent recurrence and should be multidisciplinary approach along with dermatologist colleagues. Keywords: pilonidal sinus, modified limberg flap, hair removal