Browsing by Author "Mishra, Prashant"
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Publication Jejunovesical Fistula Diagnosis After Normal Vaginal Delivery: A Case Report(Nepal Medical Association, 2024) Yadav, Deepak Kumar; Adhikari, Mahesh Bahadur; Maharjan, Bipin; Mishra, Prashant; Shrestha, Pramesh PrasadAbstract Enterovesical fistula represents an abnormal communication between the intestine and bladder. The causes are diverticulitis (56.3%), malignant tumours, which are located mainly in the intestine (20.1%), and Crohn’s disease (9.1%). Other causes include iatrogenic injury (3.2%); trauma; foreign bodies in the intestinal tract; radiotherapy; chronic appendicitis; tuberculosis; and syphilis. Normal vaginal delivery as a cause for enterovesical fistula has not been reported in many publications yet. We report a case of a 30-year-old female, who developed an jejunovesical fistula after normal vaginal delivery. It was diagnosed after diagnostic cystoscopy and computed tomography of the abdomen and pelvis. There was jejuno-vesical fistula. Resection of the segment of the jejunum with side-to-side anastomosis with bladder repair was done. A follow-up cystogram was done which showed no contrast extravasation into the peritoneum. The patient was followed up for 9 months after surgery.Publication Prostate Cancer among Patients Undergoing Radical Cystoprostatectomy for Bladder Cancer in the Department of Urology in a Tertiary Care Centre(Nepal Medical Association, 2023) Mishra, Prashant; Jiongming, Li; Jianhe, Liu; Kewei, Fang; Yongming, Jiang; Wang, Guang; Pei, Li; Tongxing, YangAbstract Introduction: Prostate cancer is the most common malignancy in men and remains one of the most prevalent and least understood of all human malignancies. Bladder cancer is the most frequently diagnosed cancer in China. Radical cystectomy remains the gold standard for muscle-invasive, recurrent and multiple bladder cancer. All male patients undergoing radical cystoprostatectomy must be evaluated for prostate cancer before planning surgery. The aim of this study was to find out the prevalence of prostate cancer among patients undergoing radical cystoprostatectomy undergoing surgery for bladder cancer. Methods: A descriptive cross-sectional study was conducted in a tertiary care centre from 1 August 2023 to 30 August 2023 where data from 1 January 2015 to 30 December 2017 was taken from medical records after obtaining ethical approval from the Ethical Review Board. All patients who underwent radical cystoprostatectomy were included in the study. Whole radical cystoprostatectomy specimens were cut transversely at 3 mm intervals and examined in the same pathological centre. Clinically significant prostate cancer was defined as a tumour with a Gleason pattern ≥4, prostate tumour with clinical stage ≥pT3, lymph node. involvement, positive surgical margin or multifocality of three or more lesions. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 210 patients, 52 (24.76%) (18.92-30.60, 95% Confidence Interval) had incidental prostate cancer. The average age of patients with incidental prostate cancer was 65.88±9.54 years. Conclusions: The prevalence of incidental prostate cancer was found to be lower than the study conducted in a similar setting.