Browsing by Author "Pandey, P"
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Publication Guillain-Barré Syndrome Following Tetanus Toxoid Vaccination: A Rare Case Report From A Tertiary Care Centre(Kathmandu University, 2025) Shah, BK; Sah, S; Pandey, P; Kurmi, SABSTRACT Guillain-Barré syndrome is an acute inflammatory polyneuropathy characterized by rapidly progressive, symmetric, ascending weakness often triggered by infection or rarely vaccination. Although influenza and Corona Virus Disease-19 vaccines have been more commonly implicated, there are limited reports of Guillain–Barré syndrome following tetanus- toxoid vaccination. We report a case of 12-years- old male who developed bilateral lower limbs weakness and hoarseness of voice 3 weeks after receiving tetanus toxoid vaccine given after injury. Neurological examination revealed bilateral hypotonia in lower limb. Cerebrospinal fluid analysis showed albuminocytologic dissociation. Nerve conduction studies were consistent with acute inflammatory demyelinating polyradiculoneuropathy. The patient was treated with intravenous immunoglobulin at 0.4 g/kg/day for 5 days and discharged on 10th day of admission. This case highlights a possible temporal association between tetanus toxoid vaccination and Guillain–Barré syndrome, though the causality cannot be definitively established. Further studies are required to clarify this potential link. KEY WORDS Guillain-Barré syndrome, Pediatrics, Tetanus toxoid, VaccinationPublication Role of Intraoperative Cholangiogram in Major Liver Resection and Complex Bilio-enteric Bypass Surgery(Kathmandu University, 2024) Ghimire, R; Pandey, P; Acharya, BPABSTRACT Background Advances in surgery have decreased postoperative morbidities but bile leak is still a major issue. Intraoperative cholangiogram (IOC) is considered better in identifying bile leaks and anatomical delineation making its expanded use in hepato-biliary surgeries. Objective To assess the role of intraoperative cholangiogram in major hepatectomy and complex bilio-enteric bypass surgery. Method A single-centered, descriptive cross-sectional study between March 2022 to February 2023 among conveniently sampled 32 patients undergoing Hepato-biliary surgeries. One ampoule of meglumine diatrizoate was instilled into the biliary tract and intraoperative pictures were taken via C-arm to visualize the biliary tree and pre- operative and intra-operative pictures were compared. Result A total of 32 patients were included in the study with a median age of 42 years and a male-female ratio of 1:1.67. During the bilio-enteric anastomosis, no intraoperative anastomotic leaks were detected. Two patients experienced postoperative bile leakage that was managed conservatively and eight cases had intraoperative bile leakage which was addressed during surgery. The average duration of hospital stay was 5 days. Conclusion An intraoperative cholangiogram is useful to delineate the biliary tract anatomy, reassure anastomosis, and identify bile leaks in difficult bilio-enteric anastomosis and from liver resection margins intraoperatively. KEY WORDS Complex hepatobiliary surgery, Intraoperative cholangiogram, Liver resectionPublication Spectrum of Dermatoses among Paediatric Patients in a Teaching Hospital of Western Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2012) Neupane, S; Pandey, PNA Keywords: Impetigo, Nepal, paediatric dermatoses