Browsing by Author "Pandit, Durga"
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Publication Clinicopathological Outcome of Early and Late Onset Renal Cell Carcinoma: An Observational Study(Institute of Medicine, Tribhuvan University, 2024) Pandit, Durga; Phuyal, Anjit; Gyawali, Milan; Guragain, Bipin; Parajuli, Purushottam; Pradhan, Manish Man; Poudyal, Sujeet; Chapagain, Suman; Luitel, Bhojraj; Chalise, Pawan Raj; Sharma, Uttam Kumar; Gyawali, PremAbstract: Introduction Renal cell carcinoma (RCC) is considered a disease of old age and is typically found in the 6th-8th decade of life. The diagnosis of RCC is increasing more rapidly in younger age patients. This study was conducted to evaluate the clinicopathological pattern and outcome of early onset RCC and compare them with the older age group patients. Methods This was a single center observational study. All the patients undergoing radical or partial nephrectomy during the period of November 2019 to October 2022 for renal masses and whose final histopathology report showed RCC were included in the study. Clinicopathological patterns and outcome were compared between the two age groups. Results Among 47 patients, 17 (36.2%) patients were at or below the age of ≤46 years and 30 (63.8%) patients in older age group. There was significant difference in male (29): female (18) ratio between the two age groups (p < 0.005). Younger age patients (≤46 yrs) had higher stage of disease at presentation compared with the older age (>46 yrs) patients [tumor extension into major veins and perinephric tissue (T3) and above 26 vs 21] and they had significantly higher mortality rate (29.4% vs 3.3%, p =0.01). Conclusion Patients aged ≤46 years of age were more frequently affected by RCC with female predominance. Younger age group had higher stage of disease at presentation with higher mortality in comparison to older age group.Publication Surgical Management of Pediatric Urolithiasis: Descriptive Study from a Tertiary Care Center in Nepal(Institute of Medicine, 2023) Guragain, Bipin; Phuyal, Anjit; Gyawali, Milan; Pandit, Durga; Parajuli, Purushottam; Pradhan, Manish M; Poudyal, Sujeet; Chapagain, Suman; Luitel, Bhojraj; Chalise, Pawan R; Sharma, Uttam K; Gyawali, Prem RABSTRACT Introduction: Urolithiasis is common in the pediatric population in low-resource countries but appropriate management is not available in all parts of the country. This study aimed to identify demographic parameters, clinical characteristics, and surgical management of pediatric urolithiasis in a tertiary care center in Nepal. Methods: This was a retrospective and descriptive study of pediatric patients (≤18 years) who underwent surgical management of urolithiasis in the Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital from January 2021 to December 2022. Results: Total 64 patients with Male: Female ratio 1.78:1 and mean age of 8.63±5.56 years presented mostly with pain abdomen (93.8%) followed by lower urinary tract symptoms (26.6%), hematuria (20.3%), and fever (14.1%). The mean number of calculi was 2.2±1.47 and the mean size was 13.97±8.30 mm. Most of the calculi (39.1%) were in the right system and 90.62% were in the upper tract. Only 15.62% of patients had calculi in the lower tract. Open surgeries were performed in only 10.93% and the rest were managed by minimally invasive procedures. Percutaneous nephrostomy tube insertion was done in 6 (9.37%) of patients and 1 (1.56%) underwent nephrectomy for nonfunctioning kidney. Conclusion: Pediatric urolithiasis patients presented with pain abdomen, lower urinary tract symptoms, or hematuria. Surgical management has shifted from open surgeries in the past to minimally invasive surgeries at present. Keywords: Minimally invasive surgery; pediatric; urolithiasis