Browsing by Author "Pandit, RK"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Publication Retrospective analysis of management of patients presenting with acute urinary retention due to benign prostatic hyperplasia: A hospital based study(Kathmandu University, 2008) Pandit, RK; Agrawal, CS; Chalise, PR; Sapkota, GAbstract Objectives: To analyze current practice of management of acute urinary retention (AUR) in men above 40 years of age at B.P.Koirala Institute of Health Sciences, Nepal. Materials and methods: A total of 68 patients (aged 50-91 years) presenting with indwelling catheter for AUR were included in the study. Because of lack of clear guideline and limited health care facility in our setup trial without catheter (TWOC) was given selectively depending mainly on preexisting symptoms. AUR presumed to be due to urinary tract infection received only antibiotic and others diagnosed of benign prostatic hyperplasia (BPH) received alfa1 blocker prior to TWOC. TWOC was given 3-15 days after such treatment. Those satis ed without catheter for at least a week were considered successful TWOC. Results: The data was available for 68 patients (mean age 66.1 years). Of 15 patients treated with antibiotic alone, 11 (73.3 %) had successful TWOC. Of 57 with presumptive diagnosis of BPH, 68.9% (31 of 45) had successful TWOC. Mean age, symptom score and prostate volume were higher for patients with unsuccessful TWOC. Conclusion: Selective TWOC may be imperative to minimize unnecessary suffering from AUR in less easily accessible health care facilities like ours. It may also reduce total cost of treatment. Key words: Acute urinary retention, benign prostatic hyperplasia, trial without catheterPublication Safe and Feasible Time Limit for Early Appendectomy in Appendiceal Mass(Kathmandu University, 2016) Pandit, RKABSTRACT Background Early appendectomy in appendiceal mass is gaining popularity among some surgeons. However, it is endowed with increasing operative difficulty with time, and safe and feasible timing is not yet clear. Objective To know safe and feasible time limit for early appendectomy in appendiceal mass. Method This is a retrospective study. Between May 2009 and July 2014, 114 patients of appendiceal mass who underwent early surgical intervention by a single surgeon were studied. Group I included 98 patients operated within seven days of onset of pain and group II included 16 patients operated between 8th and 15 days of pain. Type of operative procedure, difficulties and complications were analyzed. Result There were 58 men and 56 women. Their mean age was 24.27 ± 8.7 years. In group I, 98 (100%) patients had appendectomy and adhesiolysis was safe and feasible. In group II, 5(31.25%) patients had extra-peritoneal drainage of abscess without attempt for appendectomy. Remaining 11 patients had attempt for appendectomy, but only 3(18.75%) out of 4 patients operated on the 8th day could have appendectomy. Six (37.5%) patients had just drainage of abscess. Two (12.5%) patients, operated on the 12th and 15th days of pain had just open-closed due to dense adhesion and both resolved. One patient operated on the 10th day sustained ileal injury. Surgical site infection occurred in 16.6% (14 in 86) in group I and 33.3% (5 in 15) in group B (P= 0.001). Mean operative time was 34.4 ± 9.23 minutes and 43.7 ± 16.38 minutes for group I and group II respectively. Mean hospital stay after surgery was 2.9 ± 1.1 days and 5.5 ± 1.37 days in group I and group II respectively. Conclusion Early appendectomy in appendiceal mass seems safe and feasible up to 7th day since onset of pain in my experience. However, this limit may vary with surgeon’s experience, and further studies are required to better clarify this issue. KEY WORDS Appendiceal mass, early appendectomy, safe and feasible timing