Browsing by Author "Pokharel, Apar"
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Publication Role of Mesenchymal Stem Cells on Tonsillar Hypertrophy: An Unexplored Enigma(Nepal Medical Association, 2023) Pokharel, Apar; Bhattarai, DharmagatAbstract Tonsillar or adenoid hypertrophy is a common childhood finding which can cause significant health problems like respiratory infections and sleep apnea. Though normal growth of children is also attributed to such enlargement, infection, environmental pollutants, allergens, and gastroesophageal reflux are proposed triggering factors for tonsillar hypertrophy. While tonsilar enlargement in adults is more associated with malignancy and chronic infections like the human immunodeficiency virus, the immunology of childhood adenotonsillar hypertrophy is less understood. We postulate that upon stimulation, mesenchymal stem cells are found to reduce the secretion of interferon-gamma but increase the secretion of interleukin-4 from activated T cells. Both of these factors inhibit apoptosis in the tonsillar tissue leading to its hypertrophy. Under the umbrella of evidence, it implicates the role of mesenchymal stem cells in tonsillar hypertrophy. However, further longitudinal large studies are needed to validate the proposition.Publication Traumatic Tympanic Membrane Perforation in Children: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Pokharel, Apar; Bhandari, Chhanya; Sharma, BibekAbstract Introduction: TTraumatic perforation of the tympanic membrane in pediatric population is often encountered in primary otolaryngologic clinics or in the emergency department. The objective of the study was to find out the clinical presentation of traumatic tympanic membrane perforation in the pediatric population. Methods: A cross-sectional study was done from February, 2023 to February, 2024 after obtaining the ethical approval from the Institutional Review Board (2023/114). All the patients aged less than 18 years and presenting with traumatic tympanic membrane perforation were included in the study. Collected data was entered and analysed using Microsoft Excel. Patients were evaluated for demographics, mechanism of trauma and clinical characteristics of ear drum perforation in children. Results: A total of 384 children aged less than 18 years were included in the study among which 267 (69.53%) were males. Physical assault 109 (28.39%) was the most common cause of tympanic membrane perforation. The most common symptom at the time of presentation was ear block/hearing loss 208 (54.16%). Conductive hearing loss was present in 214 (55.73%) children. Conclusion: Traumatic perforation of the tympanic membrane resulted mostly from the blunt force trauma especially in male children.