Browsing by Author "Pradhan, Bibhu"
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Publication A Large Follicular Adenomatoid Odontogenic Tumor Occupying the Maxillary Sinus: A Case Report(Nepal Medical Association, 2023) Maharjan, Leison; Gurung, Urmila; Pradhan, BibhuAbstract Adenomatoid odontogenic tumour is a rare benign, odontogenic tumour with uncertain histogenesis. Whether it is a hamartoma or a neoplasm is still a controversial topic. It is usually associated with an unerupted maxillary canine. Here, we discuss a follicular adenomatoid odontogenic tumour in a young girl with uncommon features such as it arose from two unerupted teeth and partial resorption of the roots of other normal teeth. The tumour was large enough to completely occupy the maxillary sinus. It was treated with enucleation and curettage by lateral rhinotomy approach.Publication Fracture Nasal Bone: Causes, Presentation and Management in a Tertiary Care Center in Nepal(Institute of Medicine, 2020) Mahaseth, Rajeev K; Gurung, Urmila; Thapa, Narmaya; Pradhan, Bibhu; Kharel, BijayaABSTRACT Introduction: Fracture of nasal bone, the commonest facial fracture is frequently encountered in ENT practice. This study was conducted to assess the causes, presentation and management of fracture nasal bone in a tertiary care center. Methods: A retrospective chart review was done of patients admitted from August 2017 to July 2019 for management of isolated nasal bone fracture in the department of ENT and Head and Neck Surgery, Tribhuvan University Teaching Hospital. Results: Thirty-five patients (31 males and 4 females) of 13 to 86 years (mean age 26 years) underwent closed reduction of fracture nasal bone. The injury was sustained following physical assault in 13/35 (37%), fall from height in 10/35 (29%), road traffic accident in 8/35 (23%) and sports injury in 4/35 (11%). Pain, epistaxis, swelling over nasal dorsum, nasal deformity and wound were the presenting symptoms which most often occurred in combination. Close reduction was done under local anesthesia in 28/35 (80 %) and under general anesthesia in 7/35 (20%). The time between trauma and closed reduction ranged from 1 to 16 days with a mean of 6.2 days. Conclusion: Nasal bone fracture needing reduction was common following physical assault in males predominently of 21 to 30 years. A combination of pain, epistaxis and nasal deformity was the commonest presentation. Closed reduction of fracture under local anesthesia within 16 days of trauma was the usual practice. Keywords: Closed reduction, facial trauma, local anesthesia, nasal bone fracturePublication Ringer’s Lactate versus Isotonic Saline: The Nasal Irrigation Solution of Choice in Chronic Rhinosinusitis(Institute of Medicine, Tribhuvan University, 2024) Gurung, Urmila; Devkota, Anuj; Pokhrel, Shishir; Pradhan, BibhuAbstract: Introduction Nasal douching is a simple and highly effective treatment option for chronic rhinosinusitis. This study aimed to compare the efficacy of Ringer’s lactate versus isotonic saline for nasal irrigation in treating chronic rhinosinusitis (CRS) with or without polyposis using the SNOT-22 score. Methods This quasi-experimental study was conducted at the Department of ENT and Head & Neck Surgery, Tribhuvan University Teaching Hospital, from September 2020 to November 2021. Seventy-eight patients aged ≥ 16 years with CRS were included in the study. Patients were grouped into either isotonic saline or Ringer’s lactate groups based on the clinician’s preference. Nasal irrigation was prescribed for four weeks. Pre and post-irrigation SNOT-22 scores were analyzed using paired t-test and Student’s t-test. Results A significant improvement in the SNOT-22 scores before and after nasal irrigation was observed in both the Ringer’s lactate (26.76±14.07 vs 14.41±7.92, p<0.001) and isotonic saline groups (24.64±11.12 vs 12.58±6.62, p<0.001). However, the difference in post-nasal irrigation SNOT-22 scores between these groups remained statistically insignificant (p=0.27). Common symptoms such as nasal blockage and thick nasal discharge showed substantial improvement. The most common side effect was fluid pooling in the paranasal sinuses. Conclusion Both isotonic saline and Ringer’s lactate were effective for nasal irrigation in patients suffering from chronic rhinosinusitis, with no significant difference in their efficacy, making either solution a suitable choice for nasal irrigation in the management of the CRS.