Browsing by Author "Pun, Ashis"
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Publication Comparison of Lintula Score with Modified Alvarado Score for Diagnosing Acute Appendicitis in Adults(Nepal Health Research Council, 2024) Pun, Ashis; Rayamajhi, Akin Jung; Neupane, DipendraAbstract Background: Acute inflammation of the appendix or acute appendicitis is one of the most prevalent surgical emergencies seen in day-to-day practice. The delay in the diagnosis and the treatment of the condition can lead to complications and even death. Various scores have been developed over the time for aiding the diagnosis of Acute Appendicitis. Methods: A hospital based cross-sectional study was conducted in Bharatpur hospital of Chitwan district of Nepal from December 30, 2020 to December 29, 2022 .This study identified and enrolled acute appendicitis patients that were treated in a tertiary hospital’s emergency department of Bharatpur. The data were obtained and used to calculate modified Alvarado, and Lintula scores. All the patients were categorized into two groups according to their histopathological results, i.e., positive appendectomy and negative appendectomy. The sensitivity and specificity of different scoring systems in diagnosing Acute appendicitis was investigated. Results: Sensitivity and specificity of Modified Alvarado score were 89.2% and 80.0% respectively. Diagnostic accuracy of Modified Alvarado Score was 88.57%. Positive productive value and Negative productive values of this scoring tool were 98.3% and 36.3% respectively whereas, diagnostic accuracy of Lintula score was 75.0%. Conclusions: It can be inferred from the study that Modified Alvarado Score is a good screening tool for diagnosing need of appendectomy. Keywords: Acute appendicitis: lintula score; modified alvarado score.Publication Post Endoscopic Retrograde Cholangiography Bilateral Loss of vision: A Case Report Authors(Nepal Medical Association, 2021) Pun, Ashis; Sah, Kamlesh Kumar; Shah, Sunil Kumar; Bastola, RamjeeAbstract: Endoscopic retrograde cholangiopancreatography is an invasive endoscopic procedure done more often for therapeutic rather than diagnostic purposes. There are various complications of this procedure like pancreatitis, cholangitis, hemorrhage, perforation and other rare adverse events. In this case report, we discuss a case of a 40 years female who was referred to our center for endoscopic retrograde cholangiography. After the procedure she complained of bilateral loss of vision which was an unknown complication to us. But after looking back to literature we found two such case reports attributed to isolated bilateral lateral geniculate body infarct.Publication Ringer’s Lactate Hydration and Incidence of Post ERCP Pancreatitis: A Descriptive Cross-sectional Study(Nepal Medical Association, 2020) Pun, Ashis; Dhungana, Amit; Neupane, DipendraAbstract: Introduction: Endoscopic retrograde cholangiopancreatography is one of the most frequently used treatment modality for various pancreatobiliary problems. Frequent complications of endoscopic retrograde cholangiopancreatography include pancreatitis, cholangitis, hemorrhage and perforation. This study was done to see the prevalence of post endoscopic retrograde cholangiopancreatography pancreatitis in patient aggressively hydrated with Ringer’s Lactate solution. Methods: A descriptive cross sectional study was carried out on patient undergoing endoscopic retrograde cholangiopancreatography at Bharatpur Hospital from June 2018 to August 2020. Ethical clearance was taken from Institutional Review Committee Bharatpur Hospital (reference number 16/076/77). The convenient sampling method was applied. Data were collected and analyzed in statistical package for the social sciences version 16. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Pain abdomen was assessed using Visual Analogue Scale and it was found that 8.1% of patients (15 patients) complained of pain abdomen with visual analogue scale> 3. Serum amylase was sent only in those patients who complained of pain abdomen and only in three patients (1.6%) serum amylase was increased more than 3 times the upper limit of normal value suggestive of pancreatitis. All three patients who had pancreatitis had precut sphincterotomy. Conclusions: In this study we found that incidence of pancreatitis slumped after aggressive hydration with Ringer’s lactate solution and adjunct use of other prophylactic measures for prevention of post endoscopic retrograde cholangiopancreatography pancreatitis might yield further better results.