Browsing by Author "Rai, Binod K"
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Publication Neonatal Surgery: A Four-year Experience in a Teaching Hospital of Birgunj(Institute of Medicine, 2022) Rai, Binod K; Yadav, Dhirendra P; Ansari, Mohammad A; Raya, Akash; Alam, Mohammad S; Sah, ChandrikaABSTRACT Introduction: Neonatal surgery is one of the most challenging issues in medical field. The outcome of neonatal surgery is still poor in developing countries. The aim of this study was to report our experience regarding the etiological spectrum of neonatal surgical conditions and their outcome after surgical management. Methods: A descriptive retrospective study which included all the neonatal cases that presented to Pediatric Surgery Department of National Medical College, Birgunj in the last four years. All the neonates that underwent surgery from April 2017 to March 2021 were included in the study. Results: A total of 68 neonates were operated during the analyzed time period. Male to female ratio was 2.2:1. The age at presentation varied from 2 to 28 days and birth weight from 1.2 to 3.4 kg. Anorectal malformation (32.3%) was the commonest cause of surgery followed by tracheo-esophageal fistula (14.7%) and pyloric stenosis (8.8%). Mortality rate was 20.5% with septicemia as the commonest post operative complication. Conclusion: The outcome of neonatal surgery in our center is not up to mark as compared with centers in developed countries. Early presentation of the patients, well equipped surgical neonatal intensive care facilities and trained manpower are needed to improve the outcome. Keywords: Complication, neonate, pediatric surgery, surgical managementPublication Prediction of Spontaneous Stone Expulsion by Serum C-Reactive Protein in Patients with Distal Ureteric Calculi(Institute of Medicine, 2023) Raya, Akash; Rai, Binod K; Yadav, Aditya P; Shahi, Sanjiv KABSTRACT Introduction: Ureter obstruction caused by a ureteral stone triggers inflammatory change in the proximal submucosal layer and prevents passage of the stone which can increase C-reactive protein level. The present study was designed to see if CRP plays a role in predicting the expulsion of distal ureteric calculi of <10 mm in patients presenting to urology department. Methods: A cross-sectional study was done at National Medical College, Department of Surgery, Birgunj from January 2022 to June 2022. Total of 60 cases were included in the study who presented with distal ureteric calculi. Level of CRP was recorded and divided into <6 mg/dl and >6 mg/dl. Size of stone and rate of spontaneous expulsion was noted. Results: Among the 60 cases, 34 (56.7%) were males and 26 (43.3%) were females. Mean age of the study cases was 36.1±11.76 years and mean size of stone 6.72±1.54 mm. among the total cases 28 (47%) had CRP level <6mg/dl and 32 (53%) had CRP level >6mg/dl. Among the total cases 35 (58.3%) did not pass stone spontaneously and the size of stone was 6.9743±1.74598 mm. spontaneous passage of stone was not seen in 21 (60%) male and 14 (40%) female cases. Significant difference (p=<0.001) was seen between expulsion and non-expulsion of stone. Conclusion: Measurement of CRP at the time of presentation with distal ureteric calculi of small size can help the urologist to predict whether spontaneous expulsion is possible or not. Keywords: C-reactive protein; distal ureteric calculi; spontaneous expulsion of stone