Browsing by Author "Rajbhandari, Bikesh"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Publication Comparison Between Alvarado Score and Paediatric Appendicitis Score in Diagnosing Acute Appendicitis in Children(Nepal Paediatric Society (JNPS), 2020) Rajbhandari, Bikesh; Dahal, Geha Raj; Pokharel, Rameshwar PrasadAbstract: Introduction: Acute appendicitis is the most common atraumatic surgical emergency in childhood. The accurate diagnosis of acute appendicitis is not always easy. Alvarado score (AS) and paediatric appendicitis score (PAS) are commonly used tools to assist diagnosis. This study compares the diagnostic accuracy between AS and PAS. Methods: A prospective study was conducted from September 2016 to September 2017 in Paediatric Surgery Unit of Tribhuvan University Teaching Hospital. All eligible patients (children up to 16 years) who were operated for acute appendicitis were included. AS and PAS were calculated for all patients preoperatively. Final diagnosis of acute appendicitis was based on histopathological examination and labeled as ‘appendicitis’ or ‘no appendicitis’. A cut off score of 7 for AS and 6 for PAS was compared with ‘appendicitis’ or ‘no appendicitis’ group. Results: A total of 70 patients were included in the study. Sixty five (93%) were histologically proven acute appendicitis and five (7%) were no appendicitis. The sensitivity, specificity, PPV, NPV and accuracy of AS were 89%, 40%, 95%, 22% and 85% respectively. For PAS, sensitivity, specificity, PPV, NPV and accuracy was 97%, 40%, 95.5%, 50% and 92% respectively. On Receiver Operating Characteristic curve, ‘area under curve’ of AS was 0.64 and that of PAS was 0.84. It was not statistically significant (p = 0.152). Conclusions: There was no statistical significant difference between AS and PAS for diagnosing acute appendicitis.Publication Experience in Oral Cancer Reconstruction in a Tertiary Care Center of Nepal(Institute of Medicine, 2022) Pradhan, Rohan; Rayamajhi, Sangam; Sharma, Samit; Rai, Sushant; Rajbhandari, Bikesh; Niraula, Himalaya; Shrestha, Jayan M; Lohani, IshwarABSTRACT Introduction: Oral cancer is one of the most common malignancies in Nepal. Most patients have locally advanced disease during their initial presentation, necessitating substantial resection and leaving significant deformity. Functional and anatomical restoration of these defects is crucial. This study analyzed the clinical presentation of oral cancer, surgical management, and encountered complications in the Nepalese context. Methods: This was a single-center retrospective study of oral cancer reconstruction performed at Tribhuvan University Teaching Hospital, Kathmandu over four years period (September 2018 - September 2022). Demographics, clinical presentation, comorbidities, treatment, and complications were recorded and analyzed. Results: Out of the analysis of 36 cases of oral cancer, most of the patients were in the fifth decade of life with male to female ratio of 3:1. The most common primary site involved was buccal mucosa (38.88%). Twenty-two cases (61.11%) were in the locally advanced stage. Tobacco chewing was a common entity in personal habits. Surgery consisted of eighteen pedicled, sixteen free flaps, and five local flaps. Pectoralis major myocutaneous flap was the commonest flap performed (38.46%). The overall complication rate was 58.33%. Orocutaneous fistula was the commonest (22.22%). The partial flap loss occurred in 8.33% (15.1%) and the total flap loss occurred in three free flaps. Conclusion: The difficulties experienced in OC reconstruction were high complication rates, multiple redo surgeries, and extended hospital stays. Despite these challenges, all of our patients were released from the hospital with stable wound coverage. Furthermore, the study will provide a platform for a better understanding of the oral cancer reconstruction scenario in the context of Nepal. Keywords: Free flaps, oral cancer; pedicled flaps, reconstruction