Browsing by Author "Raya, Akash"

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    Lower Urinary Tract Symptoms, Serum PSA, Digital Rectal Examination and Prostate Volume in Patients Presenting to Urology Department: A Cross-Sectional Study
    (Institute of Medicine, 2022) Raya, Akash; Bhatta, Pashupati; Sah, Sanjay; Aryal, Vibina
    ABSTRACT Introduction: Lower urinary tract symptoms (LUTS) are common presentation in the urology department in males after 50 years. Enlarged prostate can be evaluated by digital rectal examination (DRE) and ultrasound. Serum prostate-specific antigen (PSA) has been suggested as a reliable tool to estimate prostate volume (PV) and to predict the diagnosis of prostate cancer. The aim of this study is to correlate prostate-specific antigen with clinical data like age and international prostate severity score (IPSS), DRE finding and PV among subjects with LUTS. Methods: Total of 175 cases were included in the cross-sectional study who presented with LUTS in the Urology Department. DRE was done and noted. Then the cases were advised for ultrasonography (USG) and serum PSA level was sent for investigation. According to the history given by the cases IPSS was done using the IPSS scoring questions. The result was obtained by grouping the cases according to the level of serum PSA. Results: The mean age of the total 191 cases was 72.23±10.46 years and mean PSA level in our study population was 9.08±23.69 ng/ml. Grade III PV was seen among 47.1% of the study population. IPSS scoring between 8-19 was seen among 68.1% study population. Correlation between serum PSA and age group (p=0.007) was significant. High significance (p<0.001) was seen in correlation between serum PSA and DRE finding, IPSS and PV. Conclusion: Our study showed that serum PSA level plays an important role in the evaluation of prostate enlargement. The level of serum PSA along with presenting symptoms and clinical findings can help us to plan our mode of treatment accordingly. Keywords: Digital rectal examination (DRE), International Prostate Severity Score (IPSS), lower urinary tract symptoms (LUTS), prostate volume (PV)
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    Median Duration of Hospital Stay after Early Removal of Foley’s Catheter among Patients Undergoing Transurethral Resection of Prostate: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2021) Bhatta, Pashupati Nath; Raya, Akash; Yadav, Umesh Kumar; Kumar, Vijay; Shahi, Sanjeev; Singh, Amit
    Abstract: Introduction: Transurethral resection of the prostate requires a catheter in situ post-surgery. Early removal of catheter can reduce the length of hospital stay reducing the healthcare cost. It can also reduce the risk of infection due to prolonged catheterization. Our aim was to determine the median duration of hospital stay after early foley’s removal after transurethral resection of prostate among patients in a tertiary care hospital. Methods: A descriptive cross-sectional study was done in a tertiary care hospital from July 2019 to December 2020 and ethical clearance was obtained from the institutional review committee. Foley’s catheter were removed on the first post-operative day, who met the criteria of catheter removal. Convenience sampling was done. After foley’s removal patients were observed for spontaneous voiding. Patients with complications like hematuria, clot retention, urinary retention were recatherized. The data were expressed in mean with standard deviation, median with interquartile range and frequency and percentage as applicable using Statistical Package for the Social Sciences version 16. Results: Out of the 150 participants included in the study, the median duration of hospital stay after the early removal of foley's catheter was 3 days (interquartile range 2-4 days). A total of 20 (13.3%) patients underwent recatherization. Nine (6%) patients had to be recatheterized due to clot retention, and 11 (7.3%) were due to urinary retention. Conclusions: This study showed that the median duration of hospital stay after early removal of foley's catheter among patients undergoing transurethral resection of the prostate was similar to studies done in national/international settings.
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    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, Chandrika
    ABSTRACT 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 management
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    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 K
    ABSTRACT 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
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    Tamsulosin Versus Alfuzosin as Medical Expulsion Therapy for Distal Ureteric Calculi: An Analytical Study
    (Institute of Medicine, 2021) Kumar, Vijay; Bhatta, Pashupati; Yadav, Umesh; Singh, Amit; Raya, Akash
    ABSTRACT Introduction: Urolithiasis is one of the most common urological problems. About 20% of urolithiasis accounts for ureteric calculi among which 2/3rd patients present with distal ureteric calculi. Alpha blockers are commonly used for effective treatment of ureteric calculi. The aim of this study was to compare effectiveness of Tamsulosin and Alfuzosin as medical expulsion therapy. Methods: This analytical study was carried out at National Medical College Department of Surgery,Urology Unit, Birgunj from October 2020 to March 2021. Ethical clearance (FNMC/439/075/76) was obtained from institutional review committee. Total 100 cases were included in the study who presented with distal ureteric calculi of <10 mm. The patients receiving Tamsulosin were recruited in Group T and those receiving Alfuzosin were recruited into Group A. The choice of treatment was made by the treating surgeons. Tamsulosin 0.4 mg was used for the patients in Group T and 10 mg Alfuzosin was used in Group A. Patients were followed-up weekly for 4 weeks. Stone expulsion rate, time to stone expulsion, colic episodes, emergency visit, use of analgesics and drug-related side-effects were recorded. Results: The rate of expulsion of stone in Tamsulosin group was 64% and that in Alfuzosin group was 66%. The expulsion time in Tamsulosin group was 4.28±3.49 days and that in Alfuzosin group was 5.02±4.09 days which was statistically insignificant (p=0.33). Mean episodes of colic and use of analgesics were similar in both groups. Backache was the most common side effect in both groups. Conclusion:Efficacy of both Alfuzosin 10 mg and Tamsulosin 0.4 mg as medical expulsion therapy is comparable to each other with minimum side effects of both the drugs. Keywords: Alfuzosin, medical expulsion therapy, Tamsulosin, urolithiasis

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