Browsing by Author "Shrestha, Ashish"
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Publication Endoscopic Drainage of Pancreatic Pseudocysts: Clinical Profile and Outcome Analysis(Nepal Health Research Council, 2024) Gurung, Ram Bahadur; Sharma, Pasand; Sapkota, Prakash; Shrestha, Ashish; Shrestha, PramitaBackground: Pancreatic pseudocyst is a complication of acute and chronic pancreatitis. Although surgery considered the gold standard, there is a rapid shift towards endoscopic treatment owing to its therapeutic outcome and minimal invasive involvement. This study aims to present the clinical profile and outcome analysis of the endoscopic drainage of pancreatic pseudocysts in Dhulikhel Hospital. Methods: This is a retrospective review of all patients who were diagnosed with pancreatic pseudocyst between January 2015 and December 2018 in Dhulikhel Hospital. The retrospective data were on patient characteristics, etiology, location of the cyst, other clinical characteristics. Results: The study included 51 patients and the average age of the patients in this study was 39 years and among them 62.7% were female. The mean size of pseudocyst was 7.89 cm, and the average days of hospital stay was 13.64. The most common etiology was idiopathic and more than half of the patient’s cyst was in head and/or body, 15 and 36 underwent conservative and therapeutic management respectively. The technical success rate was at 94% and reported increased pancreatic pseudocyst in Dhulikhel Hospital from 2015-18. Conclusions: The study findings highlight the increased trend of pancreatitis pseudocyst as a complication of acute or chronic pancreatitis. Endoscopic drainage of pseudocyst with plastic stent is an established method of managing it. However, pancreatic pseudocyst even larger than 6 cm can undergo spontaneous resolution.Hence, conservative management should be considered first. Keywords: Endoscopic ultrasound; endoscopic drainage; pancreatitis; pancreatic pseudocyst.Publication Hydrocele among Patients undergoing Surgery in the Department of Surgery in a Tertiary Care Center: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Deo, Kishor; Chaudhary, Arun Kumar; Shrestha, Reshika; Chaudhary, Aashutosh; Adhikari, Bindira; Bista, Apeksha; Jha, Devesh; Shakya, Niliza; Maharjan, Suresh; Shrestha, Manisha; Shrestha, Ashish; Dahal, Isha; Sutihar, AnshuAbstract Introduction: Hydrocele, an accumulation of serous fluid within the remnant of the processus vaginalis, is a common cause of painless scrotal enlargement. While prevalent, few studies have been conducted to assess the extent and risk factors of hydrocele in Nepal. This study aimed to assess the prevalence and associated factors of hydrocele among patients undergoing the surgery department at a tertiary care center in Nepal. Methods: This descriptive cross-sectional study was conducted at a tertiary care center. Data were retrospectively collected from medical records over one year (2021 July to 2022 June), including all patients undergoing surgery in the general surgery department. Ethical Approval was received from the Institutional Review Committee of the same institute (Reference number: 820/2080/81) Cases of hydrocele surgery were identified, and relevant data were extracted using a structured proforma. Descriptive analyses were performed using Microsoft Excel 2016. Results: Out of 1812 surgeries, 95 (9.72%) were hydrocele surgeries. Of these, 94 (98.95%) were non-communicating hydroceles, 79 (83.16%) were unilateral, and 90 (94.74%) showed positive transillumination tests. The mean age of patients was 50.84 ± 17.02 years, with the highest number of cases in the 46-55 age group (20%). Postoperative complications occurred in 19 (20%) patients, with seroma and surgical site infection being the most common (31.58% each). Conclusions: Hydrocele surgeries comprised a significant portion (5.24%) of surgical cases at the tertiary care center, with the majority being non-communicating and unilateral types.Publication Impact of Pictorial Health Warnings on Cigarette Packs among Current Smokers of Sub-Metropolitan City of Nepal: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Shrestha, Ashish; Bhagat, Tarakant; Agrawal, Santosh Kumari; Limbu, BinitaAbstract Introduction: Pictorial health warning on cigarette packs is one of the strategies undertaken by Nepal Government as per the directive of World Health Organization Framework Convention on Tobacco Control to control smoking. It has been more than a decade since the introduction of pictorial health warnings on cigarette packs in Nepal. The objective of this study was to assess the impact of the pictorial warnings among current smokers of Dharan, Nepal. Methods: A descriptive cross-sectional study was conducted among current smokers visiting local shops located near ward offices of Dharan after obtaining ethical approval from Institutional Review Committee (Reference number: 204/080/01 -IRC). A structured and validated Nepali questionnaire was used to interview the smokers about the impact of the pictorial warnings based on their noticeability, behavioural and cognitive responses. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 20.0. The responses of the participants were tabulated in frequencies and percentages. Results: The pictorial warnings were noticed by 277 (98.93%) participants in past one month out of which 11 (3.93%) smokers had always read or looked closely at them. Smoking less frequently was the behaviour change reported by 70 (25%) participants and smoking less around others was reported by and 56 (20%) participants. In total, 189 (67.50%) smokers had thought about the harms of smoking and 160 (57.14%) had intention to quit smoking due to the pictorial warnings. Conclusions: The pictorial health warnings were not so effective in bringing about changes in smoking behaviour of smokers.Publication Peripheral Ameloblastoma of Acanthomatous Variant: A Case Report(Nepal Medical Association, 2022) Singh, Ripu; Shrestha, Sajeev; Acharya, Pujan; Shrestha, AshishAbstract Ameloblastoma is an uncommon benign epithelial neoplasm of odontogenic origin that accounts for about 18% of the odontogenic tumour. It is a slow-growing, locally invasive but rarely metastatic tumour. Extraosseously occurring peripheral ameloblastoma is a rare variant that comprises about 2-10% of all ameloblastoma. We report a case of peripheral ameloblastoma in a 43-years old male patient affecting the mandibular canine-premolar region with a histopathological diagnosis of acanthomatous ameloblastoma. This case report emphasises the clinical, radiographic, and histological features of a rare variant that distinguishes it from the other similar appearing lesion on gingiva along with its various treatment modalities.Publication Prevalence of Cleft Lip and Palate in the Developing Countries of Asia and Africa: A Review Authors(Nepal Paediatric Society (JNPS), 2022) Shrestha, Ashish; Hoang, Ha; Gardner, Sue; Pradhan, Archana; Crocombe, LeonardAbstract: Introduction: The objective of this paper is to review the literature on the incidence of cleft lip and palate (CLP) in the developing countries of Asia and Africa. The existing literature tends to focus on developed countries and there is lack of research in developing countries. Methods: The studies that met the inclusion criteria were reviewed and data extracted. There were 20 studies done in Asian and African countries which were included. Results: The incidence of CLP in Asian countries is markedly greater than in African countries. Most studies report a male predominance in CLPs and a female predominance in cleft palates. The male dominance is seen more than other developing countries which is consistent with other Asian countries and the same has been found in African countries. In the Nepalese study, females were slightly more affected than males among all clefts. The incidence or prevalence in the frequency and types of malformations of CLP in developing countries has been provided. Conclusions: The review underlines the need for an aggressive approach to prevent and control CLP in patients in developing countries.