Browsing by Author "Shrestha, Binod Bade"
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Publication Incarcerated Littre’s Umbilical Hernia: A Case Report(Nepal Medical Association, 2024) Shrestha, Binod Bade; Lamichhane, Anmol; Pokhrel, Rahav Chandra; Parajuli, Pratik; Goyal, PrinceAbstract Littre’s hernia is an extremely rare type of hernia which has Meckel’s diverticulum as its content. A 63-year-old male, presented to the emergency department with chief complaints of swelling and pain around the umbilicus. The patient was diagnosed with an incarcerated umbilical hernia. Following the emergency laparotomy, the intraoperative finding depicted an umbilical Littre’s hernia. The patient underwent open Meckel’s diverticulectomy with mesh repair. Preoperative diagnosis of Littre’s hernia is unlikely due to its low incidence and lack of specific radiological and clinical findings, but the role of computed tomography scan and ultrasound are important in differentiating between strangulated or incarcerated bowel and omentum and in guiding the urgency of operative management.Publication Postoperative Pain after Laparoscopic Cholecystectomy in a Tertiary Care Center: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Shrestha, Binod Bade; Lakhe, Gajal; Ghimire, PradeepAbstract Introduction: Laparoscopic cholecystectomy, being minimally invasive, is widely accepted in comparison to open cholecystectomy. The major benefits are small incision, less wound pain, rapid recovery, shorter hospital stay and earlier return to activities. Although, trauma and injury are limited in laparoscopic cholecystectomy; it is not a pain free surgery. Hence, we aimed to find the prevalence of pain at wound site after laparoscopic cholecystectomy at various time intervals in post-operative period. Methods: The descriptive cross-sectional study was conducted among 125 patients who belonged to American Society of Anesthesiologists grade I & II patients, with diagnosis of symptomatic gallstone disease from October, 2022 to September, 2023 in a tertiary care hospital after ethical approval was obtained from Institutional Review Board (Reference number: MEMG/483/IRC). Total sampling was done in this study. The post-operative pain at wound site was measured at 12, 24, 36 and 48 hours. Data were analyzed using Statistical Package of Social Sciences 21.0. Results: At 12 hours postoperatively, 2 (1.60%) patients complained of severe pain, 120 (96%) patients reported moderate pain and 3 (2.40%) patients expressed their pain as being mild. Likewise, at 24, 36 and 48 hours postoperatively, none of the patients suffered from severe pain. At 24 hours post-operative, 105 (84%) patients reported moderate pain which gradually declined over 48 hours. At 36 and 48 hours post-operative mild pain was reported by 85 (68%) and 117 (93.60%) patients. The moderate pain was complained by 40 (32%) and 8 (6.40%) patients. Conclusions: The majority of patients suffered from mild to moderate pain after laparoscopic cholecystectomy, the intensity of which decreased over 48 hours.Publication Postoperative Surgical Site Infections in the Department of General Surgery of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Ghimire, Pradeep; Shrestha, Binod Bade; Karki, Om Bahadur; Timilsina, Bishowdeep; Neupane, Ananda; Bhandari, AprajitaAbstract Introduction: Surgical site infection is defined by the Centres for Disease Control and Prevention as a wound infection that occurs within 30 days of an operative procedure or within a year if an implant is left in place and the infection is thought to be secondary to surgery. It occupies 20% to 39% of all the infections acquired in hospitals. The aim of this study is to find out the prevalence of postoperative surgical site infections in the Department of General Surgery of a tertiary care centre. Methods: A descriptive cross-sectional study on a total of 384 post-operative patients of abdominal surgery was conducted in the Department of General Surgery of a tertiary care centre from August 1, 2020 to July 30, 2021 with ethical approval from the Institutional Review Committee (Reference number: 267). Convenience sampling was done. Post-operative patients fulfilling the inclusion and exclusion criteria were included in the study. Data were entered in Microsoft Excel and analyzed using the Statistical Package for the Social Sciences version 21.0. Point estimate was done at a 95% Confidence Interval along with frequency and percentages for binary data and mean with standard deviation for continuous data. Results: Among 384 patients, the prevalence of surgical site infection was found to be 65 (16.92%) (13.15-20.65 at a 95% Confidence Interval). The patients had a mean age of 42.06±21.92 years. Conclusions: The prevalence of surgical site infection was higher in our study in comparison to other similar studies conducted in similar settings.Publication Preoperative Anxiety among Patients Undergoing Elective Surgery in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Lakhe, Gajal; Shrestha, Binod Bade; Subedi, AnilAbstract Introduction: Preoperative anxiety is universal in patients before surgery. It is mostly unaddressed by health professionals due to a lack of time. The objective of this study was to find out the prevalence of preoperative anxiety among patients undergoing elective surgery in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted on 385 surgical patients in the Department of Anaesthesia, from 27 November 2021 to 20 April 2022 in a tertiary care hospital posted for elective surgery. Ethical approval was obtained from the Institutional Review Committee (Reference number: MEMG/481/IRC). A convenience sampling was used. The level of anxiety and need for information was assessed using the Amsterdam Preoperative Anxiety and Information Scale questionnaire in a preoperative holding area. Point estimate and 95% Confidence Interval were calculated. Results: Out of 385 patients posted for elective surgery, preoperative anxiety was present in 88 (22.85%) (18.66-27.04, 95% Confidence Interval) patients. The mean Amsterdam Preoperative Anxiety and Information Scale score for total anxiety and need for information was 13.59±2.47 and 5.91±3.06 respectively. Anxiety was present in 60 (68.18%) females, 45 (51.13%) young patients aged <30 years and 50 (56.81%) patients without prior experience with surgery and anaesthesia. Conclusions: The prevalence of preoperative anxiety among surgical patients was lower than in previous studies done in similar settings. Preoperative anxiety was common in females, young patients and patients without previous experience with anaesthesia and surgery.