Browsing by Author "Shrestha, Rajesh"
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Publication Cytomorphological Findings of Thyroid Lesions Based on theBethesda System and Their Relation with Thyroid Hormonal Status:A Cross-Sectional Study(Nepal APF Hospital, 2026) Khadka, Rajya; Shrestha, Hari Govinda; Karmacharya, Kavita; Parajuli, Ganesh; Shrestha, Rajesh; Adhikari, Ashish; Shrestha, Ujwal; Pradhan, DipendraAbstract: Introduction: Swelling of the thyroid gland is a common presentation of thyroid diseases, both benign and malignant, and some are associated with thyroid dysfunction. Fine needle aspiration cytology, along with ultrasound and assessment of thyroid function status, remains the mainstay of evaluation of thyroid swellings. This study aimed to classify thyroid lesions according to the Bethesda system and to assess their relationship with thyroid hormonal status. Methods: A cross-sectional study was conducted prospectively from April 2023 to April 2024 in a tertiary care center after ethical clearance from the Institutional Review Committee (Reference number: 774). Patients with thyroid lesions were included using convenience sampling, with a sample size of 141. Fine needle aspiration cytology was performed for lesion classification. Data entry and analysis were done using Microsoft Excel and Statistical Package for Social Sciences version 20. Results: Among 141 cases, the most common thyroid lesion diagnosed on fine needle aspiration cytology was benign, comprising 87 (61.70%), with benign follicular nodule accounting for 63 (44.70%) among the benign lesions. Among all, 99 (70.23%) patients presented with euthyroid status, and no statistical correlation between thyroid hormone status and benign versus malignant lesions or Bethesda classification was seen in this study. In total, 120 (85.11%) were female. The age group ranged from 18 to 87 years, and the mean age at presentation was 54.8 years. Conclusions: In this study most thyroid lesions fell into the Bethesda category II. Thus, fine needle aspiration cytology is an important diagnostic tool for thyroid lesions. However, thyroid hormone status and benign versus malignant lesions showed no statistical correlation.Publication Poor Quality of Sleep among Healthcare Workers in a Tertiary Care Centre(Nepal Medical Association, 2024) Kafle, Bikram; Tiwari, Suraj; Pokhrel, Arpana; Shrestha, Rajesh; Bagale, Yashoda; Pahari, NabinAbstract Introduction: Health personnel work under highly stressful conditions with long work hours, frequent night work, and shift duties resulting in sleep problems. Sleep problems lead to a decline in performance, cognition, memory, decision-making, medical errors and mental disorders. The study aimed to find out the prevalence of poor quality of sleep among healthcare workers in a tertiary care centre. Methods: This is a descriptive cross-sectional study conducted among healthcare workers (doctors, nurses, paramedics) of a tertiary care centre after obtaining ethical approval from the Institutional Review Committee. Data was collected from 1 October to 1 December 2023. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 127 healthcare workers, the prevalence of poor quality of sleep was seen in 61 (48.03%) (39.34-56.72, 95% Confidence Interval). A total of 31 (50.82%) were female and 30 (49.18%) were male. Conclusions: The prevalence of poor sleep quality was found to be higher than that of other studies done in similar settings. There is a need to enhance institutional support like incorporating flexible work schedules, and regular wellness programs to alleviate poor sleep quality among healthcare workers.Publication Short-term Functional Outcome of Corticosteroid Injection for Treatment of Trigger Finger in a Tertiary Care Center: A Prospective Observational Study(Nepal APF Hospital, 2026) Shrestha, Rajesh; Roy, Rabindra; Jha, Rajesh Kumar; Rijal, Shreejal; Kushwaha, Rajdev PrasadAbstract: Introduction: Trigger finger is a common cause of painful digital dysfunction resulting from impaired gliding of the flexor tendon beneath a thickened A1 pulley. Corticosteroid injection is widely used as a first-line intervention for Quinnell Grades II and III trigger finger, but short-term outcomes in Nepalese clinical settings remain limited. This study aimed to evaluate short-term pain reduction and clinical improvement following intralesional injection in these grades. Methods: This prospective observational study was conducted in the Orthopedics Department of a tertiary care center from April 3, 2023, to April 2, 2024. Ethical approval was obtained from the Institutional Review Committee (Ref. No. 245). A convenience sampling technique was used. Each participant presenting with Quinnell Grade II or III trigger finger received a single intralesional injection containing 40 mg of methylprednisolone acetate mixed with 1 ml of 2% lignocaine. Pain was assessed using the Visual Analogue Scale (0–100 mm) at baseline, 1 month, and 3 months. Clinical resolution of triggering and any injection-related complications was systematically recorded. Data were analyzed using Statistical Package for the Social Sciences version 20.0. Visual Analogue Scale scores were analyzed using the paired t-test, Results: The mean baseline Visual Analogue Scale score was 74.50±13.10 mm, which showed a significant reduction to 18.70±16.80 mm at 1 month and further to 13.50±10.50 mm at 3 months (p<0.001). Complete resolution of triggering was achieved in 39 (98%) of the cases. One (2%) patient experienced recurrence and subsequently underwent percutaneous release. A single (2%) case of superficial injection-site infection was recorded, with no major complications reported. Conclusions: Intralesional corticosteroid injection produced marked short-term pain reduction and near-complete symptom resolution in Grade II and III trigger finger, with minimal complications. These findings support its role as an effective and practical first-line treatment in outpatient settings.