Browsing by Author "Shrestha, Ramila"
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Publication Colorectal Polyps in Young Patients Undergoing Colonoscopy(Nepal Health Research Council, 2024) Bhusal, Yuvaraj; Basnet, Bhupendra Kumar; Shrestha, Ramila; Poudel, Mukesh Sharma; Khanal, Ajit; Poudyal, Nandu Silwal; Shah, Manoj Kumar; Khadka, Dibas; Bhusal, SurendraBackground: More than 10 % of colorectal carcinoma occur in patients less than 50 years. Progression of a colorectal polyp to carcinoma may take 5 to 20 years. Implementing screening guidelines and removing such polyps would reduce the progression into carcinoma. The aim of the study was to find the prevalence, distribution and histological analysis of polyps in patients under 50 years undergoing colonoscopy. Methods: Single-center cross-sectional study of 254 consecutive patients less than 50 years who underwent colonoscopy were included in the study. Patients with prior diagnosis of inflammatory bowel disease, colonic polyp(s) or colorectal carcinoma were excluded. Basic demographic data (age, gender), history of smoking and alcohol consumption were recorded. Prevalence of polyps, their location, size and histological type were estimated. Categorical data were expressed as frequencies and percentages. Results: Among 254 patients who underwent colonoscopy, 63 had colorectal polyps. 39 (61.9 %) patients with polyp were males and 33 (52.38 %) patients were of 40-49 years age. Recto-sigmoid polyps were seen in 47 (74.6 %) patients. Regular heavy alcohol consumers and active smokers had higher odds of having polyps. Adenomatous polyps and adenocarcinoma were detected in 12 and 10 patients respectively. Ulcerated or excavated appearance strongly suggested carcinomatous histology (OR: 363.8, (CI: 16.04 – 8250.90). Similarly, polyp size 5 mm or more favored adenomatous polyp or carcinoma [(OR: 177.35, CI: 9.7 – 3229)]. Conclusions: Prevalence of polyps in patients below 50 years age was 24.8 %. Most of the polyps were benign, diminutive (< 5 mm) and located in recto-sigmoid colon. One-third of the polyps were adenoma or adenocarcinoma. Keywords: Colonoscopy; colorectal polyp; screeningPublication Successful Endoscopic Management of Suspected Foreign Bodies in Upper Gastrointestinal Tract among Patients Undergoing Upper Gastrointestinal Endoscopy in a Tertiary Care Hospital: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Shrestha, Ramila; Baral, Shankar; Sharma, Mukesh; Thapa, Jiwan; Khadka, DibasAbstract: Introduction: Most ingested foreign bodies pass through the gastrointestinal tract spontaneously. However, some foreign bodies may get impacted in the upper gastrointestinal tract. A variety of endoscopic techniques and instruments are indicated for the removal of such impacted foreign bodies. This study was conducted to find out the prevalence of successful endoscopic removal of foreign bodies. Methods: This descriptive cross-sectional study was conducted among patients who presented at the Department of Gastroenterology with complaints of upper gastrointestinal foreign body ingestion from 2/11/2008 to 23/07/2020 after taking ethical approval of the research proposal was taken from Institutional Review Board (Reference no 13). Convenient sampling was done. The data were entered into Microsoft Excel and analyzed in Statistical Package of Social Sciences version 22. Results: A total of 119 cases were identified with foreign bodies ingestion. In hundred patients, foreign bodies 100 (84 %) (77.41-90.58 at 95% Confidence Interval) were extracted completely. Complete extraction failed in 19 (16%) patients. Six (5%) patients were treated by push technique and 10 (8.4%) patients with failed retrieval, received surgical intervention for foreign body removal. Conclusions: Endoscopic removal technique of foreign bodies in the upper gastrointestinal tract was successful in most of the cases and is associated with few complications.