Browsing by Author "Shrestha, Suraj"
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Publication Attenuation Measurements of the Kidney on Unenhanced CT in Ureterolithiasis(Institute of Medicine, Tribhuvan University, 2024) Gupta, Avinash; Regmi, Pradeep Raj; Shrestha, Suraj; Adhikati, Aayush; Yadav, Sushil Kumar; Katwal, Shailendra; Khadayat, RameshAbstract Introduction: Urolithiasis is a common disease worldwide that affects a wide range of patients. This study evaluated the diagnostic utility of attenuation values of bilateral kidneys on unenhanced helical Computed Tomography (CT) in ureterolithiasis patients. Methods: This cross-sectional study was performed in patients with ureteric calculus referred for unenhanced helical CT of the kidney, ureter, and bladder (CT-KUB). The attenuation of the renal parenchyma in Hounsfield units (HU) was measured, and a mean attenuation value was determined for obstructed and contralateral kidneys of each patient and compared. Results: Among the 95 patients, 40 had ureteric stones on the left kidney and 55 on the right kidney. Lower average attenuation value in obstructed kidneys (on the side of the ureteric stone) was seen in 75 (78.9%) patients. 79% (N=69) of patients and 3.15% (N=3) of patients showed zero average attenuation difference. Mean attenuation values in the upper pole, middle portion, and lower pole were 28.60 HU, 30.23 HU, and 30.59 HU for obstructed kidneys and 32.74 HU, 33.41 HU, and 31.93 HU for contralateral kidneys. Mean of mean attenuation values in the three regions were 29.81 HU for obstructed kidneys and 32.69 HU for contralateral kidneys. A significant difference of 2.88 HU was found in mean attenuation values between the obstructed kidneys and the contralateral kidneys. Conclusion: Attenuation values between the kidneys can serve as a means of differentiating between obstructed and non-obstructed kidneys in unenhanced CT KUB.Publication C-Shaped Canal in Second Molar of Mandible among Cases of Cone Beam Computed Tomography in Tertiary Care Centres: A Descriptive Cross-sectional Study Authors(Nepal Medical Association, 2021) Joshi, Neera; Shrestha, Suraj; Sundas, Sunanda; Prajapati, Kranti; Wagle, Sharada Devi; Gharti, ArchanaAbstract: Introduction: C-shaped canal configuration is mostly found in the mandibular second molar. The morphological characteristic of a C-shaped canal is the presence of a fin or web connecting the individual canal, making it difficult for cleaning, shaping, and obturation. The objective of this study was to find out the prevalence of C-shaped canal in mandibular second molar among cases of Cone Beam Computed Tomography in tertiary care centres. Methods: The descriptive cross-sectional study was conducted in the department of conservative dentistry and endodontics of tertiary care centres from 20th June 2020 to 20th December 2020 after receiving ethical approval from the Nepal Health Research Council on 19 June 2020. Cone-beam computed tomography images of 199 mandibular second molars with completely formed roots were used. Teeth with orthodontic braces, root resorption, root canal filling, and post were excluded from the study. The research was conducted taking a tooth as a unit. Convenience sampling was done. Statistical analysis was done by using Statistical Package for Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The prevalence of C-shaped canal according to this study is 25 (12.6%) (7.99-17.21 at 95% Confidence Interval). Conclusions: The findings of the study conclude that C-shaped configuration is quite frequent in mandibular second molar among cases of Cone Beam Computed Tomography. A careful pre-operative radiographic evaluation may be helpful for diagnosing C-shaped configuration prior to root canal treatment.Publication Clinical Profile of Thoracoscopic Bullectomy in Treatment of Pneumothorax(Nepal Health Research Council, 2024) Gautam, Pratima; Sapkota, Ranjan; Shrestha, Suraj; Mainali, PrakashBackground: In pneumothorax patients requiring surgery for various indications, thoracotomy was the traditional approach until the advent of video-assisted thoracoscopic surgery. In the last decade, role of thoracoscopy in the surgical management of pneumothorax has been consolidated and established. In this study, we aim to report our experience of thoracoscopy in the surgical management of pneumothorax. Methods: A descriptive review of prospectively maintained data on all the patients undergoing thoracoscopic bullectomy for pneumothorax was done. Result: Over the period of 9 years, a total of 120 patients underwent thoracoscopic bullectomy. Among them, 95 entered final analysis. Most common age group was 21-40 years, with male predominance (80%); most common diagnosis was primary pneumothorax (67%), first episode (74%), and on the right (65%) side; commonest symptom was shortness of breath (84%) of a median duration of 7 days. A chest tube was placed in 96% of patients before the operation. Commonest radiological finding was multiple bullae (45%) in the apical region (71%). Majority of patients underwent surgery via 3 ports, and a single bulla in the apical region was the most common intraoperative finding. Among the postoperative complications which occurred in 17%, an air leak was present in 9%. The median intensive care stay was 23 hours, the median chest tube duration was 3 days, and the median hospital stay was 9 days. Conclusions: Thoracoscopy can be used as a safe, feasible, and effective procedure in patients presenting with pneumothorax with minimal postoperative complications. Keywords: Bullectomy; pneumothorax; video-assisted thoracoscopic surgery.Publication Skin Manifestations in Dengue Patients of a Tertiary Hospital during Dengue Epidemic in Kathmandu: A Retrospective Study(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2024) Sitaula, Seema; Shrestha, Suraj; Mishra, Punam; Subba, Mamata; Poddar, ElishaAbstract: Introduction: With a wide range of clinical manifestations and a drastic shift in epidemiology, dengue infection is a life-threatening condition. Studies of skin manifestations in dengue fever are scarce, and hence, it is prudent to explore the skin manifestations of dengue in Nepal for prompt diagnosis and to reduce associated complications. Methods: We conducted a single-center retrospective cross-sectional study from August 1, 2022, to December 1, 2022. Information on demographics, clinical characteristics of rash, and laboratory investigations were gathered in a pre-formed proforma from patients’ charts, which were organized and analyzed using the statistical software SPSS 21. Continuous data were presented as mean, and standard deviation and categorical data were presented as frequency and percentage. Results: There were 98 dengue cases with a mean age of 39.47 years. Among 43 patients, maculopapular (72.1%), erythematous macules (23.3%), purpuric (20.9%), both macules and maculopapular (11.6%) and ecchymotic (4.6%) rashes with no mucosal involvement were found. There was no statistically significant association between platelet count and rashes. Conclusion: Patients with dengue had varied cutaneous features. Maculopapular and erythematic rashes were the most commonly observed dermatological manifestations.