Browsing by Author "Sidharth"
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Publication Pattern of Renal Cell Carcinoma – A Single Center Experience in Nepal(Kathmandu University, 2011) Sidharth; Luitel, BR; Gupta, DK; Maskey, P; Chalise, PR; Sharma, UK; Gyawali, PR; Shrestha, GK; Sayami, G; Joshi, BRABSTRACT Background Renal tumor is the 13th most common malignancy in the world and more than 90% of renal tumors are renal cell carcinomas. As there is no data available on renal cell carcinoma in Nepal, hence this study was undertaken to analyze the patterns of renal cell carcinoma in patients with renal mass at a tertiary level hospital in Nepal. Objectives To analyze the patterns of renal cell carcinoma in patients with renal mass at a tertiary level hospital in Nepal. Methods The case records of 50 consecutive patients with renal cell carcinoma presenting at the Tribhuvan University Teaching Hospital, Kathmandu from July 2006 to June 2011 were retrospectively evaluated for presenting symptoms, physical finding, investigation and histopathology report. Results Out of 50 patients, 64% were male and 36% were female. The age ranged between 11 to 78 years (mean ± SD: 55 ± 15 years). Fifty four percent of patients were smokers. Incidentally tumor was detected in 40% cases by ultrasonography and the typical triad was present in only 4%. The tumor was occupying upper pole in 40% of cases. The tumor size ranged from 3 to 15 cm (mean ± SD: 7.3 ± 2.9 cm). Histopathologically, 76% of the patient had organ confined renal cell carcinoma (T1- 2 N0 M0). Clear cell was the most common type seen in 86%. Fuhrman’s nuclear grade 2 was found in 50%. Conclusion Many of the renal cell carcinoma are detected incidentally, at an early stage and are of clear cell subtype. KEY WORDS Incidental renal tumor, Nepal, Renal cell carcinoma.Publication Urological complications after Kidney transplantation(Kathmandu University, 2010) Chalise, PR; Sharma, UT; Gyawali, PR; Shrestha, GN; Joshi, BR; Gurung, GS; Ghimire, RK; Kafle, MP; Sigdel, MR; Shah, DS; Raut, KB; SidharthABSTRACT Background Renal transplantation is a regular service at Tribhuvan University Teaching Hospital and complications have been known to occur after it. This study was conducted to assess complications after transplantation. Objectives To determine the incidence of urological complications after living related renal transplantation at Tribhuvan University Teaching Hospital. Methods A clinical study was performed (from August 2008 to July 2010) which included 50 living-related renal transplantations at Tribhuvan University Teaching Hospital. All the donors and recipients were evaluated preoperatively with necessary investigations and followed up postoperatively with standard hospital transplant protocol. The incidence of urological complications were documented and analyzed. Results Fifty living-related, renal transplantations were carried out during the study period. Seven doors had minor post operative complications; three had post operative fever, two had chest infections and each one had superficial surgical site infections and severe pain at incision site. Ureteroneocystostomy was performed with double J stent in all recipients. Urological complications were noted in 12 (24%) recipients. Clinical significant hematuria occurred in four cases. One patient had ureteric necrosis and urinary leak which required re-exploration post operatively. Two patients developed delayed ureteric stricture which were managed by antegrade Double J stenting and ureteric reimplantation. Peri-graft abscess occurred in two cases, which were drained percutaneously. surgical site infections was seen in one case. Conclusions Urological complications are inevitable in renal transplantation and our complications rate appears similar to that reported in literature. Key words double J stent, renal transplantation, urological complications