Browsing by Author "Singh, Yogendra P"
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Publication Academic Reading, Writing, and Publishing in Nepal: Initiation from Institute of Medicine(Institute of Medicine, 2021) Singh, Yogendra PNAPublication Assessment of a Scoring System to Predict Difficult Laparoscopic Cholecystectomy(Institute of Medicine, 2020) Sigdel, Prem R; Subedi, Nirajan; Phuyal, Suman; Pokharel, Ashik; Ghimire, Bikal; Singh, Yogendra PABSTRACT Introduction: Laparoscopic cholecystectomy (LC) has become the procedure of choice for management of symptomatic gallstone disease. It would be useful to have some reliable predictive factors for conversion in LC. Our aim is to predict difficult laparoscopic cholecystectomy preoperatively by using a scoring system. Methods:A total of 136 patients were included. The parameters considered for this study were old age, male sex, history of hospitalization, obesity, abdominal surgery scar, palpable gall bladder, gall bladder wall thickness, pericholecystic collection and impacted stone. Results: Among 136 cases, 70.6% were easy, 24.3% were difficult and 5.1% were very difficult intraoperatively. The factors like age >50 years, history of hospitalization for acute cholecystitis, previous abdominal surgery, palpable gall bladder, wall thickness >4mm and impacted stone were found statistically significant in predicting difficult LC. The preoperative scoring is statistically and clinically a good test for predicting the difficult LC (area under the curve = 0.824) with sensitivity of the test being 82.3% and specificity 72.7%. Conversion rate was 3.67%. Conclusion: The factors like age >50 years, history of hospitalization for acute cholecystitis, previous abdominal surgery, palpable gall bladder, wall thickness >4 mm and impacted stone are the preoperative predictors of difficult LC. Keywords: Cholecystitis, difficult, laparoscopic cholecystectomy, open cholecystectomy, symptomatic gall stone diseasePublication Batwing Technique in Large Volume Excision of Breast Lesions: Case Report(Institute of Medicine, 2019) Khanal, Suman; Singh, Yogendra P; Sharma, RashmiABSTRACT Oncoplastic surgical techniques are seeing widespread use for excision of large volume breast lesions. Batwing technique is one of the volume displacement techniques that can be used to manage lesions in central quadrant of the breast. Such techniques are still underused in Nepal. Here we present three cases with large volume benign breast lesions managed with simple, easy-to-learn technique of Batwing oncoplasty. Keywords: Batwing, fibroadenoma, oncoplasty, phyllodesPublication Publication Case of HER2-Enriched Multifocal Breast Cancer Associated with Pregnancy(Institute of Medicine, 2019) Khanal, Suman; Singh, Yogendra P; Shrivastav, ShreyaABSTRACT Pregnancy-associated breast cancer is less common and often presents in advanced stage. Management is similar to non-pregnant cases with trimester-specific considerations. In this case report, we present a case of worrisome mother with locally advanced multifocal pregnancy-associated breast cancer who was so much concerned about effects of neoadjuvant chemotherapy on fetus leading to its delayed initiation, and show why targeted therapy is still not within reach in a developing economy like Nepal. Short term data of chemotherapy though reveal relative safety, long term data are lacking. This may be a hindrance in counselling, when patients are more anxious and worrisome. Keywords: Breast cancer, chemotherapy, HER2-neu, pregnancyPublication Characteristics of Articles Published in the Journal of Institute of Medicine Nepal: A Cross-sectional Study(Institute of Medicine, 2022) Shrestha, Lava; Singh, Yogendra P; Sharma, Mohan RABSTRACT Introduction: Scholarly journals publish various types of manuscripts. The objective of this study was to analyze the types of articles published in the Journal of Institute of Nepal (JIOM Nepal) from 2019 April to 2021 April and describe bibliometric characteristics. Methods: Seven issues of JIOM Nepal published from April 2019 to April 2021 were analyzed for types of study, areas of medical science, the number of authors, gender of the primary author, contributing specialty, and author’s affiliation. Results: Total articles published were 139, with a mean number of 19.8±4.4 articles per issue. More than half of the published articles were cross-sectional studies (93, 66.9%), followed by case reports (25, 17.9%). The majority of primary authors (94, 67.6%) were faculty from constituent campuses of the Institute of Medicine (IOM) Tribhuvan University. Thirty-eight (27.3%) contributing authors were females. Fifty-three (38.1%) articles published were diagnosis-related. Authors from surgical specialties were the most common article contributors [67 (48.2 %)], while basic science specialties contributed 13 (9.4%) publications. Conclusion: Cross-sectional studies were the most commonly published articles and surgical specialties published more than half of the articles. The majority of the articles were related to diagnosis. Greater efforts are needed to produce further progress of the journal. A mixture of original articles, reviews, and case reports from different medical domains will be more interesting to the readers. Keywords: Article, authors, characteristics, journalPublication Granular Cell Tumor of Breast: Rare Tumor Masquerading as Malignancy(Institute of Medicine, 2020) Hirachan, Suzita; Singh, Yogendra P; Jha, Anamika; Manandhar, UshaABSTRACT Granular cell tumor (GCT) is a rare soft tissue tumor that arises from the Schwann cells of peripheral nerves. It was first postulated by Abrikossoff in 1926 as Myoblastoma. About 5-15% of these tumors occur in the breast and less than 1% has the potential to be malignant. Here we present a case of 41 years old premenopausal woman with Benign GCT of the right breast, having clinically malignant features. The clinical and radiological features of GCT are similar to malignant lump. However, histology showing presence of sheets of polygonal cells with abundant granular eosinophilic cytoplasm with round nuclei and granules with Periodic acid–Schiff (PAS) positive, diastase resistant and S-100 antigen positive are confirmatory. Treatment of Granular cell tumor is wide local excision. There is apparently no role of chemotherapy and radiotherapy. The presence of GCT in the breast is quite rare and clinically as well as radiologically it may mimic malignancy, however with histopathology and appropriate immunohistochemistry, proper diagnosis can be made. Keywords: Breast cancer, excision, granular cell tumorPublication Health Research During COVID-19 Pandemic: Nepalese Perspectives(Institute of Medicine, 2021) Singh, Yogendra PNA.Publication Publication Initial Experience with Simple Oncoplastic Breast Conserving Surgery in Nepal: A Case Report(Institute of Medicine, 2020) Singh, Yogendra P; Khanal, SumanABSTRACT Oncoplastic breast conserving surgery is increasingly used in the management of early breast cancer. Though its use in Nepal is increasing, it is still under-utilized. We present a case of upper outer quadrant early breast cancer located away from nipple-areola complex managed with radial ellipse segmentectomy 10 years back and under regular follow up. We recommend its usage in upper outer quadrant lesions because of its simplicity, access for sentinel lymph node biopsy and good cosmetic outcome. Keywords: Early breast cancer, lumpectomy, simple oncoplastic surgeryPublication Learning to Live with COVID-19 in Nepal: A Unique Experience(Institute of Medicine, 2020) Singh, Yogendra PNA.Publication Post-operative Pancreatitis as a Predictor of Postoperative Pancreatic Fistula in Patients Following Pancreaticoduodenectomy(Nepal Health Research Council, 2022) Subedi, Nirajan; Ghimire, Bikal; Kansakar, Prasan B S; Bhandari, Ramesh S; Lakhey, Paleswan J; Singh, Yogendra PAbstract Background: Postoperative pancreatic fistula remains the single most important determinant of morbidity and mortality following pancreaticoduodenectomy. A new entity was proposed by Saxon Connor “Post-Operative pancreatitis”, which is defined by raised serum amylase more than the upper limit of institutional serum amylase value on Post-Operative day 0 or 1. There has been shown to be an association between postoperative pancreatitis and postoperative pancreatic fistula. We have conducted this study to see the incidence of postoperative pancreatitis and its association with postoperative pancreatic fistula. Methods: This was a prospective observational study. All patients undergoing pancreaticoduodenectomy at a tertiary care center for one and a half years were included. A cut-off value of serum amylase 80U/L was used to make a diagnosis of postoperative pancreatitis. The patients were followed up for one month. Pancreas specific complications were defined according to the definition given by the International Study Group of Pancreatic Surgery. Results: A total of 49 pancreaticoduodenectomies were done in the given period. The incidence of postoperative pancreatitis was 31(63.3%) and postoperative pancreatic fistula was 19(38.8%). Postoperative pancreatic fistula was seen in 19(61.2%) of patients having postoperative pancreatitis (P<0.001). Post-operative pancreatitis was also significantly associated with post pancreatectomy hemorrhage, increased hospital stay, and mortality. In multivariate analysis, preoperative endoscopic biliary drainage and increased serum amylase on the first postoperative day came out to be an independent predictor of postoperative pancreatic fistula. Conclusions: Post-operative Pancreatitis was associated with an increased incidence of Post-operative pancreatic fistula and other postoperative complications like Post pancreatectomy hemorrhage and mortality. Keywords: Pancreaticoduodenectomy; postoperative pancreatitis; postoperative pancreatic fistula; post pancreatectomy haemorrhage