Browsing by Author "Singh, Yogendra Prasad"
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Publication Comparative Outcomes of Doxorubicin and Cyclophosphamide with Sequential versus Concurrent Paclitaxel in the Adjuvant Treatment of Non-Metastatic Breast Cancer: A Cross-Sectional Analytical Study(Nepal Medical Association, 2025) Paudel, Bishal; Paudel, Bishnudutta; Shrestha, Rakshya; Panthi, Bishal; Shilpakar, Ramila; Dulal, Soniya; Kharel, Sanjeev; Dhunagana, Reechashree; Singh, Yogendra Prasad; Shrestha, BipsanaAbstract Introduction: Studies have compared the efficacy and toxicities of doxorubicin and cyclophosphamide every three weeks for four cycles followed by four cycles of paclitaxel every three weeks (AC/T); with paclitaxel, doxorubicin, and cyclophosphamide (TAC) every three weeks for six cycles for adjuvant treatment of breast cancer in western countries. Genetic and environmental disparities in Nepalese population warrant the need for similar studies in Nepal. This study compares the toxicity patterns and compliance of AC/T versus TAC in the adjuvant treatment of non-metastatic breast cancer in Nepalese women. Methods: A hospital-based cross-sectional analytic study was conducted at Bir Hospital, Kathmand after obtaining the ethical approval (Reference number: 931/076/077). Sixty women who completed either AC/T or TAC regimens were evaluated. Confounding was minimized by strict inclusion/ exclusion criteria (restriction), group matching, and random sampling. Primary outcome was grade 3–4 hematological toxicity; secondary outcomes included other adverse effects and compliance. Results: Although hematological toxicities were higher in the TAC group, differences were not statistically significant. Non-hematological toxicities (fatigue, nausea, vomiting, pain, nail changes) were significantly higher in the TAC group. Edema was more prevalent in the AC/T group (p=0.04). Compliance without modification favored AC/T (64.5% vs. 34.5%; p=0.038). Conclusions: Sequential AC/T demonstrated superior tolerability and compliance. Confounder control through study design and statistical methods strengthens the validity of these findings, though larger studies are warranted.Publication Inadequate Completion of Computed Tomography Request Forms of Patients Visiting the Department of Radiology in a Tertiary Care Centre(Nepal Medical Association, 2023) Sah, Ramswarth; Lohani, Benu; Singh, Yogendra PrasadAbstract Introduction: From both medical and legal points of view, it is vital that computed tomography request forms should be adequately filled up. It is the responsibility of physicians to collect adequate clinical information that justifies the computed tomography examination and the ethical responsibility of radiological technologists and radiologists is to perform only the justified radiological examinations. Thus, a properly filled request form is crucial for understanding the clinical problem, using the proper protocol for avoiding unnecessary radiation exposure and providing concise radiological reports. The aim of this study was to find out the prevalence of inadequate completion of computed tomography request forms of patients visiting the Department of Radiology of a tertiary care centre. Methods: This descriptive study was performed in the Department of Radiology from 22 April 2021 to 21 April 2022 after receiving ethical approval from the Institutional Review Committee. Computed tomography request forms from emergency, ward and outpatient Departments were used in the study whereas that from other hospitals and clinics were excluded. A convience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of 470 computed tomography examination forms, the prevalence of inadequate computed tomography request forms was 195 (41.49%) (37.03-45.94, 95% Confidence Interval). Conclusions: The prevalence of the inadequacy of completion of computed tomography examination forms was higher than other similar studies done in similar settings.