Browsing by Author "Thapa, Anupama"
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Publication Duplex Collecting System with Ectopic Ureters Opening into Vagina: A Case Report Authors(Nepal Medical Association, 2022) Singh, Suraj; Dahal, Sulochana; Kayastha, Anuj; Thapa, Bijay; Thapa, AnupamaAbstract: Continuous urinary leakage, along with normal deliberate voiding, must suggest diagnosis of ectopic ureter, specifically in girls. Combination of a duplicated collecting system with distal, infrasphincteric, vaginal insertion of ureter is an uncommon congenital anomaly and rare cause of urinary incontinence. We present a case report of a 7-year-old girl who presented to the urology department with urinary incontinence despite successful toilet training and history of recurrent urinary tract infections. Right duplex collecting system was seen on ultrasound. Magnetic resonance urography revealed a near complete right duplex collecting system with ectopic insertion of ureter into vagina, and aplastic uterus with bilateral normal ovaries suggestive of Mayer-Rokitansky-Kuster-Hauser syndrome. Surgical treatment consisted of "common sheath" reimplantation of ectopic ureters into bladder, with complete resolution of symptoms. This case suggests to us that congenital abnormalities of the genitourinary tract should be considered in case of urinary incontinence and recurrent urinary tract infections.Publication Length of Stay in the Emergency Department during COVID-19 Pandemic in a Tertiary Care Hospital: A Descriptive Cross-sectional Study Authors(Nepal Medical Association, 2021) Singh, Suraj; Koirala, Bibek; Thami, Rabin; Thapa, Anupama; Thapa, Bijay; Kayastha, Anuj; Dahal, PriyankaAbstract: Introduction: Emergency Department overcrowding has become worsening problem internationally which may affect patient, emergency department efficiency and quality of care and this may lead to increased risk of in hospital mortality, higher costs, medical errors and longer times to treatment. With this pandemic COVID-19 likely to go on for months, if not a year or longer, the Emergency Department should be prepared for large influx of patients infected with COVID-19. The aim of this study is to find-out the length of stay in emergency department during COVID-19 pandemic at a tertiary care hospital in Nepal. Methods: This is a descriptive cross-sectional study conducted in the Emergency Department of Kanti Children’s Hospital. Ethical clearance was obtained from Institutional review committee Kanti Children’s Hospital. Data collection was done from the emergency records from July 23, 2020 to July 29, 2020. The calculated sample size was 211. The data thus obtained was entered in Statistical Package for the Social Science software version 20 and necessary calculations were done. Results: The median length of stay in emergency department was found to be 1.75 hours (Interquartile range 0 to 30 hours). Conclusions: Definitive management starts in respective wards and Intensive Care Units. During COVID-19, with longer emergency stay, chances of cross-infection increases, and the health workers serving in emergency department will be at risks. So guidelines for shorter emergency stay should be implemented.Publication Omphalocele, Exstrophy of Cloaca, Imperforate Anus, and Spinal Defects Complex: A Case Report(Nepal Medical Association, 2023) Singh, Suraj; Kayastha, Anuj; Thapa, Anupama; Thapa, Bijay; Dahal, SulochanaAbstract Omphalocele, exstrophy of cloaca, imperforate anus, and spinal defects complex is a rare malformation complex that includes omphalocele, cloacal exstrophy, imperforate anus and spinal defects with the incidence of 1 in 200,000 to 400,000 pregnancies and is even rarer in twin gestation. The etiology of this complex is still unclear. Most cases are sporadic. Prenatal screening must be done for diagnosis and appropriate multidisciplinary management of cases. In severe cases, termination of pregnancy is considered. We present a 4-day first twin child with underdeveloped ambiguous genitalia delivered via emergency lower section cesarean section at 32+3 weeks of gestation with giant liver containing omphalocele, cloacal exstrophy, imperforate anus and meningocele with severe pulmonary artery hypertension and non-visualization of right kidney and ureter, absence of uterus, fallopian tubes and right ovary. Separation and repair of the cecum and bladder were done. The ladd procedure was performed. Ileostomy was created and single-stage repair of the abdominal wall was done.Publication Patent Vitello - Intestinal Duct: A Case Report(Nepal Paediatric Society (JNPS), 2021) Thapa, Bijay; Thapa, Anupama; Kayasthya, AnjuAbstract: A wide variety of anomalies may occur as a result of the vitello- intestinal duct (VID) failing to obliterate completely. These anomalies occur in approximately 2% of the population and may remain silent throughout life or may present incidentally with an intra-abdominal complication. Complete patency of vitello-intestinal duct is the rarest of all the anomalies of VID. We report a case of 27 day old female presenting with pinkish umbilical mass since birth referred to us by a paediatrician as umbilical granuloma, which turned out to be patent vitello- intestinal duct.