Browsing by Author "Thapa, NM"
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Publication Chondrosarcoma of Posterior Nasal Septum(Kathmandu University, 2012) Gurung, U; Joy, L; Thapa, NM; Pradhan, BABSTRACT Chondrosarcoma is a rare non-epithelial tumor comprising of 10-20% of primary bone tumor. The nasal septum is a rare site for its occurrence. We present one such case of chondrosarcoma of the nasal septum who was treated with endoscopic removal followed by post operative radiotherapy and discuss the relevant clinical presentation, diagnosis and treatment and review the literature also. KEYWORDS chondrosarcoma, excision, nasal septumPublication Sinonasal Mucormycosis Amidst the Second Wave of COVID-19 Pandemic; Clinical Spectrum and Outcome in a Tertiary Care Center in Nepal(Kathmandu University, 2024) Gurung U; Dongol K; Paudel S; Thapa, NM; Pradhananga, RB; Gyawali, BR; Shrestha GSABSTRACT Background Mucormycosis is an angioinvasive opportunistic fungal infection which surged during the second wave of COVID-19 pandemic. Objective This study assessed patient demographics, risk factors, clinical characteristics, and outcomes of sinonasal mucormycosis during the second wave of COVID-19 pandemic. Method The clinical records of patients with histologically proven sinonasal mucormycosis, admitted between May 2021 to October 2021, in a tertiary center were reviewed. Result There were 25 patients (18 males, 7 females). The age ranged from 16 to 70 years (mean 51 ± 9.5 years). Uncontrolled diabetes mellitus detected in 23 patients was the most common co-morbidity. COVID-19 infection was documented in 20 patients. The mean time of diagnosis was 12 days after the onset of COVID-19 infection. Based on the disease extent, six patients had sino-nasal, seven had rhino-orbital, and 12 had rhino-orbital-cerebral involvement. The most common first presenting symptom was orbital (17/25) followed by facial (5/25) and orodental (3/25). All patients received intravenous amphotericin B for 2 to 8 weeks. Maintenance with posaconazole ranged from 3 to 9 months. Sixteen patients underwent surgical debridement. Out of the 25 patients, 14 (56%) had good recovery. Poor outcome was observed mostly with intracranial involvement. Conclusion Uncontrolled diabetes mellitus was a common risk factor. Advanced disease at presentation was frequently encountered due to rapid extrasinus spread. Nearly 50% of patients had good recovery whilst poor outcome was observed, mostly with intracranial involvement. Adequate blood sugar control, early administration of antifungals, and aggressive surgical debridement are the mainstay of treatment. KEY WORDS COVID-19, Hyperglycemia, Mucor, Mucormycosis, PandemicPublication Three Years of Experience of ENT-Head and Neck Trauma in a Tertiary Care Centre of Nepal(Kathmandu University, 2024) Thapa, NM; Das, SABSTRACT Background Trauma to ENT-Head and Neck region is one of the commonest emergencies. The neck and face being exposed parts of our body are vulnerable to traumatic injuries. Objective To study epidemiological pattern, site, mode and cause of trauma in ENT Head and Neck region, their management and outcome. Method This retrospective study was conducted in the department of ENT-Head and Neck Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Medical records of the patients admitted with Head and Neck trauma from April 14, 2019 to April 13, 2022 were retrieved from the Medical Records Section and reviewed. Trauma cases which were managed on an OPD basis and those patients with incomplete data and polytrauma were excluded. Result Most of the trauma cases were in the adults 139 (72.41%). Males were more common than females (80.73%). Oral cavity and oropharyngeal injury 37 (69.81%) was most common in the pediatric patients. In adults nose and facial trauma79 (56.83%) was the most common site of injury. Fall was the most common mode of injury in pediatric patients 36 (67.92%) while in adults it was interpersonal violence 43 (30.94%). Conclusion ENT-Head and Neck trauma was more commonly observed in male adults. Paediatric patients were found to be vulnerable to fall while in adults interpersonal violence was the most common mode of trauma. Oral cavity and oro-pharynx were the most common sites of injury in children while nose and facial trauma were the most common in adults. There were no significant complications and mortality reported during the hospital stay. KEY WORDS ENT-head and neck trauma, Fall injury, Fracture reduction, Road traffic accident (RTA), Suicidal cutthroat