NepMed Repository :: Browsing by Author "Yadav, B"

Browsing by Author "Yadav, B"

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Experience of Surgical Resection and Reconstruction of Chest Wall Tumor in Dhulikhel Hospital
(Kathmandu University, 2025) Karmacharya, RM; Vaidya, S; Bhatt, S; Guragai, M; Sharma, S; Bhandari, S; Shrestha, M; Shah, B; Yadav, B
ABSTRACT Background Chest wall tumors are rare thoracic tumor which can be either primary or metastatic. Conventional radiography is the first line of investigation followed by further imaging like computed tomography or magnetic resonance imaging. When indicated preoperative biopsy by fine-needle aspiration need to be done. Small chest wall tumor can be surgically treated by excision and primary repair. Bigger chest wall tumor is treated by excision and chest wall reconstruction. Objective To know the features of chest wall tumor, symptoms, histopathological findings, surgical procedures performed and outcome following the surgery. Method This is the retrospective study that included chest wall tumor subjected for excision and repair during January 2018 till December 2023 in Thoracic surgical unit of Dhulikhel Hospital. Variables such as presenting complaints, size and extent of tumor, type of surgery, outcome of the surgery, hospital stay, neoadjuvant chemotherapy and post excision chemo or radiotherapy and recurrence of the tumor were included. When primary repair is not possible following wide excision, reconstruction using double prolene sandwich mesh was done. Result There were 38 cases of chest wall tumor. Mean age of the patient was 42 years (SD 15.25 years, range 20 - 68 years). Of them, 22 patients were female (57.9%) and 16 patients were male (42.1%). Chest pain was the most common symptoms (84.2%) followed by lesion in chest (81.6%). Average size of the tumor was 14.8 ± 3.6 cm (Range 5 cm to 25 cm). Most common histopathological finding was neurofibroma (31.6%) filled by schwannoma (15.8%). All the patients underwent wide local excision. In terms of repair, primary repair was possible in 68.4% while in 31.6% patients repair using double prolene and bone cement sandwich was done. Average hospital stay was 6.6 days (SD 2.3, range 3-9 days). Conclusion Chest wall tumor can have different histopathological findings. In patients where wide resection is possible, it can be repaired by either primary repair or by repair using double prolene and bone cement sandwich. KEY WORDS Chest wall tumor, Reconstruction, Resection
Sensitivity and Specificity of Ankle Brachial Index for Diagnosis of Peripheral Arterial Disease in Diabetic Patients Presenting to University Hospital of Nepal
(Kathmandu University, 2025) Karmacharya, RM; Vaidya, S; Yadav, B; Sharma, S; Bhatt, S; Bhandari, N; Bhandari, S; Maharjan, S; Bhusal, J
ABSTRACT Background Diabetes is a significant risk factor for peripheral arterial disease (PAD) that increases morbidity and mortality. Hence, early detection of peripheral arterial disease is necessary. Evidence shows Ankle Brachial Index (ABI) as a promising test to diagnose peripheral arterial disease. However, sensitivity and specificity need to be evaluated before clinical use. Objective To determine Ankle Brachial Index sensitivity and specificity for the diagnosis of peripheral arterial disease in diabetic patients. Method Diabetic patients were recruited from Dhulikhel Hospital. Doppler ultrasonography (DUS) was done in all the recruited participants and peripheral arterial disease was assessed. Based on Jager’s criteria, those with grade III and IV stenosis were diagnosed as peripheral arterial disease and underwent ankle brachial index. Ankle brachial indexscores below 0.9 and above 1.5 were considered abnormal. The diagnosis by ankle brachial index was matched against the gold standard doppler ultrasonography to determine its specificity and sensitivity. Descriptive statistics and independent t-tests were used for statistics. P-value < 0.05 was considered statistically significant. Result There were total of 237 diabetic patients of which 31.2% had peripheral arterial disease. We found high sensitivity and specificity of ankle brachial index when tested against doppler ultrasonography with the values ranging from 88.68-89.66% and 86.67-90% respectively. Conclusion Ankle brachial index can be used in clinical settings to diagnose peripheral arterial disease in individuals with diabetes mellitus. KEY WORDS Ankle brachial index, Diabetes, Peripheral arterial disease, Sensitivity, Specificity
Sonographic measurement of the atrium of fetal lateral ventricle in low risk population of pregnant women at 16-38 weeks of gestation
(Institute of Medicine, 2016) Yadav, B; Thapa, BR; Ghimire, RK; Joshi, BR
Abstract The purpose of this study was to establish the size of atrium of fetal lateral ventricle and to evaluate its changes in normal fetuses in low risk population of pregnant women in the second and third trimesters of pregnancy. Methods: This was a prospective cross-sectional study involving 290 women with uncomplicated singleton gestation between 16-38 weeks. Atrium was visualized in 264 cases. The fetal biparietal diameter (BPD) was measured first. Atrium was measured at the level of the glomus of the choroid plexus, perpendicular to the ventricular cavity, positioning the calipers inside the echoes generated by the lateral walls. Nomogram of the sizes of atrium was prepared. Results: Atrium was visualized in 91% of the fetuses. The ages of the patients ranged from 17-30 years (mean 24.29, SD 2.78). The maximum numbers of case were at 23 and 27 weeks of gestation and the minimum number of cases were at 37 weeks of gestation. The mean size of the atrium of lateral ventricle was 6.28mm, (SD1.2; range 3.5-8.9 mm). The size of atrium showed significant positive correlation with gestational age (r2 value of 0.78; p<0.001 for atrium) Conclusion: Atrium of lateral ventricle showed continuous increment and showed significant correlation with the gestational age. The findings were consistent with the previous studies done by various authors. The percentile fitted values and nomograms will be valuable for the serial measurement of the atrium of lateral ventricle for complicated pregnancies. Keywords: ventricle, atrium
Sonographic measurement of the size of fetal cisterna magna in low risk population of pregnant women at 16-38 weeks of gestation
(Institute of Medicine, 2018) Yadav, B; Ghimire, RK; Joshi, BR
Abstract Introduction: The purpose of this study was to determine the normal size values of fetal cistern magna(CM) and to evaluate its changes in normal fetuses in low risk population of pregnant women in the second and third trimesters of pregnancy using transabdominal ultrasonography. Methods: This was a prospective cross-sectional study involving 290 women with uncomplicated singleton gestation between 16-38 weeks. CM was visualized in 264 cases. Gestational age was calculated by measuring fetal biparietal diameter (BPD). CM was measured from the posterior aspect of the cerebellar vermis to the inner edge of occipital bone. Nomogram of the sizes of CM was prepared. Results: CM was visualized in 91% of the fetuses. The ages of the patients ranged from 17-30 years (mean 24.29, SD 2.78). The maximum numbers of case were at 23 and 27 weeks of gestation and the minimum number of cases were at 37 weeks of gestation. The mean size of the CM was 6.32mm, (SD1.09; range 3- 9 mm). Conclusion: The size of fetal CM showed continuous increment and showed significant positive correlation with the gestational age( r2 value of 0.48; p<0.001). The findings were consistent with the previous studies done by various authors. The percentile fitted values and nomograms will be valuable for the serial measurement of the CM for complicated pregnancies. Keywords: cisterma magna, ultrasonography, vermis

Browsing by Author "Yadav, B"

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