Issue 56 july-Sep, 2022 https://hdl.handle.net/20.500.14356/926 2026-04-23T11:40:07Z 2026-04-23T11:40:07Z Laudari, Uttam Pradhan, Rosi Shrestha, Dibesh Bhandari, Shreya Thapa, Prabin Bikram https://hdl.handle.net/20.500.14356/993 2023-05-31T07:17:32Z 2022-01-01T00:00:00Z

Title: Feasibility of Telementoring as an Intraoperative Time-out Tool during Laparoscopic Cholecystectomy for Prevention of Biliovascular Injuries Authors: Laudari, Uttam; Pradhan, Rosi; Shrestha, Dibesh; Bhandari, Shreya; Thapa, Prabin Bikram Abstract: Abstract Laparoscopic cholecystectomy is commonly performed procedure for gallbladder diseases. Biliovascular injuries are well known complications and various standard and safe strategies have been developed for safe cholecystectomy. Intraoperative time out is one of the strategies where two or more surgeons stop during surgery before dividing any structure in Calot’s triangle. COVID-19 pandemic has expanded the horizon of telesurgery, teleconsultation, use of artificial intelligence and robotics in surgical training and execution. Easily available mobile applications like Facebook messenger, WhatsApp and Viber can be used for intraoperative time-out during difficult cholecystectomy with expert surgeon outside the vicinity of theatre. Such tools are cost effective and definitely boost the confidence of surgeons during surgery in case of any complexity, or help in stopping the procedure and in timely referral. Keywords: Cholecystectomy; laparoscopy; telementoring. Description: Case Report

2022-01-01T00:00:00Z Dongol, Kripa Rayamajhi, Pabina Pradhananga, Rabindra Bhakta Dulal, Malati Sedhai, Milan Gurung, Bikash https://hdl.handle.net/20.500.14356/992 2023-05-31T07:17:32Z 2022-01-01T00:00:00Z

Title: Mucormycosis of the Middle Ear and Neck Post COVID 19 Authors: Dongol, Kripa; Rayamajhi, Pabina; Pradhananga, Rabindra Bhakta; Dulal, Malati; Sedhai, Milan; Gurung, Bikash Abstract: Abstract Mucormycosis is an opportunistic infection caused by fungi of order Mucorales and affect immunosuppressed patients. The cases of mucormycosis have surged during the COVID pandemic, especially in cases requiring steroids and mechanical ventilation. Here we present a case of a 40-year-old diabetic post COVID female patient. She presented with right earache, right facial paralysis (grade four) of two weeks duration and right sided neck swelling for ten days. Ultrasonography and computed tomography revealed multiple abscesses in the right side of the neck. Histopathological examination of tissue from the neck and middle ear confirmed the diagnosis of mucormycosis. This is a rare case of concurrent neck and middle ear mucormycosis in a post COVID patient. Keywords: Coronavirus; COVID 19; middle ear; mucormycosis; neck. Description: Case Report

2022-01-01T00:00:00Z Shrestha, Sabin Sah, Anisha Yadav, Anil Koirala, Sanjib Parajuli, Surya Bahadur https://hdl.handle.net/20.500.14356/991 2023-05-31T07:17:32Z 2022-01-01T00:00:00Z

Title: Fibrocalculous Pancreatic Diabetes - a Unique Differential among Diabetic Authors: Shrestha, Sabin; Sah, Anisha; Yadav, Anil; Koirala, Sanjib; Parajuli, Surya Bahadur Abstract: Abstract Fibrocalculous pancreatic diabetes is a unique variant of diabetes mellitus and also known as type 3c diabetes mellitus. It is related to the patient who is young, non-alcoholic and belonging predominantly from the tropical region. It is a severe form of diabetes which can also be linked to the fact that it predisposes to malignancy.1 Among the variants of diabetes that we commonly encounter, fibrocalculous pancreatic diabetes has been rarely diagnosed in the developing countries. With the advancement of diagnostic capacity, it can be identified clinically and managed efficiently. It should be considered in patients with typical features of diabetes, abdominal pain, and pancreatic calculi. There is limited reporting of this case in Nepal because of misdiagnosis, so we are reporting a 40 years male who presented with recurrent episodes of abdominal pain with mucus mixed stool for the last 28 years and was diagnosed as fibrocalculous pancreatic diabetes. Keywords: Blood glucose; eastern Nepal; fibrocalculous pancreatic diabetes; pancreas. Description: Case Report

2022-01-01T00:00:00Z Pandey, Udesh Timilsina, Bhusan Raj Acharya, Samrachana Paudel, Ujjawal KC, Sudeep Raj Pradhan, Sulav https://hdl.handle.net/20.500.14356/990 2023-05-31T07:17:32Z 2022-01-01T00:00:00Z

Title: Renal Hydatid Cyst in a Child Managed with Albendazole Authors: Pandey, Udesh; Timilsina, Bhusan Raj; Acharya, Samrachana; Paudel, Ujjawal; KC, Sudeep Raj; Pradhan, Sulav Abstract: Abstract Primary Renal hydatid cyst is a rare entity. We report a case of isolated right renal hydatid cyst in a 13-year-old female who presented with pain in the right lumbar region for 4-5 months and a palpable mass in the right upper quadrant. The radiological features were suggestive of a hydatid cyst in the right kidney with no cyst in the liver, lungs, or left kidney. She was managed medically with oral Albendazole tablets (400 mg twice daily). A total of 6 cycles of Albendazole were given with each cycle lasting for 4 weeks and a drug-free period of 2 weeks in between two consecutive cycles and kept on follow-up for a year. Her condition improved with no recurrence on follow-up after one year. Keywords: Albendazole; echinococcus granulosus; renal hydatid cyst. Description: Case Report

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