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Papers by Dhundi Paudel

Kathmandu University Medical Journal, Mar 31, 2021

Journal of Chitwan Medical College, Mar 9, 2021

BioMed Research International

Background. Testicular cancer is a malignant tumor of the testicles, the male reproductive organs... more Background. Testicular cancer is a malignant tumor of the testicles, the male reproductive organs that produce sperm and testosterone. It is one of the most common cancers in young men. This form of cancer can be easily diagnosed by self-examination of testicles and is curable if detected early. Periodic self-examination must be performed for early detection. Due to lack of knowledge on testicular cancer and testicular self-examination techniques, patients can potentially miss early detection. This study is aimed at assessing the knowledge, attitude, and practice regarding testicular cancer and testicular self-examination among male college students pursuing a Bachelor’s degree. Methods. A web-based cross-sectional analytical study was adopted to assess the knowledge, attitude, and practice of testicular cancer and testicular self-examination among male college students pursuing a Bachelor’s degree and living in Bharatpur Metropolitan City in the Chitwan District of Nepal. The snowb...

Journal of Chitwan Medical College, Dec 16, 2020

JNMA; journal of the Nepal Medical Association, 2021

INTRODUCTION Ureteric calculi are lying at any point of ureter from the pelvic ureteric junction ... more INTRODUCTION Ureteric calculi are lying at any point of ureter from the pelvic ureteric junction to the vesicoureteral junction. If left untreated, ureteropelvic junction obstruction can lead to hydronephrosis. With the improved availability of computed tomography and ultrasound scanning, hydronephrosis is being diagnosed more frequently. The main aim of this study is to find out the prevalence of moderate Hydronephrosis among ureteral calculus on ultrasonography imaging in a tertiary care center of Nepal. METHODS A descriptive cross-sectional study was conducted among 110 acute ureteral calculus cases at Radiodiagnosis and Imaging Department of Chitwan Medical College and Teaching Hospital, Bharatpur from 15th August 2020 to 15th May 2021. The ethical approval was taken from the Institutional Review Committee of same institution. Convenient sampling technique was used to select the participant. The collected data was entered in excel 16 and analysed in Statistical Package for Socia...

Journal of Chitwan Medical College, 2019

Background: Superior mesenteric artery syndrome is a rare but vital cause of upper gastrointesti... more Background: Superior mesenteric artery syndrome is a rare but vital cause of upper gastrointestinal obstruction which occurs when the third portion of the duodenum is trapped between aorta and superior mesenteric artery. The sig­nificant decrease of the angle and distance between the superior mesenteric artery and aorta is the etiology of Superior mesenteric artery syndrome.The study aimed to identify the angulations and distance of superior mesenteric artery from aorta and their correlation with body mass index in patients re­ferred for contrast enhanced computed tomography of abdomen examination in Chitwan Medical College. Methods: The angle between the aorta and superior mesenteric artery was measured in arterial phase of the abdominal scan in the multiplanar recon­structed image in sagittal plane. The distance between the superior mesen­teric artery and aorta was measured in axial plane at the level of 3rd part of duodenum. Results: The aortomesenteric distance was obtained to ...

Journal of Chitwan Medical College, 2019

A 27 years old primigravida woman at 19 weeks of gestation was came for routine antenatal checkup... more A 27 years old primigravida woman at 19 weeks of gestation was came for routine antenatal checkup in Chitwan Medical College was diag­nosed as twin pregnancy with thoracophagus conjoined twin. The fetal biometrics of both were consistent with the gestational age. Fetuses were found with fusion of the skin contour, at the level of the lower chest with complex appearing fused cardiac near midline and liver ap­pears separate. Both fetal heads were in breech presentation facing faces with each other at the same level. Bilateral upper and lower limbs were identified in both fetuses with same gender. The parents decided to terminate the pregnancy but refused autopsy.

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2005

The present study is undertaken on 50 tonsillectomy cases to determine the correlation between su... more The present study is undertaken on 50 tonsillectomy cases to determine the correlation between surface culture swabs and tonsillar core. Tonsillar disease may stem from the bacteria within the core of the tonsil, rather than the bacteria identified on its surface. Also no consistent pattern of combinations of different pathogenic bacteria was noted. The study proves that surface culture does not reliably predict core pathogens.

Nepalese Journal of ENT Head and Neck Surgery, Feb 28, 2017

Journal of Nepalgunj Medical College

Introduction: Nasal obstruction is the most common symptom of deviated nasal septum. Septoplasty ... more Introduction: Nasal obstruction is the most common symptom of deviated nasal septum. Septoplasty is a surgical procedure that corrects deformity of the nasal septum. Sinonasal outcome test 22 is a subjective questionnaire tool that include various nasal symptoms which is useful to measure patient`s symptoms outcome after septoplasty. Aims: To determine the symptomatologic outcome in patients with deviated nasal septum following septoplasty using Sinonasal outcome test 22. Methods: This prospective longitudinal study was done atNepalgunj Medical College and Teaching Hospital, Kohalpur including 60 patients of symptomatic deviated nasal septum who underwent septoplasty. Details of patient symptoms as per Sinonasal outcome test - 22 were graded from zero to five preoperatively and were compared one month following surgery. Results: Patients who underwent septoplasty were commonly in the age group 20-45 years and least in the age group 46-60 years with a mean age of 25.48. In the prese...

Annals of Medicine & Surgery, 2022

Background Burnout is a syndrome of emotional exhaustion and depersonalization that reduces effic... more Background Burnout is a syndrome of emotional exhaustion and depersonalization that reduces efficiency at work. No studies have been reported focusing only on residency burnout and risk factors from our country until now. This study aimed to find out the impact and the association of specific demographic and practice characteristics with burnout among resident doctors. Methods A prospective cross-sectional survey of all resident doctors under training at that point of time in 2019 in the National Academy of Medical Sciences, Nepal in different specialties was done. We evaluated demographic variables, practice characteristics, and assessed burnout through validated Maslach burnout inventory (MBI) tools, and data were analyzed. Results A total 347 among 410 resident doctors (227 male) responded to the survey. Median age was 30 years (range 25–44). Overall, 147 (42.4%) of responding residents were burned out with high emotional exhaustion in 58 (16.6%), high depersonalization in 55 (15.9%), and low personal achievement in 34 (9.8). In regression analysis, out of independent variables gender, marital status, having children, specialty, hours of work per week and year of residency, specialties (general surgery odds ratio [OR]; 12.595, confidence interval [CI],[ 1.037–152.9], P; 0.047), obstetrics, and gynecology (odds ratio [OR]; 13.977, confidence interval [CI]; [1.324–147.5], P; 0.028), and anesthesiology (odds ratio [OR]; 11.54, confidence interval [CI]; [1.014–131.4], P; 0.049)) and hours of work per week (≥80 h) (odds ratio [OR]; 2.511, confidence interval [CI]; [1.128–5.589], P; 0.024), were significantly associated with high burnout. Conclusions Burnout is common among trainee resident doctors which is possibly preventable. Thus, the concern should be to prepare strategies to identify and minimize burnout from the individual, institutional, and societal sides. It is essential to preserve and promote the mental health of trainee residents to prevent serious consequences in the personal lives of resident doctors and as well as on patient outcomes.

Journal of Nepalgunj Medical College, 2021

Introduction: Tonsillitis is inflammation of tonsils which is characterized by various signs and ... more Introduction: Tonsillitis is inflammation of tonsils which is characterized by various signs and symptoms with sore throat being the most consistent symptom. The condition is mostly caused by bacterial infection with Streptococci being the most common bacteria. McIssac scoring technique is clinical symptoms based scoring method designed for diagnosing streptococcal tonsillitis. Aims: To find out the association between McIssac Score and beta hemolytic streptococcal infection in acute tonsillitis. Methods: This hospital based, prospective study was carried out in the Department of ENT, Nepalgunj Medical College from July 2020 to June 2021. Patients were scored as per McIssac score. The specimens were collected from the tonsillar surface using sterile cotton swabs and subjected for culture and sensitivity. Results:The most common affected age group was 21 to 30 years (46%). Females were affected more commonly (57%). The most common organism isolated in the study was Group A beta hemol...

Journal of Nepal Medical Association, 2013

Chronic suppurative otitis media is a severe type of chronic ear infection which is quite common ... more Chronic suppurative otitis media is a severe type of chronic ear infection which is quite common in all geographical situations of Nepal. The mainstay of treatment of this disease is surgery, preferably of canal down method. The objective of the study was to identify the common presentation(s) and the clinical and operative finding(s) in patients with chronic suppurative otitis media attico-antral type and evaluation of efficacy of canal-wall down mastoidectomy in the achievement of dry ear and change in hearing in a setting of a peripheral hospital of Nepal in terms of subjectivity. Per-operative evaluation of mastoid cavities in terms of types of pathologies and post- operative assessment of ears in terms of achieving a dryness and change in hearing ability was carried out in the ENT Department, Bharatpur Hospital, Chitwan, Nepal. Study was done from January 2005 to December 2010. Seventy three patients with chronic suppurative otitis media atticoantral-type were evaluated preoper...

Journal of Nepalgunj Medical College

Introduction: Tonsillectomy is frequently performed surgical procedure. There are several differe... more Introduction: Tonsillectomy is frequently performed surgical procedure. There are several different methods with varied advantages and disadvantages. In spite of the different techniques available there is no consensus and definite evidence for best method. The most commonly performed are conventional dissection and bipolar electrocauterization methods. Aims: The aim of the study was to compare time required for the completion of surgery, intraoperative and postoperative blood loss along with post operative pain between conventional dissection and bipolar electrocauterization methods. Methods: This comparative study was conducted from August 2019 to March 2021 in total of 30 patients planned for tonsillectomy in department of Otorhinolaryngology, Nepalgunj Medical College Teaching Hospital.In every patient right side tonsillectomy was done with conventional dissection method and left side tonsillectomy was done with bipolar electrocauterization method. Results: The mean age was 27.2...

Thyroglossal duct cyst (TGDC) is most common congenital benign cervical mass. Carcinoma arising i... more Thyroglossal duct cyst (TGDC) is most common congenital benign cervical mass. Carcinoma arising in the TGDC accounts for only about 0.7 to 1.5 % of all TGDC. Presentation of TGDC carcinoma is similar to that of benign duct cyst. Papillary carcinoma is common carcinoma in TGDC, median age of presentation is 40 years, with female to male ratio of 3:2. Diagnosis of TGDC carcinoma is often based on pathological analysis of masses. FNAB have only 53 % true positive rate in a diagnosis. USG, CT scan, thyroid scan play important role in diagnosis of malignancy. Sistrunks ' procedure, total thyroidectomy with or without lymphnode dissection and treatment with radioactive iodine have to considered according to clinical and microscopic finding.

Journal of Nepalgunj Medical College

Introduction: Laryngopharyngeal reflux is an extra esophageal variant of gastro esophageal reflux... more Introduction: Laryngopharyngeal reflux is an extra esophageal variant of gastro esophageal reflux disease and is characterized by change in voice, recurrent throat clearing, chronic cough, discomfort in throat, globus. The larynx and pharynx are devoid of the normal acid clearance mechanism even three episodes of reflux per week seems to be associated with a significant disease. Aims: The aim of the study was to evaluate the correlation between the reflux symptom index and reflux finding score in patients with Laryngopharyngeal reflux. Methods: This prospective analytical study was conducted from November 2019 to October 2020 in total of 65 patients presented in department of Otorhinolaryngology, Nepalgunj Medcial College and Teaching Hospital, Nepalgunj. Reflux symptom index questionnaire with nine Questions were answered by patients on a 5 point scale. Reflux symptom index of more than 13 out of total score of 45 was considered to indicate Laryngopharyngeal reflux were as, reflux ...

Introduction: Tympanoplasty is typically performed in conjunction with a canal wall down mastoide... more Introduction: Tympanoplasty is typically performed in conjunction with a canal wall down mastoidectomy in patient with Chronic Otitis Media Squamous. The results from experimental and clinical studies of the type III stapes columellar reconstruction have shown that interposing a disk of cartilage between the graft and the stapes head improves hearing in the lower frequencies by 5 to 10 dB. They hypothesize that the cartilage acts to increase the “effective” area of the graft that is coupled to the stapes, which leads to an increase in the middle ear gain of the reconstructed ear. Aims: To assess the hearing improvement after cartilage augmented Type III Tympanoplasty in chronic otitis media squamous disease. Methods: This study was conducted in 44 patients with Chronic Otitis Media squamous in the patients attending the department of Otorhinolaryngology in NGMC teaching hospital from November 2018 to March 2020. Canal Wall Down mastoidectomy with cartilage augmented type III Tympano...

Journal of Nepalgunj Medical College

Introduction: Hearing impairment is the most common congenital abnormality that occurs in 1 to 4/... more Introduction: Hearing impairment is the most common congenital abnormality that occurs in 1 to 4/1000 newborns. It has a profound effect on their optimal development of language, speech and cognitive skill. Early detection in order to achieve effective treatment is essential. An association between low birth weight and hearing loss is commonly associated with multiple risk factors that can alter hearing in a synergistic fashion. Universal neonatal hearing screening programs have become widely implemented aiming for the screening, confirmation of the diagnosis and intervention by 1, 3 and 6 months respectively. Transient Evoked Otoacoustic emissions is one of the test found to be a quick, objective, non-invasive, accurate and easy test for early detection of this problem. Aims: Early detection of hearing loss in neonates focusing on low birth weight for early optimum rehabilitation. Methods: A comparative case control study conducted in 100 neonates under 2 groups. 50 neonates with...

Kathmandu University Medical Journal, Mar 31, 2021

Journal of Chitwan Medical College, Mar 9, 2021

BioMed Research International

Background. Testicular cancer is a malignant tumor of the testicles, the male reproductive organs... more Background. Testicular cancer is a malignant tumor of the testicles, the male reproductive organs that produce sperm and testosterone. It is one of the most common cancers in young men. This form of cancer can be easily diagnosed by self-examination of testicles and is curable if detected early. Periodic self-examination must be performed for early detection. Due to lack of knowledge on testicular cancer and testicular self-examination techniques, patients can potentially miss early detection. This study is aimed at assessing the knowledge, attitude, and practice regarding testicular cancer and testicular self-examination among male college students pursuing a Bachelor’s degree. Methods. A web-based cross-sectional analytical study was adopted to assess the knowledge, attitude, and practice of testicular cancer and testicular self-examination among male college students pursuing a Bachelor’s degree and living in Bharatpur Metropolitan City in the Chitwan District of Nepal. The snowb...

Journal of Chitwan Medical College, Dec 16, 2020

JNMA; journal of the Nepal Medical Association, 2021

INTRODUCTION Ureteric calculi are lying at any point of ureter from the pelvic ureteric junction ... more INTRODUCTION Ureteric calculi are lying at any point of ureter from the pelvic ureteric junction to the vesicoureteral junction. If left untreated, ureteropelvic junction obstruction can lead to hydronephrosis. With the improved availability of computed tomography and ultrasound scanning, hydronephrosis is being diagnosed more frequently. The main aim of this study is to find out the prevalence of moderate Hydronephrosis among ureteral calculus on ultrasonography imaging in a tertiary care center of Nepal. METHODS A descriptive cross-sectional study was conducted among 110 acute ureteral calculus cases at Radiodiagnosis and Imaging Department of Chitwan Medical College and Teaching Hospital, Bharatpur from 15th August 2020 to 15th May 2021. The ethical approval was taken from the Institutional Review Committee of same institution. Convenient sampling technique was used to select the participant. The collected data was entered in excel 16 and analysed in Statistical Package for Socia...

Journal of Chitwan Medical College, 2019

Background: Superior mesenteric artery syndrome is a rare but vital cause of upper gastrointesti... more Background: Superior mesenteric artery syndrome is a rare but vital cause of upper gastrointestinal obstruction which occurs when the third portion of the duodenum is trapped between aorta and superior mesenteric artery. The sig­nificant decrease of the angle and distance between the superior mesenteric artery and aorta is the etiology of Superior mesenteric artery syndrome.The study aimed to identify the angulations and distance of superior mesenteric artery from aorta and their correlation with body mass index in patients re­ferred for contrast enhanced computed tomography of abdomen examination in Chitwan Medical College. Methods: The angle between the aorta and superior mesenteric artery was measured in arterial phase of the abdominal scan in the multiplanar recon­structed image in sagittal plane. The distance between the superior mesen­teric artery and aorta was measured in axial plane at the level of 3rd part of duodenum. Results: The aortomesenteric distance was obtained to ...

Journal of Chitwan Medical College, 2019

A 27 years old primigravida woman at 19 weeks of gestation was came for routine antenatal checkup... more A 27 years old primigravida woman at 19 weeks of gestation was came for routine antenatal checkup in Chitwan Medical College was diag­nosed as twin pregnancy with thoracophagus conjoined twin. The fetal biometrics of both were consistent with the gestational age. Fetuses were found with fusion of the skin contour, at the level of the lower chest with complex appearing fused cardiac near midline and liver ap­pears separate. Both fetal heads were in breech presentation facing faces with each other at the same level. Bilateral upper and lower limbs were identified in both fetuses with same gender. The parents decided to terminate the pregnancy but refused autopsy.

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2005

The present study is undertaken on 50 tonsillectomy cases to determine the correlation between su... more The present study is undertaken on 50 tonsillectomy cases to determine the correlation between surface culture swabs and tonsillar core. Tonsillar disease may stem from the bacteria within the core of the tonsil, rather than the bacteria identified on its surface. Also no consistent pattern of combinations of different pathogenic bacteria was noted. The study proves that surface culture does not reliably predict core pathogens.

Nepalese Journal of ENT Head and Neck Surgery, Feb 28, 2017

Journal of Nepalgunj Medical College

Introduction: Nasal obstruction is the most common symptom of deviated nasal septum. Septoplasty ... more Introduction: Nasal obstruction is the most common symptom of deviated nasal septum. Septoplasty is a surgical procedure that corrects deformity of the nasal septum. Sinonasal outcome test 22 is a subjective questionnaire tool that include various nasal symptoms which is useful to measure patient`s symptoms outcome after septoplasty. Aims: To determine the symptomatologic outcome in patients with deviated nasal septum following septoplasty using Sinonasal outcome test 22. Methods: This prospective longitudinal study was done atNepalgunj Medical College and Teaching Hospital, Kohalpur including 60 patients of symptomatic deviated nasal septum who underwent septoplasty. Details of patient symptoms as per Sinonasal outcome test - 22 were graded from zero to five preoperatively and were compared one month following surgery. Results: Patients who underwent septoplasty were commonly in the age group 20-45 years and least in the age group 46-60 years with a mean age of 25.48. In the prese...

Annals of Medicine & Surgery, 2022

Background Burnout is a syndrome of emotional exhaustion and depersonalization that reduces effic... more Background Burnout is a syndrome of emotional exhaustion and depersonalization that reduces efficiency at work. No studies have been reported focusing only on residency burnout and risk factors from our country until now. This study aimed to find out the impact and the association of specific demographic and practice characteristics with burnout among resident doctors. Methods A prospective cross-sectional survey of all resident doctors under training at that point of time in 2019 in the National Academy of Medical Sciences, Nepal in different specialties was done. We evaluated demographic variables, practice characteristics, and assessed burnout through validated Maslach burnout inventory (MBI) tools, and data were analyzed. Results A total 347 among 410 resident doctors (227 male) responded to the survey. Median age was 30 years (range 25–44). Overall, 147 (42.4%) of responding residents were burned out with high emotional exhaustion in 58 (16.6%), high depersonalization in 55 (15.9%), and low personal achievement in 34 (9.8). In regression analysis, out of independent variables gender, marital status, having children, specialty, hours of work per week and year of residency, specialties (general surgery odds ratio [OR]; 12.595, confidence interval [CI],[ 1.037–152.9], P; 0.047), obstetrics, and gynecology (odds ratio [OR]; 13.977, confidence interval [CI]; [1.324–147.5], P; 0.028), and anesthesiology (odds ratio [OR]; 11.54, confidence interval [CI]; [1.014–131.4], P; 0.049)) and hours of work per week (≥80 h) (odds ratio [OR]; 2.511, confidence interval [CI]; [1.128–5.589], P; 0.024), were significantly associated with high burnout. Conclusions Burnout is common among trainee resident doctors which is possibly preventable. Thus, the concern should be to prepare strategies to identify and minimize burnout from the individual, institutional, and societal sides. It is essential to preserve and promote the mental health of trainee residents to prevent serious consequences in the personal lives of resident doctors and as well as on patient outcomes.

Journal of Nepalgunj Medical College, 2021

Introduction: Tonsillitis is inflammation of tonsils which is characterized by various signs and ... more Introduction: Tonsillitis is inflammation of tonsils which is characterized by various signs and symptoms with sore throat being the most consistent symptom. The condition is mostly caused by bacterial infection with Streptococci being the most common bacteria. McIssac scoring technique is clinical symptoms based scoring method designed for diagnosing streptococcal tonsillitis. Aims: To find out the association between McIssac Score and beta hemolytic streptococcal infection in acute tonsillitis. Methods: This hospital based, prospective study was carried out in the Department of ENT, Nepalgunj Medical College from July 2020 to June 2021. Patients were scored as per McIssac score. The specimens were collected from the tonsillar surface using sterile cotton swabs and subjected for culture and sensitivity. Results:The most common affected age group was 21 to 30 years (46%). Females were affected more commonly (57%). The most common organism isolated in the study was Group A beta hemol...

Journal of Nepal Medical Association, 2013

Chronic suppurative otitis media is a severe type of chronic ear infection which is quite common ... more Chronic suppurative otitis media is a severe type of chronic ear infection which is quite common in all geographical situations of Nepal. The mainstay of treatment of this disease is surgery, preferably of canal down method. The objective of the study was to identify the common presentation(s) and the clinical and operative finding(s) in patients with chronic suppurative otitis media attico-antral type and evaluation of efficacy of canal-wall down mastoidectomy in the achievement of dry ear and change in hearing in a setting of a peripheral hospital of Nepal in terms of subjectivity. Per-operative evaluation of mastoid cavities in terms of types of pathologies and post- operative assessment of ears in terms of achieving a dryness and change in hearing ability was carried out in the ENT Department, Bharatpur Hospital, Chitwan, Nepal. Study was done from January 2005 to December 2010. Seventy three patients with chronic suppurative otitis media atticoantral-type were evaluated preoper...

Journal of Nepalgunj Medical College

Introduction: Tonsillectomy is frequently performed surgical procedure. There are several differe... more Introduction: Tonsillectomy is frequently performed surgical procedure. There are several different methods with varied advantages and disadvantages. In spite of the different techniques available there is no consensus and definite evidence for best method. The most commonly performed are conventional dissection and bipolar electrocauterization methods. Aims: The aim of the study was to compare time required for the completion of surgery, intraoperative and postoperative blood loss along with post operative pain between conventional dissection and bipolar electrocauterization methods. Methods: This comparative study was conducted from August 2019 to March 2021 in total of 30 patients planned for tonsillectomy in department of Otorhinolaryngology, Nepalgunj Medical College Teaching Hospital.In every patient right side tonsillectomy was done with conventional dissection method and left side tonsillectomy was done with bipolar electrocauterization method. Results: The mean age was 27.2...

Thyroglossal duct cyst (TGDC) is most common congenital benign cervical mass. Carcinoma arising i... more Thyroglossal duct cyst (TGDC) is most common congenital benign cervical mass. Carcinoma arising in the TGDC accounts for only about 0.7 to 1.5 % of all TGDC. Presentation of TGDC carcinoma is similar to that of benign duct cyst. Papillary carcinoma is common carcinoma in TGDC, median age of presentation is 40 years, with female to male ratio of 3:2. Diagnosis of TGDC carcinoma is often based on pathological analysis of masses. FNAB have only 53 % true positive rate in a diagnosis. USG, CT scan, thyroid scan play important role in diagnosis of malignancy. Sistrunks ' procedure, total thyroidectomy with or without lymphnode dissection and treatment with radioactive iodine have to considered according to clinical and microscopic finding.

Journal of Nepalgunj Medical College

Introduction: Laryngopharyngeal reflux is an extra esophageal variant of gastro esophageal reflux... more Introduction: Laryngopharyngeal reflux is an extra esophageal variant of gastro esophageal reflux disease and is characterized by change in voice, recurrent throat clearing, chronic cough, discomfort in throat, globus. The larynx and pharynx are devoid of the normal acid clearance mechanism even three episodes of reflux per week seems to be associated with a significant disease. Aims: The aim of the study was to evaluate the correlation between the reflux symptom index and reflux finding score in patients with Laryngopharyngeal reflux. Methods: This prospective analytical study was conducted from November 2019 to October 2020 in total of 65 patients presented in department of Otorhinolaryngology, Nepalgunj Medcial College and Teaching Hospital, Nepalgunj. Reflux symptom index questionnaire with nine Questions were answered by patients on a 5 point scale. Reflux symptom index of more than 13 out of total score of 45 was considered to indicate Laryngopharyngeal reflux were as, reflux ...

Introduction: Tympanoplasty is typically performed in conjunction with a canal wall down mastoide... more Introduction: Tympanoplasty is typically performed in conjunction with a canal wall down mastoidectomy in patient with Chronic Otitis Media Squamous. The results from experimental and clinical studies of the type III stapes columellar reconstruction have shown that interposing a disk of cartilage between the graft and the stapes head improves hearing in the lower frequencies by 5 to 10 dB. They hypothesize that the cartilage acts to increase the “effective” area of the graft that is coupled to the stapes, which leads to an increase in the middle ear gain of the reconstructed ear. Aims: To assess the hearing improvement after cartilage augmented Type III Tympanoplasty in chronic otitis media squamous disease. Methods: This study was conducted in 44 patients with Chronic Otitis Media squamous in the patients attending the department of Otorhinolaryngology in NGMC teaching hospital from November 2018 to March 2020. Canal Wall Down mastoidectomy with cartilage augmented type III Tympano...

Journal of Nepalgunj Medical College

Introduction: Hearing impairment is the most common congenital abnormality that occurs in 1 to 4/... more Introduction: Hearing impairment is the most common congenital abnormality that occurs in 1 to 4/1000 newborns. It has a profound effect on their optimal development of language, speech and cognitive skill. Early detection in order to achieve effective treatment is essential. An association between low birth weight and hearing loss is commonly associated with multiple risk factors that can alter hearing in a synergistic fashion. Universal neonatal hearing screening programs have become widely implemented aiming for the screening, confirmation of the diagnosis and intervention by 1, 3 and 6 months respectively. Transient Evoked Otoacoustic emissions is one of the test found to be a quick, objective, non-invasive, accurate and easy test for early detection of this problem. Aims: Early detection of hearing loss in neonates focusing on low birth weight for early optimum rehabilitation. Methods: A comparative case control study conducted in 100 neonates under 2 groups. 50 neonates with...