Sandesh Poudel - Academia.edu (original) (raw)

Papers by Sandesh Poudel

Journal of Nepal Health Research Council, Mar 1, 2022

Journal of Chitwan Medical College, Mar 25, 2021

Vaginal agenesis seen in Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a condition with signi... more Vaginal agenesis seen in Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a condition with significant psychological and social consequences where there is embryonic underdevelopment of müllerian duct. It is estimated to occur one in 4000 to 5000 live births. Normalizing sexual life with vaginal reconstruction to adequate length is usually the treatment of choice. Among many non-surgical and surgical options available, McIndoe vaginoplasty is the commonest surgical management performed worldwide with various modifications, like the use of amnion as a graft. A 19-year-old girl with normal secondary sexual characters came with vaginal agenesis with hypoplastic uterus. MRI revealed streak like structure over the pelvis with imperforate hymen and atresia of the vagina. Surgical intervention included creation of vaginal canal from a potential space between urethra and bladder above and rectum below and a fresh amnion mounted mould was placed within the canal. The amnion graft was seen well taken with resultant 4 to 5 cm of vaginal canal when mould was removed 10 days later. She was counselled and taught to remove and insert the mould to prevent vaginal narrowing and maintain the length. Amnion graft vaginoplasty has with good success rate with minimal postoperative pain, infection and scarring and thus is a rewarding procedure especially in low resource countries.

Europasian Journal of Medical Sciences, 2021

Background: Cervical cancer ranks the most common cancer among Nepalese women. Cervical and vagin... more Background: Cervical cancer ranks the most common cancer among Nepalese women. Cervical and vaginal infections constitute the most common gynecological problems. Through Pap smear screening, early diagnosis, follow up and treatment, morbidity and mortality can be reduced by 70% and 80% respectively. Methods: This retrospective study was conducted to know the incidence of abnormal cervical epithelial lesions and cervico-vaginal infections. It was carried out in the Outpatient Department of Gynecology at Chitwan Medical College from April 2018 to March 2019. The data were collected and standard statistical analysis done using Microsoft Excel 2007. Results: The most prevalent cervical epithelial cell abnormality was atypical squamous cells of undetermined significance (3.43%) whereas the least common was low grade squamous intraepithelial lesion (0.21%). The most prevalent cervical vaginal infection was Bacterial vaginosis (12.30%) whereas the least prevalent was Trichomoniasis (0.29...

Nepal Journal of Obstetrics and Gynaecology, 2021

Aims: To evaluate the midterm outcome of sacrospinous fixation done during surgical management of... more Aims: To evaluate the midterm outcome of sacrospinous fixation done during surgical management of pelvic organ prolapse. Methods: This was an interview based cross sectional follow up study done among the patients who underwent sacrospinous fixation procedure along with pelvic organ prolapse surgery in Kathmandu Model Hospital and Paropakar Maternity Hospital. This was conducted between 15 th February 2021 and 15 th April 2021. Post-operative cases 22 to 30 months (average 2 years) from the day of surgery were included. Results: Out of 321 eligible SSF patients from both the hospital, 156 agreed to participate. Among them, 77 (48%) were in 60-69 years of age and 82% were postmenopausal; 33% were more than para 3; 20% had right gluteal pain that was decreased to 1.9% by 2 years; and 20% had some degree of urgency and stress incontinence. Conclusion: Sacrospinous fixation is safe and effective procedure which can be done during pelvic organ prolapse surgery with good success rate and ...

Europasian Journal of Medical Sciences, 2021

Background: Relaparotomy after cesarean section is associated with significant maternal morbidity... more Background: Relaparotomy after cesarean section is associated with significant maternal morbidity and mortality which can be prevented with proper precaution during the primary surgery. The objective of the study was to determine factors associated with relaparotomy after cesarean section. Methods: A hospital based descriptive cross sectional study conducted by analyzing the records of 3 years from 1st July 2017 to 30th June 2020, among the women who underwent relaparotomy after cesarean section at Paropakar Maternity and Women’s Hospital, Kathmandu. Results: There were 21,270 cesarean sections among 64,475 deliveries with the mean incidence of 32.6%. A total of 22 patients underwent relaparotomy out of which 18 had their primary surgery performed at our hospital i.e. 0.08% of the total caesarean section, and 4 cases were referred from peripheries. 60% of primary surgery were done by residents and the commonest indications of primary surgery were previous CS (36.3%) and obstructed...

Nepal Journal of Obstetrics and Gynaecology, 2019

Aim: To determine the maternal and perinatal outcome in teenage pregnancies. Methods: A hospital... more Aim: To determine the maternal and perinatal outcome in teenage pregnancies. Methods: A hospital based descriptive cross sectional study conducted from April 2017 to April 2018, among the pregnant women of age group≤19 years, admitted to the labour ward atRapti Sub regional Hospital, Dang. Results: The total of 853 pregnant adolescent women were admitted during the study period, most of which belonged to 19 years of age (38.6%) and were primipara (93.3%) and 42.1% belonged to janjati group. 79.6% had normal delivery, while 14.1% of the cases underwent caesarean section, 5.9% had instrumental delivery and in 0.5% had perineal injury. Anaemia complicated 63% of teenage mothers, more in age group of ≤ 18yrs than in > 18years (61.4%vs 38.6%) and 4.6% had maternal complications, the majority being PPH (2.9%) followed by oligohydraminos, eclampsia, wound infection and vulvar haematoma. Preterm delivery occurred in 15.5% of the cases (≤ 18yrs vs>18yrs being 9.8% vs 5.7%), other neo...

Journal of Social Sciences, 2010

The study investigated the extent to which intelligent quotient, emotional intelligence and spiri... more The study investigated the extent to which intelligent quotient, emotional intelligence and spiritual intelligeInce would jointly and relatively predict prison-adjustment among Nigerian prisoners. The participants were five hundred prisoners randomly selected from five prisons in Nigeria. They are made up of four hundred and fifty eight males and forty-two females. The study utilized expost facto correlational research design. Multiple regression analysis and pearson product moment correlation were was used to analyse data collected to test the three research questions raised in the study. The results showed significant positive correlations between the independent variables and prison adjustment with emotional intelligence taking the lead (r = 0.95), followed by spiritual intelligence (r = 0.83) and lastly, intelligent quotient (r = 0.79). Also, the three independent variables contributed a total of 93.2% to the criterion (Prison Adjustment), while relative contributions as revealed by the Beta results showed Emotional Intelligence (B = 0.736), Spiritual Intelligence (B = 0.443) and Intelligent Quotients (B = 0.173). On the basis of the findings, it was recommended that prisoners should be exposed to emotional intelligence training as well as regular, functional religious programmes to enhance their effective adjustment. It was therefore concluded that emotional intelligence and spiritual intelligence skills are far more important than intelligent quotient. Therefore instead of placing more emphasis on being brilliant, let students and people who demonstrate high level of emotional intelligence and spiritual intelligence be properly encouraged.

Journal of College of Medical Sciences-nepal, 2020

Background: The aim of the study was to share the experience of laparoscopic gynecologic surgery ... more Background: The aim of the study was to share the experience of laparoscopic gynecologic surgery in a government hospital outside Kathmandu valley Method: A descriptive cross-sectional study was carried out in Bharatpur Hospital from 15 Dec, 2018 to 15 June, 2019. Fifty consecutive patients who underwent laparoscopic gynecological procedures were included in the study and analyzed demographics, indication, hospital stay and complications. Results: The mean age of the patients (n = 50) was 34.6 ± 12.5 years (Range: 17 – 66 years). More than athird of the total patients (n = 18, 36.0%) were between 26 – 35 years. Majority (n = 26, 56.0 %) of the patients were multipara (≥ 2 child). Hasson type was more frequently utilized type of primary port incision in the surgeries performed (52.0%, n = 26). The median duration of surgery was 2.08 hours (Range: 0.83 – 3.25 hours). The commonest post-operative diagnosis was dermoid cyst (n = 14, 28.0%). Complications were observed in eight patients...

Journal of Nepal Health Research Council, Mar 1, 2022

Journal of Chitwan Medical College, Mar 25, 2021

Vaginal agenesis seen in Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a condition with signi... more Vaginal agenesis seen in Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a condition with significant psychological and social consequences where there is embryonic underdevelopment of müllerian duct. It is estimated to occur one in 4000 to 5000 live births. Normalizing sexual life with vaginal reconstruction to adequate length is usually the treatment of choice. Among many non-surgical and surgical options available, McIndoe vaginoplasty is the commonest surgical management performed worldwide with various modifications, like the use of amnion as a graft. A 19-year-old girl with normal secondary sexual characters came with vaginal agenesis with hypoplastic uterus. MRI revealed streak like structure over the pelvis with imperforate hymen and atresia of the vagina. Surgical intervention included creation of vaginal canal from a potential space between urethra and bladder above and rectum below and a fresh amnion mounted mould was placed within the canal. The amnion graft was seen well taken with resultant 4 to 5 cm of vaginal canal when mould was removed 10 days later. She was counselled and taught to remove and insert the mould to prevent vaginal narrowing and maintain the length. Amnion graft vaginoplasty has with good success rate with minimal postoperative pain, infection and scarring and thus is a rewarding procedure especially in low resource countries.

Europasian Journal of Medical Sciences, 2021

Background: Cervical cancer ranks the most common cancer among Nepalese women. Cervical and vagin... more Background: Cervical cancer ranks the most common cancer among Nepalese women. Cervical and vaginal infections constitute the most common gynecological problems. Through Pap smear screening, early diagnosis, follow up and treatment, morbidity and mortality can be reduced by 70% and 80% respectively. Methods: This retrospective study was conducted to know the incidence of abnormal cervical epithelial lesions and cervico-vaginal infections. It was carried out in the Outpatient Department of Gynecology at Chitwan Medical College from April 2018 to March 2019. The data were collected and standard statistical analysis done using Microsoft Excel 2007. Results: The most prevalent cervical epithelial cell abnormality was atypical squamous cells of undetermined significance (3.43%) whereas the least common was low grade squamous intraepithelial lesion (0.21%). The most prevalent cervical vaginal infection was Bacterial vaginosis (12.30%) whereas the least prevalent was Trichomoniasis (0.29...

Nepal Journal of Obstetrics and Gynaecology, 2021

Aims: To evaluate the midterm outcome of sacrospinous fixation done during surgical management of... more Aims: To evaluate the midterm outcome of sacrospinous fixation done during surgical management of pelvic organ prolapse. Methods: This was an interview based cross sectional follow up study done among the patients who underwent sacrospinous fixation procedure along with pelvic organ prolapse surgery in Kathmandu Model Hospital and Paropakar Maternity Hospital. This was conducted between 15 th February 2021 and 15 th April 2021. Post-operative cases 22 to 30 months (average 2 years) from the day of surgery were included. Results: Out of 321 eligible SSF patients from both the hospital, 156 agreed to participate. Among them, 77 (48%) were in 60-69 years of age and 82% were postmenopausal; 33% were more than para 3; 20% had right gluteal pain that was decreased to 1.9% by 2 years; and 20% had some degree of urgency and stress incontinence. Conclusion: Sacrospinous fixation is safe and effective procedure which can be done during pelvic organ prolapse surgery with good success rate and ...

Europasian Journal of Medical Sciences, 2021

Background: Relaparotomy after cesarean section is associated with significant maternal morbidity... more Background: Relaparotomy after cesarean section is associated with significant maternal morbidity and mortality which can be prevented with proper precaution during the primary surgery. The objective of the study was to determine factors associated with relaparotomy after cesarean section. Methods: A hospital based descriptive cross sectional study conducted by analyzing the records of 3 years from 1st July 2017 to 30th June 2020, among the women who underwent relaparotomy after cesarean section at Paropakar Maternity and Women’s Hospital, Kathmandu. Results: There were 21,270 cesarean sections among 64,475 deliveries with the mean incidence of 32.6%. A total of 22 patients underwent relaparotomy out of which 18 had their primary surgery performed at our hospital i.e. 0.08% of the total caesarean section, and 4 cases were referred from peripheries. 60% of primary surgery were done by residents and the commonest indications of primary surgery were previous CS (36.3%) and obstructed...

Nepal Journal of Obstetrics and Gynaecology, 2019

Aim: To determine the maternal and perinatal outcome in teenage pregnancies. Methods: A hospital... more Aim: To determine the maternal and perinatal outcome in teenage pregnancies. Methods: A hospital based descriptive cross sectional study conducted from April 2017 to April 2018, among the pregnant women of age group≤19 years, admitted to the labour ward atRapti Sub regional Hospital, Dang. Results: The total of 853 pregnant adolescent women were admitted during the study period, most of which belonged to 19 years of age (38.6%) and were primipara (93.3%) and 42.1% belonged to janjati group. 79.6% had normal delivery, while 14.1% of the cases underwent caesarean section, 5.9% had instrumental delivery and in 0.5% had perineal injury. Anaemia complicated 63% of teenage mothers, more in age group of ≤ 18yrs than in > 18years (61.4%vs 38.6%) and 4.6% had maternal complications, the majority being PPH (2.9%) followed by oligohydraminos, eclampsia, wound infection and vulvar haematoma. Preterm delivery occurred in 15.5% of the cases (≤ 18yrs vs>18yrs being 9.8% vs 5.7%), other neo...

Journal of Social Sciences, 2010

The study investigated the extent to which intelligent quotient, emotional intelligence and spiri... more The study investigated the extent to which intelligent quotient, emotional intelligence and spiritual intelligeInce would jointly and relatively predict prison-adjustment among Nigerian prisoners. The participants were five hundred prisoners randomly selected from five prisons in Nigeria. They are made up of four hundred and fifty eight males and forty-two females. The study utilized expost facto correlational research design. Multiple regression analysis and pearson product moment correlation were was used to analyse data collected to test the three research questions raised in the study. The results showed significant positive correlations between the independent variables and prison adjustment with emotional intelligence taking the lead (r = 0.95), followed by spiritual intelligence (r = 0.83) and lastly, intelligent quotient (r = 0.79). Also, the three independent variables contributed a total of 93.2% to the criterion (Prison Adjustment), while relative contributions as revealed by the Beta results showed Emotional Intelligence (B = 0.736), Spiritual Intelligence (B = 0.443) and Intelligent Quotients (B = 0.173). On the basis of the findings, it was recommended that prisoners should be exposed to emotional intelligence training as well as regular, functional religious programmes to enhance their effective adjustment. It was therefore concluded that emotional intelligence and spiritual intelligence skills are far more important than intelligent quotient. Therefore instead of placing more emphasis on being brilliant, let students and people who demonstrate high level of emotional intelligence and spiritual intelligence be properly encouraged.

Journal of College of Medical Sciences-nepal, 2020

Background: The aim of the study was to share the experience of laparoscopic gynecologic surgery ... more Background: The aim of the study was to share the experience of laparoscopic gynecologic surgery in a government hospital outside Kathmandu valley Method: A descriptive cross-sectional study was carried out in Bharatpur Hospital from 15 Dec, 2018 to 15 June, 2019. Fifty consecutive patients who underwent laparoscopic gynecological procedures were included in the study and analyzed demographics, indication, hospital stay and complications. Results: The mean age of the patients (n = 50) was 34.6 ± 12.5 years (Range: 17 – 66 years). More than athird of the total patients (n = 18, 36.0%) were between 26 – 35 years. Majority (n = 26, 56.0 %) of the patients were multipara (≥ 2 child). Hasson type was more frequently utilized type of primary port incision in the surgeries performed (52.0%, n = 26). The median duration of surgery was 2.08 hours (Range: 0.83 – 3.25 hours). The commonest post-operative diagnosis was dermoid cyst (n = 14, 28.0%). Complications were observed in eight patients...