Papers by Bharat bahadur bhandari
Journal of Society of Surgeons of Nepal
Introduction: The COVID-19 pandemic has had a major impact on healthcare in many countries. This ... more Introduction: The COVID-19 pandemic has had a major impact on healthcare in many countries. This study assessed the effect of a nationwide lockdown during the second wave of COVID-19 on surgical management for acute surgical conditions and the subsequent impact on postoperative mortality. Methods: This was a retrospective study, evaluating data from the hospital discharge database during the second wave of COVID -19 pandemic. All adult patients admitted through the emergency and outpatient department requiring surgical treatment between April 29 and June 29, 2021 were included in the study. The primary outcome was the change in number of hospital admissions for acute surgical conditions. Mortality was assessed among the patients with COVID-19 infected cases. Results: During the second wave of nationwide COVID-19 lockdown period, a total of 329 patients were provided surgical consultation either in emergency or outpatient basis. Among them, 227 cases required surgery. Out of this 122...
Medical Journal of Shree Birendra Hospital
Introduction: Urothelial bladder cancer is a cancer of environment and age, and its incidence inc... more Introduction: Urothelial bladder cancer is a cancer of environment and age, and its incidence increases with age peaking in the 80s. Unlike in other malignancies in which cancer tends to be aggressive in young individuals, the probability of developing muscle invasive bladder cancer increases with age. The standard treatment for non-metastatic muscle invasive bladder cancer is radical cystectomy. However, there is controversy regarding the outcome of radical cystectomy in elderly patients, especially more than 80 years. Methods: This is a retrospective study of prospectively collected data. All patients > 80 years of age with bladder carcinoma were included in the study. A patient with good functional status was offered Radical Cystectomy. Patients not fit for surgery or refusing surgery were managed with TURBT. Results: A total of 23 patients were included in the study. Out of which, 13 patients underwent radical cystectomy (RC) with ileal conduit and while ten patients who refu...
Medical Journal of Shree Birendra Hospital, 2020
Introduction: The incidence of small and medium size renal stones is rising. Stone clearance, ble... more Introduction: The incidence of small and medium size renal stones is rising. Stone clearance, bleeding, urine leak and infectious complications are major concerns for urologist. Urologist chooses best technique from list of armamentarium available. Minimally invasive approach like Percutaneous Nephrolithotomy (PCNL) has significantly influenced the renal stone management since 1976. Miniaturisation of the instruments allow more effective and safer alternatives for urolithasis management. Methods: This is a retrospective study in which the outcome of mini PCNL (mPCNL) was compared with standard PCNL (sPCNL) in management of nephrolithiasis.
Journal of Kathmandu Medical College, 2020
Background: The longitudinal tear or defect in the epithelial lining of the anal canal distal to ... more Background: The longitudinal tear or defect in the epithelial lining of the anal canal distal to the dentate line is called anal fissure. It is of two types: acute and chronic. The break in the cycle of pain, spasm and ischemia is essential for successful treatment of anal fissure. Among multiple non-surgical treatment approaches, the appropriate approach with good patient compliance might be the use of topical agents as chemical sphincterotomy. However, the effectiveness of these agents has not been evaluated widely. Objectives: To evaluate clinical effectiveness of topical 0.2% glyceryl trinitrate, topical 2% diltiazem and their combination in the treatment of chronic anal fissure. Methodology: The study was prospective comparative type including total 158 patients. Initially, they were given first line therapy followed by chemical sphincterotomy agents. The study drugs were given to 84 patients (three groups - 0.2% glyceryl trinitrate, 2% diltiazem and their combination) who were...
Journal of Society of Surgeons of Nepal, 2016
Rhabdomyosarcoma of urethra is extremely a rare presentation. Only few cases were found documente... more Rhabdomyosarcoma of urethra is extremely a rare presentation. Only few cases were found documented and published in literature. We present a case of rhabdomyosarcoma in the urethra presenting with history of gross heamaturia. Diagnosis of this case was made cystoscopically and confirmed by histopathologically. Complete radical surgery followed by six cycle chemotherapy was given in this case.
Journal of Patan Academy of Health Sciences, 2016
Introductions: Laparoscopic surgery is a rapidly emerging option in urology. With the advances in... more Introductions: Laparoscopic surgery is a rapidly emerging option in urology. With the advances in technology and instruments, currently this is viable alternative to treat complex surgical diseases as well as reconstructive surgery.Methods: This was a prospective observational study to analyze the outcome of laparoscopic nephrectomy. A total of 51 patients had undergone laparoscopic nephrectomy over the period of five years. The variables analyzed were, age, sex, operative time, estimated blood loss, length of hospital stay, conversion rate and complication.Results: The patients’ mean age was 41.1 years (range 15-71 years). Indications for nephrectomy were non-functional kidney secondary to stone disease in 26 (50.98%). Mean operative time was 1.43 hours. Median hospital stay was 2.3 days.Conclusions: Laparoscopic surgery is a safe and feasible treatment option for benign renal diseases with comparable outcomes. Non- functional kidney secondary to renal stone was the major cause of ...
Journal of Patan Academy of Health Sciences, 2015
Introductions: Ureteral stones account for 20% urinary stone. Two third of ureteral stones are se... more Introductions: Ureteral stones account for 20% urinary stone. Two third of ureteral stones are seen in lower third of ureter. Medical expulsive therapy is effective for such stones. This study was designed to observe the efficacy of ‘tamsulosin’ a selective alpha-1 adrenoreceptor antagonist in the management of lower ureteric stone.Methods: A cross sectional study of 70 cases of distal ureteral stones of sizes 5 to 10 mm was taken in the Department of Surgery of Shree Birendra Hospital, Nepalese Army Institute of Health Sciences (NAIHS) from January 2011 to 2013. Patients were randomly divided into tamsulosin and analgesic only groups. Stone expulsion at the end of three weeks was confirmed by X-ray or Ultrasonography.Results: Out of 70 patients, stone clearance rate in tamsulosin group was 28 in 35 cases (80%) and 21 in 35 cases (60%) in group II with analgesic only. The mean time of stone expulsion was 8.3 days in group I and 13.5 days in group II.Conclusions: In this study the us...
Medical Journal of Shree Birendra Hospital, 2018
Introduction: Double J stent is one common armamentarium used in urological procedure. It can ser... more Introduction: Double J stent is one common armamentarium used in urological procedure. It can serve both therapeutic and prophylactic function. However the use of double J stent is invariably associated with minor to some of major complications. Forgotten DJ stent is one untoward issue of stenting patient that is largely preventable and entails complex urological procedure to remove it. Methods: We performed descriptive study where data were collected prospectively from patients who have double J ureteral stent in situ after urological procedure. Stent left more than three months was defined as forgotten DJ stent. Demographic characteristics, clinic-radiological data and details of management were noted to evaluate the mode of presentation, associated complications and mode of treatment. The reason behind forgetting those stent was asked with study population and presented. Results: The total of 27 cases of forgotten DJ stent cases were recorded during period of December 2013 to January 2018. Mean age of patient was 46.6 ± 12.25 years. The longest indwelling time was 10 years. Stent syndrome was common mode of presentation followed by encrustation. Majority (92.5%) of the patients were managed with endourological approach and 26% (7) of cases required more than one modalities of treatment. Conclusions: The forgotten stent is an avoidable condition through proper patient counselling. When required the management necessitates simple cystoscopic to complex endourolgical intervention.
Medical Journal of Shree Birendra Hospital, 2018
Introduction: Neurogenic bladder (NGB) is common in daily urological practice; however, informati... more Introduction: Neurogenic bladder (NGB) is common in daily urological practice; however, information on types of urological complications encountered in army and veterans are not under strict surveillance and little is known to them about the best way to manage the condition. This observational study aimed to determine the types of urological complications encountered in regular soldiers and veterans with traumatic spinal cord injury (SCI) with NGB, and the usage of bladder management programs to deal with NGB. Methods: We retrospectively reviewed the charts and records of interviewed patients with SCI in our urology clinic. Demographic data collected included: age, gender, mode of injury and level of spinal injury. Also noted were episodes of urinary tract infection (UTI), renal lesions, and bladder program followed. Results: The mean age of our study sample (N = 63) was 40 ± 10.8 years and all were male. Age at onset of injury was 33.8 ± 16.6 years and duration since SCI insult was 90.6 ± 54 months. Symptomatic urinary tract infection (75%), chronic cystitis (53.3%), hydro-nephrosis (36.5%) and urinary bladder calculi (33.3%) were the common urological lesion observed. Indwelling Foley's catheterization is a method of urinary bladder management in 54% study population where urinary tract infection is more common (p < 0.05). Conclusions:Urinary tract infection, hydro-nephrosis and Urinary bladder calculi were the most common urological complications encountered in army and veterans with NGB. Indwelling Foley's catheter was the most frequently used bladder management program with the higher risk for UTI.
Medical Journal of Shree Birendra Hospital, 2017
Dermoid cysts are extremely rare in the urinary bladder and pose a diagnostic dilemma to both the... more Dermoid cysts are extremely rare in the urinary bladder and pose a diagnostic dilemma to both the Urologist and the Histopathologist. Only a few cases were found documented and published in literature. We present a case of dermoid cyst in the urinary bladder presenting as a bladder mass which is very rare tumour. Diagnosis of this case was made cystoscopically and confirmed by histopathologically. Complete excision of mass was possible by endoscopic resection.
Medical Journal of Shree Birendra Hospital, 2016
Medical Journal of Shree Birendra Hospital, 2016
Medical Journal of Shree Birendra Hospital, 2015
Introduction: Helicobacter pylori (H. Pylori) as a primary etiological factor in carcinoma stomac... more Introduction: Helicobacter pylori (H. Pylori) as a primary etiological factor in carcinoma stomach. Associationof H. Pylori in gastric cancer has been documented to be in more than 50% of cases. In underdevelopedcountries, this association is shown to be much higher according to different studies.Methods: A prospective observational study of 40 consecutive cases of carcinoma stomach was under takenin surgical department of Shree Birendra hospital and Bir hospital, for a period of two years 2009 to 2011.Location and pathological types of the lesion were noted and all specimens were investigated to see presenceof helicobacter pylori by rapid urease test (RUT) and histological examination.Results: Out of 40 patients, helicobacter pylori positivity was seen in 27 (67.5%) cases by both rapid ureasetest and Histopathological examination (HPE). Regarding the pathological types, out of 26 intestinal type of castomach, 20 (76.92%) cases were positive for H. pylori infection, whereas out of 1...
Medical Journal of Shree Birendra Hospital, 2013
Introduction: Female stress urinary incontinence (SUI) is a fairly common problem, with widely va... more Introduction: Female stress urinary incontinence (SUI) is a fairly common problem, with widely varying prevalence rates primarily due to inconsistencies in the definitions of SUI and also due to differences in the populations studied. Surgery is the definitive treatment for women who have failed a trial of conservative treatment. Although hundreds of different surgical procedures have been described, and published in literature, the ideal surgical technique that is simple, inexpensive and easy to learn and perform, with high efficacy needs yet to be established. One of the procedures, the transobturator sling (TOT), which is a subfascial sling, is a new, simple and most promising surgical technique with a good outcome. Methods: This is a prospective observational study undertaken in 20 patients of stress incontinence who underwent a TOT with outside-in technique between Jan 2010 and Jan 2012 . Various outcomes were recorded and patients were followed up for a period of at least 1 ye...
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Papers by Bharat bahadur bhandari