Browsing by Author "Dahal, M"
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Publication Predicting cubitus varus in supracondylar fractures of the humerus by Baumann’s angles in post reduction X-rays(Kathmandu University, 2006) Dahal, M; Kumar, P; Singh, GK; Arora, SS; Singh, MPObjectives: The present study presents the technique to predict cubitus varus by post reduction Affected Side and Normal Side Baumann’s angle difference (ASBA and NSBA) respectively. It intends to correlate the Baumann’s angle to the final carrying angle of the injured elbow and presents the relevant mathematical clinical rule along with its prediction test characteristics. Material and Methods: Total 57 patients of 6.5±1.67yrs, 22 were males and 8 females with 19/30 having left side injury. Isolated closed supracondylar fractures of humerus up to 5 days duration included and previous trauma, pathological fracture, other injury, elbow disease were excluded .30/57 completed >1 year follow-up. Results: The Mean NSBA was 74.4±4.14º. The mean normal side carrying angles (NSCA) were 9.56 ± 2.2º. The NSCA IQR (Inter Quartile Range) was 8.8-10º. The ASBA was 79.9±9.1º and affected side carrying angles (ASCA) was 0.20±8.7º. The ASCA was best predicted by the difference between ASBA-NSBA (ASCA=3.87-0.65(ASBA- NSBA; F=15.91). At a cut off of 8.8º (the lower limit of IQR for NSCA), a value >0º for ASBA- NSBA was 80% predictive of cubitus varus. With pre test probability of varus at 70%, sensitivity was 0.94 and specificity 0.42. Discussion: A prediction rule to predict the final carrying angle from ASBA NSBA difference is presented with a positive predictive value 0.80, specificity of 0.42, and sensitivity of 0.94 at a pre test probability of 0.70.When the diagnosis of cubitus varus is ASCA<8.8º (Lower limit of the IQR for NSCA). Conclusion: If affected side Baumann’s Angle – Normal Side Baumann’s Angle is equal to or greater than 0 then there was 80% probability of having cubitus varus. Key words: Supracondylar fractures of humerus, Baumann’s angle, Complications, Carrying angle, Cubitus Varus.Publication Thyroid Angiosarcoma : An unusual and challenging case report at B.P. Koirala Institute of Health Sciences(Kathmandu University, 2025) Lamichhane, U; Paudyal, P; Karki, S; Pradhan, A; Dahal, M; Shah, SPABSTRACT Angiosarcoma is an uncommon malignant vascular tumor of endothelial origin and commonly described in soft tissue. Thyroid is an uncommon site for angiosarcoma and is a very aggressive tumor commonly occurring in elderly female, characterized by its prevalence in Alpine regions of central Europe. The main aim of this case report is to provide an insight on thyroid angiosarcoma (TAS) occurring in non- Alpine region, to know the major diagnostic features of thyroid angiosarcoma and distinguish it from anaplastic thyroid carcinoma with angiomatoid features. Due to its overlapping microscopic features diagnosis of primary thyroid angiosarcoma (TAS) was challenging. However, the combination of thorough microscopic findings and immunohistochemical studies (CD 31, Vimentin, Thyroglobulin and Thyroid Transcription Factor-1) are vitally important in differentiating these two tumors to achieve at a final diagnosis. This significantly helps to decide the best treatment option and predict the behaviour. KEY WORDS Anaplastic carcinoma, Angiosarcoma, Thyroid gland