NepMed Repository :: Browsing by Author "Kandel, Manoj"

Browsing by Author "Kandel, Manoj"

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Comparison of Carrying Angle of Elbow between Patients with and without Lateral Epicondylitis: An Observational Study
(Nepal Medical Association, 2025) Shrestha, Sarik Kumar; Kandel, Manoj; Chalise, Bhanubhakta; Gautam, Keshav Mani; Panta, Sunil; Chaudhary, Pritam; Subedi, Suman; Darjee, Prakash
Abstract Introduction: Lateral epicondylitis is a common cause of elbow pain, characterized by pain on the lateral side of the elbow joint. Its multifactorial etiology may result from repetitive micro-trauma, overuse of the forearm extensor muscles, use of vibrating tools, and anatomical variables causing lateral wear. In case of increased carrying angle of elbow, the course of extensor carpi radialis brevis during movement can be altered, thus increasing the tension on the extensor carpi radialis brevis tendon and increasing the risk for lateral epicondylitis. This study aims to find out the difference in carrying angle of elbow in patients with and without lateral epicondylitis. Methods: An observational cross-section study comparing carrying angle of elbow in patient with and without lateral epicondylitis was performed after ethical approval from the Institutional Review Committee (Reference number: 080/081-019) Patients presenting who had undergone radiographic examination of the elbow were recruited in the study and divided into the lateral epicondylitis group and the normal group. The mean carrying angle of elbow in both groups was compared using the parametric test. Results: This study included 82 participants, with 41 participants in the lateral epicondylitis group and 41 participants in the normal group. The mean carrying angle of elbow among patients with lateral epicondylitis group was 14.35±1.4 degrees; and the normal group, it was 12.40±1.26 degrees (p<0.001). Conclusions: The carrying angle of elbow in patients with lateral epicondylitis was significantly more than those without lateral epicondylitis.
Demography of Total Joint Replacement Surgeries Performed in a Tertiary Care Hospital: A Cross-sectional Survey Authors
(Nepal Medical Association, 2021) Thapa, Shrawan Kumar; Kandel, Manoj; Panta, Sunil; Adhikari, Bishwa Raj
Abstract: Introduction: Total joint replacement of hip and knee is considered as one of the most successful orthopedic surgeries in the twenty-first century because of the only solution to end-stage arthritis of these joints. The real burden of the problem is yet to be established in developing countries like Nepal. This study aims to describe the demographic findings of the joint replacement surgeries among total lower limb surgeries in a tertiary care hospital. Methods: This cross-sectional survey was conducted using the hospital records of 73 total joint replacement surgeries of the lower limb in the Department of Orthopedics of a tertiary care hospital from November 2016 to November 2020. Ethical approval was taken from the Institutional Review Committee (reference number: 077/78-011). Convenience sampling was done. Data analysis was done using the Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: There were 73 total joint replacement of hips and knees. Of which, 32 (43.84%) total hip replacements were done in which one (3.13%) patient had a simultaneous bilateral hip replacement in single-stage and the other one (3.13%) had two-stage bilateral hip replacement. Forty one (56.16%) total knee replacements were done in which 18 (24.65%) had a simultaneous bilateral knee replacement and five (6.85%) had a unilateral knee replacement. Conclusions: Total joint replacements of the hip were more common among the lower limb surgeries.
Hoffa’s Osteochondroma - Para-articular Extrasynovial Infrapatellar Fat Pad Osteochondroma: A Case Report
(Nepal Medical Association, 2021) Panta, Sunil; Thapa, Shrawan Kumar; Paudel, Krishna Prasad; Kandel, Manoj; Adhikari, Bishwa Raj
Abstract: Osteochondroma usually arises from the metaphyseal region of growing bones. The occurrence of extraskeletal osteochondroma is rare with very few case reports. Para-articular osteochondroma is a type of extraskeletal osteochondroma. It frequently occurs around the knee, usually at infrapatellar Hoffa’s fat pad. It is usually intracapsular but extrasynovial and arises from the capsule and connective tissues due to osteocartilaginous metaplasia. We present a case of 19-years male with anterior knee pain for 3 years, swelling, and deformity of the knee with flexion limitation for one year. Radiography revealed ovoid, corticated lesion free from adjoining bones. Mass interpreted as benign, so planned for excision. Well circumscribed nodule excised from the medial parapatellar approach. Histology revealed cartilaginous tissues surrounded by fibrous tissues with scattered enchondral ossification. Postoperatively and subsequent follow-up resulted in pain-free joint, complete recovery of range of motion with no clinicoradiological evidence of recurrence.
Prevalence of Osteoporosis in Patients with Distal Radius Fracture from Low-energy Trauma: An Observational Study
(Nepal Medical Association, 2025) Kandel, Manoj; Shrestha, Sarik Kumar; Paudel, Krishna Prasad; Panta, Sunil; Banjade, Deepak; Syangtan, Ramesh; Thapa, Sushil
Abstract Introduction: Osteoporosis is characterized by low bone mass, leading to enhanced bone fragility. Low-energy fractures of distal radius are related to osteoporosis and is therefore related to increased risk of subsequent hip fractures. The objective of this study was to study the prevalence of osteoporosis in patients with distal radius fracture from low-energy trauma. This will emphasise the need to investigate these patients for osteoporosis and make practitioners should be aware of the possibility of osteoporosis in such patients. Methods: This observational cross-section study evaluated the prevalence of osteoporosis in patients with distal radius fracture from low-energy trauma among patients presenting to tertiary level hospital of Nepal from October 2022 to September 2023.The participants’ demographic data, mechanism of injury, BMD values and T-score values were recorded and diagnosis of osteoporosis and osteopenia was made according to WHO diagnostic criteria. Ethical approval was taken from Institutional Review Committee (Reference Number: 079/80-015). Results: The study involved 96 patients with mean age of 68.27±4.09 years. The mean BMD among the participants was 0.69±0.02 and the mean T-score was -2.75±0.23. Diagnosis of osteoporosis was made in 88 (91.67%) patients and diagnosis of osteopenia was made in 8 (8.33%) patients based on the T-score using the WHO criteria. Of the 88n(%) patients who met the diagnosis of osteoporosis, only 45 (46.88%) patients had started treatment with bisphosphonates for osteoporosis. Conclusions: We have found a high prevalence of osteoporosis among patients with low-energy distal radius fracture.
Radial Head Arthroplasty among Patients with Radial Head Fracture in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Kandel, Manoj; Banjade, Deepak; Thapa, Shrawan Kumar; Kandel, Prakash; Adhikari, Bishwa Raj; Neupane, Kabin
Abstract Introduction: Proximal radial fractures are a common type of fracture around the elbow joint. Among these comminuted radial head fractures are commonly associated with secondary injuries and instability of the elbow joint. Management of the radial head in such cases is very important in restoring the stability of the elbow joint and starting early mobilization. The aim of this study was to find out the prevalence of radial head arthroplasty among patients with radial head fracture in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted from 25 January 2019 to 25 December 2020 among patients with a radial head fracture at the Department of Orthopaedics of a tertiary care centre. Ethical approval was obtained from the Institutional Review Committee (Reference number: 076/77-08A). A convenience sampling method was used. The study group consisted of patients between 20 to 60 years of age with isolated radial head fractures. Radial head arthroplasty was done for Mason types III and IV fractures and functional outcome was calculated postoperatively with Mayo elbow score on follow-up at 3-, 6- and 12-month intervals. Point estimate and 95% Confidence Interval were calculated. Results: Out of 96 patients with radial head fracture, 22 (22.92%) (17.59-28.25, 95% Confidence Interval) underwent radial head arthroplasty. The mean Mayo elbow score was 96.33±7.74 at 12 months of follow-up. Conclusions: The prevalence of radial head arthroplasty among irreparable radial head fractures was similar compared to other studies done in a similar setting.

Browsing by Author "Kandel, Manoj"

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