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Browsing by Author "Karki, Netra Bahadur"

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    Displaced Midshaft Clavicular Fractures among Patients with Clavicular Fracture Admitted to the Orthopaedic Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2023) Nepal, Prabin; Karki, Netra Bahadur; Shrestha, Kumar; Karki, Umash; KC, Samir; Shrestha, Sailendra Kumar Duwal
    Abstract Introduction: Midshaft clavicular fractures are common among young adults. Open reduction and internal fixation of displaced midshaft clavicular fractures with plate and screws have been shown to decrease nonunion, symptomatic malunion, and residual shoulder disability compared with non-operative treatment allowing early pain-free movement and early return to work. The aim of this study was to find out the prevalence of displaced midshaft clavicular fractures among patients with clavicular fractures admitted to the orthopaedics department of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Orthopedics of a tertiary care centre from 31 January 2016 to 31 December 2019 after receiving ethical approval from the Institutional Review Committee (Reference number: 659/2021 P). Data were collected using hospital-based records from patients of the age group 18 to 50 years. Convenience sampling method was used. Point estimate and 95% confidence interval were calculated. Results: Among 120 patients, the prevalence of displaced midshaft clavicular fractures was 40 (33.33%) (24.90-41.76, 95% Confidence Interval). Among them 39 (90%) were males and 4 (10%) were females and the mean age of 31.45 years. The average Constant-Murley score were 95.68±5.59. Conclusions: The prevalence of displaced midshaft clavicular fractures among patients with clavicular fractures admitted to the Department of Orthopedics was lower than the other studies done in similar settings.
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    Musculoskeletal Manifestations in COVID-19 Patients at Paramilitary Hospital: A Cross-sectional Study
    (Nepal APF Hospital, 2025) KC, Samir; Shrestha, Sailendra Kumar Duwal; Nepal, Prabin; Karki, Umash; Karki, Netra Bahadur; Mahaseth, Adarsha
    Abstract: Introduction: Musculoskeletal symptoms are common in coronavirus disease 2019 (COVID-19) but are understudied in low-resource settings such as Nepal. This study aimed to assess the prevalence, spectrum, and severity of musculoskeletal manifestations in adults with acute COVID-19. Methods: We conducted a hospital-based, cross-sectional study at Nepal Armed Police Force Hospital, Kathmandu, from June to September 2023. Adults (≥18 years) with RT-PCR–confirmed COVID-19 were enrolled consecutively. Demographic, clinical, and laboratory data were collected. Musculoskeletal symptoms—myalgia, arthralgia, fatigue, low back pain, and paresthesia—were assessed using standardized questionnaires and severity scores (VAS/NRS). COVID-19 severity was classified per NIH criteria. Associations between symptom prevalence/severity and disease severity or viral load (Ct values) were analyzed using chi-square and ANOVA tests. Results: A total of 250 patients (47.6% male; mean age 49.8±18.1 years) were studied. Myalgia (70.0%), arthralgia (63.2%), and fatigue (61.2%) were the most frequent symptoms, followed by low back pain (44.0%) and paresthesia (4.4%). Symptom severity increased significantly with COVID-19 severity (p<0.001 for all). Myalgia, arthralgia, and fatigue had higher mean scores in moderate/ severe cases. There was a significant inverse association between RT-PCR Ct values and symptom severity, with higher viral loads correlating with more severe symptoms (p<0.001). Persistence of musculoskeletal symptoms at follow-up was observed exclusively in severe cases. Conclusions: Musculoskeletal symptoms, particularly myalgia, arthralgia, and fatigue, are highly prevalent and severe in COVID-19 patients in Nepal, with greater intensity in those with more severe disease and higher viral loads. Persistent symptoms after recovery highlight the need for integrated rheumatological and rehabilitative care in post-COVID management.

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