Browsing by Author "Lamichhane, Apar"
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Publication Hand Injury among Patients Visiting Emergency Department in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Thapa, Anurag Singh; Rai, Shankar Man; Nakarmi, Kiran Kishor; Karki, Bishal; Magar, Mangal Gharti; Nagarkoti, Krishna Kumar; Dahal, Peeyush; Maharjan, Niran; Pokharel, Pashupati Babu; Lamichhane, AparAbstract Introduction: The hand is a complex organ responsible for activities of daily living, making it susceptible to injuries and accidents. Hand injuries can result in significant functional impairment and it occurs in a younger productive age group. Therefore, it is important to understand the prevalence and patterns of hand injuries. The aim of the study was to find out the prevalence of hand injuries among patients visiting the emergency department of a tertiary care centre. Methods: A descriptive cross-sectional study was in the Emergency Department of a dedicated trauma centre from 1 June 2022 to 31 August 2022. Ethical approval was obtained from the Institutional Review Board (Reference number: 148412078179). Demographic profile, pattern, and mechanism of hand Injuries of all 96 consecutive patients were assessed after taking informed consent. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 4679 patients visiting the emergency department of the trauma centre, hand injuries were seen in 96 (2.05 %) (1.64-2.46, 95% Confidence Interval). Conclusions: The prevalence of hand injuries was found to be lower than in other similar studies done in similar settings.Publication Initial experience of reconstruction of surgical defect in head and neck with free flap at dedicated cancer center in Nepal(Society of Otolaryngologists of Nepal, 2021) Yadav, Deepak; Raymajhi, Sangam; Yogal, Rijendra; Neupane, Yogesh; Lamichhane, Apar; Devkota, ManishAbstract: Background: Due to the complexity of surgery, fear of flap failure and lack of resources, free flap reconstruction is rarely performed at most centers in Nepal. Recently free flap reconstruction following ablative surgery for head and neck cancer has been started at Kathmandu cancer center. This study aims to determine the short-term outcomes and success rates of free flap reconstruction following ablative surgery for head and neck cancer at Kathmandu Cancer Center. Materials and methods: This is a retrospective chart review of all patients who required free flap reconstruction following head and neck surgery for cancer from July 2021 to December 2022. Various characteristics of patients and details of treatment were extracted from the records. Results: During the study period, 38 patients with a median age of 50 underwent surgery for head and neck cancer and required reconstruction with free flap. Primary cancer was the indication for surgery in 32 patients whereas one had undergone surgery for residual tumor and five had undergone surgery for recurrence or second primary. Free radial artery forearm flap (FRAFF) was utilized in 20 patients, free anterolateral thigh flap (FALTF) in 11 patients and free fibula osteocutaneous flap (FFOCF) in 7 patients. Median duration of surgery was 540 minutes. Reexploration within 24 hours was required for two patients, one for hematoma and other for ischemia. One patient experienced free flap failure due to arterial ischemia, resulting in an overall success rate of 97%. Conclusion: Dedicated, skilled teams can achieve comparable success and acceptable short-term outcomes in free flap reconstruction. Keywords: Anastomosis, FALTF, FFOCF, FRAFF, ischemia, oral cavity, neck dissection, Squamous cell cancer.