Browsing by Author "Lamichhane, Suraj"
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Publication Stuttering after Intravenous Anesthesia: A Case Report(Nepal Medical Association, 2021) Lamichhane, Suraj; Upreti, Murari Raj; Dhakal, YogeshAbstract: Stuttering is a form of speech disorder characterized by involuntary prolongation and repetition of sound, words, syllables or phrases as well as involuntary silent pauses or blocks. We report a case of a healthy twenty-six-year-old male patient without significant past history, who underwent short intravenous anesthesia for incision and drainage for perianal abscess. Postoperatively, the patient presented with prominent stuttering after six hours of surgery. To our knowledge, this is the first reported case of stuttering following short intravenous anesthesia without any airway manipulation. He was diagnosed with a functional speech disorder after excluding organic causes. His speech eventually normalized with six weeks of intensive speech therapy. This event posed a significant challenge for the surgical and anesthesia team to find the potential cause, to plan further management, and lead to two days prolongation of hospital stay.Publication Ultrasound Guided Trigger Point Injection and Sciatic Nerve Hydrodissection for Atypical Piriformis Syndrome: A Case Report(Nepal APF Hospital, 2026) Pun, Iswar Kumar; Amatya, Shirish Prasad; Moktan, Sushila Lama; Lamichhane, Suraj; Pun, InshaAbstract: Introduction : Chronic low back pain is a common complaint and is often attributed to lumbar disc disease. Less recognized causes, such as piriformis syndrome, can be overlooked, especially when routine tests and imaging are inconclusive. Early accurate diagnosis and targeted therapy are essential for effective pain relief. Case presentation: A 39-year-old male experienced six years of atraumatic low back pain radiating to his left leg and sole, worsening over 10 days and aggravated by prolonged sitting or standing. Examination revealed left piriformis tenderness but negative provocative tests, with minimal sensory deficit in the left L5 dermatome. Imaging showed a lumbarisation of sacral vertebra and L4–L5 disc bulge with bilateral lateral recess narrowing causing indentation of L4 exiting nerve root, which did not fully explain his symptoms. He had previously tried physiotherapy, oral steroids, neuromodulators, and analgesics without relief. Ultrasound-guided piriformis trigger point injection and sciatic nerve hydrodissection provided rapid and significant pain relief, confirming the piriformis as the primary pain source. Conclusion: This case highlights the diagnostic and therapeutic utility of ultrasound-guided, safe, and minimally invasive interventions in atypical piriformis syndrome refractory to conservative management.