Browsing by Author "Luitel, Prajjwol"
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Publication Correlation Between Radiological Grading and Clinical Scoring in Knee Osteoarthritis Patients(Nepal Health Research Council, 2024) Sapkota, Kshitiz; Gautam, Sandesh; Luitel, Prajjwol; Sapkota, Radhika; Pokharel, SabinBackground: Osteoarthritis is characterized by mechanical joint abnormalities, primarily involving articular cartilage and subchondral bone degradation. Diagnosis of knee osteoarthritis relies on American College of Rheumatology criteria, and severity assessment utilizes the Western Ontario and McMaster Universities Osteoarthritis Index score and Kellgren and Lawrence grading. Despite reported associations, discrepancies persist in the correlation between Western Ontario and McMaster Universities Osteoarthritis Index and Kellgren and Lawrence grade. Methods: Descriptive cross-sectional study was conducted at the National Trauma Centre, over six months with consecutive convenience sampling. Demographic and clinico-radiological data were collected. Mean, SD and correlation coefficient was calculated. Results: Consecutive convenient sampling yielded 80 participants meeting American College of Rheumatology criteria, aged 52-81 years, predominantly female (67.50%). Significant positive correlations were identified between age, Western Ontario and McMaster Universities Osteoarthritis Index score, and KL grade. Results showed most cases with Kellgren and Lawrence grade III and strong correlations (r=0.73, p=0.00) between total Western Ontario and McMaster Universities Osteoarthritis Index scores and Kellgren and Lawrence grading. Notably, pain, stiffness and physical functions individually exhibited a significant possitive correlation with Kellgren and Lawrence grading. The study affirms age-related influences on osteoarthritis, emphasizes female predilection, and underscores the importance of assessing both clinical and radiological parameters. Conclusions: In conclusion, this study supports Western Ontario and McMaster Universities Osteoarthritis Index efficacy in dynamic disease assessment and management, especially in settings where radiological examinations may be impractical, thus establishing Western Ontario and McMaster Universities Osteoarthritis Index as a versatile tool for systematic monitoring and intervention in knee osteoarthritis. Keywords: knee osteoarthritis; radiology; rheumatology; scoring; X-Ray.Publication Efficacy and Safety of Colonoscopic Band Ligation for Lower Gastrointestinal Bleeding due to Hemorrhoid(Nepal Health Research Council, 2024) Upadhya, Pawan Sapkota; Luitel, Prajjwol; Paudel, Sujan; Neupane, Nischal; Adhikary, Shailesh; Awale, Laligen; Pandit, NarendraBackground: Lower gastrointestinal bleeding is a significant cause of morbidity and mortality. Hemorrhoids are frequently encountered cause of lower gastrointestinal bleeding in outpatient settings in Nepal. Rubber band ligation is one of the most important, cost-effective, and commonly used treatments for first to third-degree internal hemorrhoids. Colonoscopic Rubber band ligation provides enhanced visualization and maneuverability, improving safety and efficacy of Rubber band ligation compared to traditional Rubber band ligation methods. This study aimed to assess the safety, efficacy, and patient acceptance of Colonoscopic Rubber band ligation for lower Lower gastrointestinal bleeding due to hemorrhoids. Methods: This study, conducted in a tertiary care center of Nepal over one year, explores the immediate, late complications, efficacy and treatment satisfaction of patients undergoing Colonoscopic Rubber band ligation for lower GI bleeding due to hemorrhoids. Results: We included 28 among 108 patients presenting to the surgical outpatient department with Lower gastrointestinal bleeding. Symptoms of irritation, discharge, pain resolved in all patients at 3 months and that of bleeding and prolapse in 96.4% and 92% respectively. 75% were able to resume work the day after the procedure. Post-procedure complications were reported in 53.5% of cases. 78.6% of patients rated Colonoscopic Rubber band ligation treatment as “excellent help”. Conclusions: Colonoscopic Rubber band ligation is feasible, safe and efficient for the treatment of symptomatic grade II hemorrhoids with most patients experiencing relief and high satisfaction. Further multicenter research with longer follow-up is needed to confirm long-term effectiveness. Keywords: Colonoscopy; hemorrhoids; per rectal bleeding; rubber band ligation procedure.