Browsing by Author "Maharjan, A"
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Publication Nepali Translation and Reliability Analysis of Quantitative Androgen Deficiency in the Aging Male Questionnaire(Kathmandu University, 2020) Risal, P; Maharjan, A; Bhatt, RD; Tamrakar, DABSTRACT Background Androgen deficiency is diagnosed on the basis of clinical symptoms and laboratory assessment of testosterone level. Different screening tools have been developed to evaluate the sign and symptoms. Objective In this study, we examine the validity and reliability of the Nepali version of the quantitative Androgen Deficiency in Aging Male (qADAM) questionnaire to screen androgen deficiency in Nepali male. Method English dialectal quantitative Androgen Deficiency in Aging Male questionnaire was forward translated to Nepali version and backward translated. This version was reviewed by a panel of an endocrinologist, a clinical psychiatrist, a physician, and a clinical biochemist. A final Nepali version of qADAM was developed. Thirty-one healthy male aged 31-70 years were administered with the questionnaire in two separate occasions two weeks apart. Cronbach’s alpha and test-retest reliability were calculated to identify validity and reliability, respectively. Result In the Nepali translated questionnaire, Cronbach’s alpha for internal consistency from ten items is good (0.68). The Cronbach’s alpha for internal consistency from nine items without item 7 is 0.706. Seven out of ten items had an R-value of > 0.7. In the total sample, Standard Error Mean (SEM) ranged from 0.00-0.44 for qADAM. SEM% are low for all variables (0.00-11.20%). MDC95 ranged 0.00-1.234. MDC95% ranged 0.00 – 31.05% and was < 30% for majority of variables (90%). Conclusion The final translated Nepali questionnaire seems reliable and valid. A future study measuring the Nepali questionnaire with testosterone level and another biochemical test in control and androgen deficiency patients will help validate the questionnaire. KEY WORDS Nepali translation, qADAM, Reliability analysisPublication Outcomes of Treatment of Thoracolumbar Burst Fractures with Intact Neurology Treated in Karnali Academy of Health Sciences, Nepal(Kathmandu University, 2025) Kathayat, TS; Rokaya, PK; Rawal, M; Karki, PD; Dhakal, B; Thapa, S; Maharjan, AABSTRACT Background The vulnerability of the thoracolumbar junction for a higher incidence of fracture with neural injury is mainly due to its anatomical peculiarity. The management of thoracolumbar burst fractures remains controversial due to the potential for further neurological deterioration and vertebral collapse at the thoracolumbar junction. Objective To investigate the outcomes of treatment of thoracolumbar burst fractures with intact neurology treated in Karnali Academy of Health Sciences, Nepal. Method This retrospective comparative study was done at Karnali Academy of Health Sciences, which included patients with thoracolumbar burst fractures classified as AO type A3 and A4, treated conservatively or operatively at 2 years follow-up. Data on demographics, kyphotic angles at injury were collected and at 2 years follow-up, and Patient-Reported Outcomes with the Nepali version (PROST) and Visual Analog Scale (VAS) scores for pain assessment. Result The results showed that 32 patients had a mean age of 43.47 years, with a majority in the 30-49 age group, showed a female predominance (56.3%) and fall injuries as the most common cause (78.2%). A total of 18 cases of AO type A3 and A4 were managed conservatively, while 14 cases were managed operatively of AO type A4. There was a significant difference in the kyphotic angle correction in operative cases (19.57 ± 8.19 vs 13.21 ± 5.57 degree (p-value < 0.001). In addition, there was no statistically significant improvement in functional outcome via PROST scores (p-value = 0.718) and VAS score (p-value = 0.450) in conservative and operative treatment. Conclusion Surgical intervention significantly improved kyphotic angles in AO type A4 patients, but the conservative management in both AO type A3 and AO A4 showed no significant change in kyphotic angle. However, PROST Nepali score and VAS score among conservative and operative cases were comparable and not statistically significant. KEY WORDS Burst fracture, PROST Nepali, Thoracolumbar vertebra, Treatment outcome, Visual analog scalePublication Sensitivity and Specificity of Nepali Version of Quantitative Androgen Deficiency in Aging Males (qADAM) Questionnaire in Diabetic Patients(Kathmandu University, 2023) Bhatt, RD; Risal, P; Maharjan, A; Timalsina, D; Qiqiang, HEABSTRACT Background Diabetes mellitus (DM) is a chronic disorder with hyperglycemia that affects multiple systems with hypogonadism and erectile dysfunction some common issues affecting their quality sexual life. Quantitative androgen deficiency in aging males (qADAM) questionnaire is a trusted tool to assess hypogonadism and erectile dysfunction among diabetic patients and has been commonly used in Nepal too. However, the accuracy, sensitivity, and specificity of its Nepali version are yet to be tested. Objective To assess the accuracy, sensitivity, and specificity of the Nepali version of the quantitative androgen deficiency in aging males questionnaire among diabetic patients. Method A cross-sectional study was conducted among diabetic patients attending Dhulikhel Hospital, Kathmandu University Hospital. The Patients were asked to complete the valid Nepali translated version of quantitative Androgen Deficiency in Aging Males questionnaire. Participants’ serum total and free testosterone, lipid profile, fasting blood glucose, HbA1c and Sex Hormone Binding Globulin (SHBG) were measured in clinical biochemistry laboratory and the accuracy, sensitivity and specificity of Nepali version of quantitative androgen deficiency in aging males were analyzed. Result The translated Nepali version of quantitative androgen deficiency in aging males questionnaire showed 61.9% sensitivity, 45.5% specificity, and 56.7% accuracy in diagnosing hypogonadism in reference to serum testosterone level. Conclusion This Nepali translated version of quantitative androgen deficiency in aging males questionnaire can be a noninvasive tool to assess hypogonadism and erectile dysfunction. KEY WORDS Diabetes, Hypogonadism, Nepali Translation, Quantitative androgen deficiency in aging males