Browsing by Author "Maharjan, Basanta"
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Publication A solution for EPL ruptures in pediatric forearm fractures fixed with intramedullary devices: a case series on EIP to EPL transfer(Madhesh Institute of Health Sciences (MIHS), 2025) Maharjan, Basanta; Bajracharya, Aayush; Shrestha, Shriraj; Bhandari, Pramod; Shrestha, ShefaliABSTRACT: Delayed rupture of the extensor pollicis longus (EPL) tendon is a rare complication following pediatric forearm fractures, particularly after intramedullary fixation. We present a series of three cases managed with extensor indicis proprius (EIP) to EPL tendon transfer, highlighting surgical outcomes. All three patients, aged between 10 and 13 years, presented with inability to extend the thumb between four to eight months after fixation of both bone forearm fractures with intramedullary devices. EPL rupture was diagnosed clinically and confirmed by ultrasonography. Surgical management involved removal of intramedullary devices and EIP to EPL tendon transfer using the Pulvertaft weave technique in a single setting. Postoperative recovery was uneventful in all patients, with restoration of thumb extension and return to normal activities. This case series underscores the importance of maintaining a high index of suspicion for EPL rupture in children with loss of thumb extension following pediatric forearm fixation with an intramedullary device and the efficacy of timely tendon transfer in restoring function.Publication Back Pain among COVID-19 Positive Health Care Workers in a Tertiary Care Hospital in Nepal: A Descriptive Cross-sectional Study Authors(Nepal Medical Association, 2021) Shrestha, Shriraj; Bajracharya, Ayush; Dahal, Saurav; Bhandari, Parash; Maharjan, Basanta; Bajracharya, SurajAbstract: Introduction: The world has been threatened with the emergence of the Novel Corona Virus straining the health care system and creating a global pandemic. This is not the first pandemic, and it certainly will not be the last to affect humanity. As the medical community is exposed to these highly contagious new diseases with arrays of symptoms like fever, cough, shortness of breath, anosmia, insomnia, and myalgia. Back pain can also be considered as one of the symptoms of COVID-19 infection. Therefore, this study aimed to find out the prevalence of back pain among the Health care workers who were tested positive for COVID-19 by the end of their isolation period. Methods: This descriptive cross-sectional study was done from April 2021 to June 2021 in KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal, after receiving ethical approval from the Institutional Review Committee (Registration number: 2077/078/57). Convenience sampling was done. Data collection and entry were done in Microsoft excel, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 156 COVID-19 positive patients, the prevalence of back pain was seen among 64 (41%) patients (95% Confidence Interval= 42.23-57.75). Among them 21 (32.8%) were males and 43 (67.2%) were females. Likewise, the minimum age was 20 years and the maximum was 68 years with a mean of 33.5±10.28. Conclusions: This study demonstrated that a high proportion of healthcare workers were suffering from back pain and the findings are similar to the data from other international studies.Publication Multi Drug Resistant Pathogens Causing Urinary Tract Infections in Children at Kathmandu Model Hospital(Nepal Paediatric Society (JNPS), 2012) Shrestha, Basudha; Gurubacharya, Rajesh Lal; Maharjan, Basanta; Shrestha, SanjitAbstract: Introduction: Antibiotic resistance of urinary tract pathogens has increased globally. Updated knowledge of the antibiotic resistance patterns of uropathogens in the health institutes is important for the selection of an appropriate empirical antimicrobial therapy. The aim of this study was to evaluate the multi drug resistant urinary isolates in the children from 1 to15 years and evaluate the options for empiric antibiotic therapy. Materials and Methods: The study was conducted from December 2011 to May 2012 in the Bacteriology laboratory, Kathmandu Model Hospital. Urine samples received in the laboratory were processed for routine, culture and its sensitivity. The antimicrobial susceptibility of bacterial isolates was determined following Clinical and Laboratory Standard Institute (CLSI) recommended Kirby-Bauer Disc Diffusion method. Results: Of the total 372 urine samples received in the laboratory, 60 (16.13%) showed significant growth; of which 55.0 % (33/60) were MDR isolates. Escherichia coli were the predominant isolate from urine sample. Out of 49 Escherichia coli isolates, 27 (45.0%) were Multi drug resistant. Enterococcus faecalis (N=3) was the most predominant Gram positive isolate and 66.67 % (2/3) of this organism were multi drug resistant. Among the first line drugs used against gram negative isolates, nitrofurantoin was the most effective drug followed by quinolones, while among the second line drugs; meropenem was the most effective drug followed by chloramphenicol and amikacin, whereas; nitrofurantoin (100%) was the most effective drug for Gram positive isolates followed by norfloxacin and cefotaxime. Conclusion: High percentages of multi drug resistant uropathogens were revealed in children. Nitrofurantoin was found to be the most effective drug for gram positive, gram negative and multi drug resistant isolates.