Browsing by Author "Maharjan, Sagar"
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Publication Epidemiology and Management of Open Fractures in a Tertiary Care Hospital in Nepal: An Observational Study(Nepal Medical Association, 2025) Maharjan, Sagar; Chaudhary, Arun Kumar; Shrestha, Rohit; Shrestha, Pramit Ram; Gautam, Prabesh; Basi, Ashkal; Malla, Manasil; Acharya, Shreedhar Prasad; Khadka, Sushant KumarAbstract Introduction: An open fracture is an orthopedic emergency that requires immediate resuscitation and stabilization. Understanding presentation and management patterns can help prepare in emergency settings. This retrospective descriptive cross-sectional study stated the demographic profile, management pattern, and seasonal distribution of patients presenting with open fractures. Methods: An observational cross-sectional study was conducted in a tertiary care center, Medical records of all patients with open fractures who underwent immediate orthopedic interventions between January 2021 and December 2023 were evaluated retrospectively after obtaining ethical approval from the Institutional Review Committee (Reference number: 29/24). Descriptive statistics were used to analyze data. Results: The study included a total of 133 cases of open fractures managed during the study period. Out of these, male patients were 104 (78.20%) and female patients 29 (21.80%), with a median age of 35.00 (25.00 - 42.00) years. Mode of injuries included road traffic accidents 53 (39.85%) and falls 32 (24.06%). Tibia fracture was seen in 56 (42.11%) cases, and spinal anesthesia was used in 52.63% of cases. External fixators 36 (27.07%) and intramedullary nails 29 (21.80%) were the primary surgical interventions. Conclusions: Male patients with open fractures were more in comparison to female patients. Road traffic accidents were the most common cause of injury. Gustilo IIIB fractures were the most frequent kind of injury with tibia most commonly involved. External fixator application was the most common procedure for immediate stabilization.Publication Investigating the Efficacy and Safety of Diacerein in the Management of Knee Osteoarthritis with reference to its conventional management(Nepal Health Research Council, 2022) Shrestha, Rohit; Tamrakar, Sudichhya; Koju, Pramesh; Maharjan, Sagar; Malla, Subhechhya; Shrestha, Sony ShakyaAbstract Background: Designated as a “priority disease” by World Health Organization, Osteoarthritis is the most common chronic rheumatic disease. Providing a proper treatment for Osteoarthritis is still a major public health challenge. Diacerein has been proposed as a slow acting, symptom modifying or even disease modifying drug used in Osteoarthritis having a risk-benefit ratio far better than conventionally used drugs. However, the evidence of efficacy and safety of use of Diacerein in Osteoarthritis is yet to be explored. Hence, this study attempted to investigate the efficacy and safety of Diacerein in the management of knee osteoarthritis. Methods: This is an analytical cohort study comparing Diacerein with Non-steroidal anti-inflammatory drugs for two months in the management of knee OA. Efficacy was assessed by scores of Lysholm Knee Scoring Scale, Knee injury and Osteoarthritis Outcome Score – Physical Function Short form and Western Ontario and McMaster Universities Osteoarthritis Index. Results: After two months of treatment, the post- treatment scores were significantly superior to the baseline scores in both the treatment groups (p<0.001). There were no significant differences among the post-treatment scores in two different treatment groups (p>0.05). Discoloration of urine and gastritis were the frequently reported adverse effects in Diacerein treatment group and Non-steroidal anti-inflammatory drugs treatment group respectively. Conclusions: Our findings have shown Diacerein is as effective as Non-steroidal anti-inflammatory drugs in treating knee OA patients. Diacerein was generally well tolerated, with a good safety profile. These findings indicate the need for further studies with experimental study design in larger scale. Keywords: Diacerein; Efficacy; Knee Osteoarthritis; NSAIDs; Safety