Browsing by Author "Nepal, Prabin"
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Publication Anterior Cruciate Ligament Reconstruction with Semitendinosus Tendon Autograft among Paramilitary Patients Undergoing Arthroscopic Surgery in a Tertiary Care Centre(Nepal Medical Association, 2024) Shrestha, Sailendra Kumar Duwal; Nepal, Prabin; Karki, Umash; Karki, Netra; KC, Samir; Tamrakar, Rojan; Shrestha, Kumar; Joshi, PramodAbstract Introduction: In orthopaedic practice, injuries to the anterior cruciate ligaments occur almost on an epidemic scale, yet it continues to be of interest in orthopaedic surgery whether semitendinosus or gracilis hamstring autografts can be used for better anterior cruciate ligament reconstruction. This study aimed to determine the prevalence of anterior cruciate ligament reconstruction using semitendinosus tendon autografts among paramilitary patients undergoing arthroscopic surgery in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among paramilitary individuals who had knee injuries and were admitted between 6 february 2020 and 26 January 2022 for arthroscopic surgery after obtaining ethical approval from the Institutional Review Committee. Demographic details and the mode of injury were obtained from the patients. The treating orthopaedic surgeons evaluated the pre- and post-analysis Lysholm Knee Score and Lysholm Knee Scale based on the patient's response. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 166 patients, anterior cruciate ligament reconstruction using a semitendinosus tendon autograft was done in 58 (34.94%) (27.69-42.19, 95% Confidence Interval). Most of the patients in the pre-analysis had mild/periodic limp issues 52 (89.66%), followed by instability during athletics or other severe exertion 43 (74.14%). Conclusions: The prevalence of anterior cruciate ligament injuries in our study is higher than other studies done in similar settings.Publication Correlation of Spinopelvic Parameters in Lumbar Prolapsed Disc in Armed Police Personnel(Rapti Academy of Health Sciences (RAHS), 2024) Karki, Sunder; Chapagain, Sunder; Karki, Netra; Nepal, Prabin; Shrestha, Sailendra Kumar Duwal; Lamichhane, SumanAbstract: Introduction: A prolapsed intervertebral disc is a common problem in armed police personnel due to their demanding job nature. Spinopelvic parameters affect the stability of the spine and play a role in the load sharing of the intervertebral disc, contributing to the disc degeneration. Spinopelvic parameters measured in standing radiographs may provide a hint to disc degeneration. This study was conducted to assess the correlation of spinopelvic parameters in lumbar prolapsed intervertebral discs. Methods: An observational, retrospective study was conducted at Nepal Armed Police Force Hospital over a period from January 01, 2020, to October 10, 2023. The spinopelvic parameters were measured on lateral lumbar X-rays of the armed police personnel and were collected from the PACS system. The correlation between the spinopelvic parameters pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL), and pelvic tilt (PT) and prolapsed intervertebral disc (PIVD) was done. Results: A total of 73 patients (55 M/18 F) with the most common site for PIVD being L4-L5 (50%), and L5-S1 (28%). The measured mean spinopelvic parameters were LL (30.43°±5.77°), PT (15.67°±8.04°), PI (48.99°±9.52°), and SS (30.02°±9.5°). Statistically significant weak correlations were found between LL and PIVD at the L4-L5 level as well as between PI and PIVD at the L4-L5 level. Conclusion: There exists a negative correlation between the lumbar lordosis and pelvic incidence with PIVD at the most common site, L4-L5. So, patients with lower lumbar lordosis and pelvic incidence have a high chance of PIVD.Publication Displaced Midshaft Clavicular Fractures among Patients with Clavicular Fracture Admitted to the Orthopaedic Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Nepal, Prabin; Karki, Netra Bahadur; Shrestha, Kumar; Karki, Umash; KC, Samir; Shrestha, Sailendra Kumar DuwalAbstract Introduction: Midshaft clavicular fractures are common among young adults. Open reduction and internal fixation of displaced midshaft clavicular fractures with plate and screws have been shown to decrease nonunion, symptomatic malunion, and residual shoulder disability compared with non-operative treatment allowing early pain-free movement and early return to work. The aim of this study was to find out the prevalence of displaced midshaft clavicular fractures among patients with clavicular fractures admitted to the orthopaedics department of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Orthopedics of a tertiary care centre from 31 January 2016 to 31 December 2019 after receiving ethical approval from the Institutional Review Committee (Reference number: 659/2021 P). Data were collected using hospital-based records from patients of the age group 18 to 50 years. Convenience sampling method was used. Point estimate and 95% confidence interval were calculated. Results: Among 120 patients, the prevalence of displaced midshaft clavicular fractures was 40 (33.33%) (24.90-41.76, 95% Confidence Interval). Among them 39 (90%) were males and 4 (10%) were females and the mean age of 31.45 years. The average Constant-Murley score were 95.68±5.59. Conclusions: The prevalence of displaced midshaft clavicular fractures among patients with clavicular fractures admitted to the Department of Orthopedics was lower than the other studies done in similar settings.Publication Musculoskeletal Manifestations in COVID-19 Patients at Paramilitary Hospital: A Cross-sectional Study(Nepal APF Hospital, 2025) KC, Samir; Shrestha, Sailendra Kumar Duwal; Nepal, Prabin; Karki, Umash; Karki, Netra Bahadur; Mahaseth, AdarshaAbstract: Introduction: Musculoskeletal symptoms are common in coronavirus disease 2019 (COVID-19) but are understudied in low-resource settings such as Nepal. This study aimed to assess the prevalence, spectrum, and severity of musculoskeletal manifestations in adults with acute COVID-19. Methods: We conducted a hospital-based, cross-sectional study at Nepal Armed Police Force Hospital, Kathmandu, from June to September 2023. Adults (≥18 years) with RT-PCR–confirmed COVID-19 were enrolled consecutively. Demographic, clinical, and laboratory data were collected. Musculoskeletal symptoms—myalgia, arthralgia, fatigue, low back pain, and paresthesia—were assessed using standardized questionnaires and severity scores (VAS/NRS). COVID-19 severity was classified per NIH criteria. Associations between symptom prevalence/severity and disease severity or viral load (Ct values) were analyzed using chi-square and ANOVA tests. Results: A total of 250 patients (47.6% male; mean age 49.8±18.1 years) were studied. Myalgia (70.0%), arthralgia (63.2%), and fatigue (61.2%) were the most frequent symptoms, followed by low back pain (44.0%) and paresthesia (4.4%). Symptom severity increased significantly with COVID-19 severity (p<0.001 for all). Myalgia, arthralgia, and fatigue had higher mean scores in moderate/ severe cases. There was a significant inverse association between RT-PCR Ct values and symptom severity, with higher viral loads correlating with more severe symptoms (p<0.001). Persistence of musculoskeletal symptoms at follow-up was observed exclusively in severe cases. Conclusions: Musculoskeletal symptoms, particularly myalgia, arthralgia, and fatigue, are highly prevalent and severe in COVID-19 patients in Nepal, with greater intensity in those with more severe disease and higher viral loads. Persistent symptoms after recovery highlight the need for integrated rheumatological and rehabilitative care in post-COVID management.