Browsing by Author "Pokharel, RK"
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Publication Osteoid-Osteoma of the Ilium Associated with Malignant Hypertension in an Adult Female(Institute of Medicine, 2014) KC, Bikash; Lakhey, RB; Shah, LL; Pokharel, RKAbstract Osteoid-osteoma, a benign bone tumor, is rare in the ilium bone. Its incidence is uncommon after third decades of life, and can represent a significant diagnostic challenge, resulting in a delay of treatment. We present a 38 years old lady who presented with history of severe right gluteal pam, more during night, and was relieved with non-steroidal anti-inflammatory drugs. Malignant hypertension was associated co-morbid condition without any underlying cause. Plain radiograph was initially normal and her diagnosis was delayed for more than six months until computed tomography (CT) scans and magnetic resonance imaging (MRI) showed a circumscribed lesion of the right ilium suggestive of Osteiod Osteoma. Keywords: iliac bone, gluteal pam, malignant hypertension, Osteoid esteoma Minimally invasive flouroscopy guided curettage was done, and histopathological findings confirmed the diagnosis of osteoid-osteoma, After surgery, the pain was significantly relieved and, surprisingly, the hypertension was controlled, and she was discharged on single antihypertensive drug in maintenance dosePublication Radiographic evaluation of Calcaneal angles in patients presenting to tertiary care center of Nepal(Institute of Medicine, 2016) Rokaya, PK; Pokharel, RK; Lamichhane, APAbstract Introduction: Fractures of the calcaneus are the most common tarsal fracture and they account for approximately 2% of all fractures. Recognizing the normal limits of the calcaneal angles is important in determining the degree of deformity and quality of reduction, and can thus help to predict the morbidity after calcaneal fractures. No study about the normal ranges of the calcaneal angles in the Nepalese populations is to our knowledge till date. Methods: Lateral plain radiographs of foot and ankle of 140 patients without a calcaneal fracture were analyzed at Department of Orthopedics TUTH, Maharajgunj, Kathmandu between February2012 to September2013. Böhler angle and Gissane angle were measured. The distribution characteristics of these angles with respect to age, gender, and side of the body were analyzed and compared with those of previous studies. Results: The mean BA was 31.3 plus/minus 5.28 deg (range of 18-47°) and the mean GA was 108.4 plus/minus 10.59 deg (range of 85-135°) There were no significant differences for calcaneal angles with respect to side (for BA, p = 0.728 for GA, P ^ =0.091) and for sex (for BA, P = 0.555 for GA, p = 0.212 ) There were no significant differences between the age groups for calcaneal angles (for BA, p = 0.659 for GA, p = 0.912 ) Conclusion: Calcaneal parameters specific to the Nepalese population have to be taken into consideration by the orthopedic surgeons to improve the standard of calcaneal fracture treatment in Nepal. The range herein reported of ( 47 deg for BA, 35 - 135 deg for GA) may be used as reference values for the Nepalese population. Keywords: Böhler angle, Calcaneus, Radiograph, Gissane angle