Browsing by Author "Pradhanang, Amit"
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Publication Early Experience of Minimally Invasive Tubular Lumbar Microdiscectomy at a Tertiary Care Centre in Nepal(Institute of Medicine, Tribhuvan University, 2024) Pradhanang, Amit; Sedain, Gopal; Karki, Anjan Singh; Bohara, Sandeep; Shrestha, Dipendra Kumar; Sharma, Mohan Raj; Shilpakar, Sushil Krishna; Jha, PrabhatAbstract: Introduction Lumbar disc herniation is a leading cause of low back pain and radiculopathy. Open microdiscectomy, though effective, involves muscle dissection and longer recovery. Minimally invasive tubular microdiscectomy aims to reduce these drawbacks. This study evaluates its early outcomes in Nepal. Methods Our observational study included patients who underwent MIS tubular lumbar microdiscectomy at our hospital from August 2023 to July 2024. Data on operative duration, blood loss, and return to work time were collected. Functional outcomes were assessed at three months using the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) for spinal and radicular pain. Results A total of 22 patients were included. The mean operative duration was 121.5 ± 31.67 minutes, and mean intraoperative blood loss was 60 ± 20.17 mL. The mean return to work time was 1.86 ± 0.2 weeks. At three months, the mean ODI score significantly improved from 54.36 ± 8.8 to 0.91 ± 1.47 (p < 0.001). VAS scores for spinal pain decreased from 3.05 ± 0.84 to 1.5 ± 0.3 (p < 0.001), and radicular pain from 4.91 ± 0.86 to 1.36 ± 0.65 (p < 0.001). No major complications occurred, and 5% of patients had transient paresthesia, which resolved spontaneously. Conclusion MIS tubular lumbar microdiscectomy is an alternative procedure for lumbar disc herniation, offering short-term functional improvement. Long-term comparative studies are needed to assess its durability against open microdiscectomy.Publication Outcomes of Patients with Traumatic Brain Injury between Two-Wheeler and Non-Two-Wheeler Vehicles: A Cohort Study(Institute of Medicine, Tribhuvan University, 2025) Shrestha, Bishwash; Sharma, Mohan Raj; Shilpakar, Sushil Krishna; Sedain, Gopal; Pradhanang, Amit; Jha, PrabhatAbstract: Introduction Traumatic brain injury (TBI) is growing public health concern and one of the most devastating types of injury. Pattern of injuries and outcome in two-wheeler and non-two-wheeler vehicular accidents should be evaluated and addressed separately. This study aimed to determine the outcome between two wheeler and Non two-wheeler vehicular Traumatic brain injury (TBI) patients. Methodology This was a retrospective cohort study which include the data from October 2020 to December 2022, of patients with vehicular traumatic brain injuries, admitted in Department of Neurosurgery, Tribhuvan University Teaching Hospital, Nepal. Primary data was collected from emergency records, in-patient files, operative notes and post-operative discharge. Patients were followed up via phone calls and at follow up visits. Results A total of 75 patients with mean age of 39.39 ± 18.3 years and male to female ratio of 3.6:1 were enrolled in the study. 63 patients and 12 patients were included in two-wheeler and non-two-wheeler TBI patients. Among two wheeler patients, 39.68% used helmet whereas 16.6% of non two-wheeler patients used seatbelts. Alcohol consumption was high in 2 wheelers (52.38%) than in non two-wheelers (25%). Majority of the patients had mild head injury,73% among two wheelers and 83.3% in non 2-wheelers. Favourable Extended Glasgow Coma score (4-8) was seen in 98.4% of two-wheeler TBI patients and among all of non two-wheeler TBI patients. Conclusion There are differences in outcomes between TBI of two-wheelers and non-two-wheelers. Favourable outcomes in terms of Extended Glasgow coma score was seen in non-two-wheelers as compared to two-wheelers in our study.