Browsing by Author "Rijal, Badri"
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Publication A Five-year Study of Spinal Disorders among Patients Presenting to the National Trauma Center of Nepal: An Observational Study(Nepal Medical Association, 2024) Rijal, Badri; Adhikari, Min Chandra; Bhusal, Suzit; Shrestha, Reshika; Chaudhary, Ashlesha; Pandey, Dipendra; Phuyal, Mandish Prasad; Prasai, Akanshya; Chaudhary, AashutoshAbstract Introduction: Spinal cord injuries result in severe neurological impairments and disabilities. With an estimated 15.4 million cases globally in 2021, spinal cord injuries are more common in low- and middle-income countries, yet research in these areas is limited. This study aimed to find the pattern of spinal injuries and outcomes associated with spine injuries over a five-year duration at a tertiary trauma care center. Methods: This observational cross-section study was conducted at the National Trauma Center, Kathmandu from 2075 to 2080 B.S. with ethical clearance from the Nepal Health Research Council (Reference number: 968). Total-population sampling was used. A structured proforma was employed as the primary data collection tool. Data was analyzed using SPSS. Results: Of the 20843 patients, 2070 (9.93%) had spinal injuries. The median age was 43 (IQR 32-56) years, with 1391 (67.20%) male patients. The median hospital stay was 12 (IQR 7-20) days. Falls accounted for 1221 (58.99%) cases, and road traffic accidents for 195 (9.42%). Spinal fractures were present in 1076 (51.98%) patients with 456 (42.38%) in lumbar vertebra. There were 225 (10.87%) cases of subluxation with 214 (95.11%) in cervical level. Conclusions: The study provides insights into the patterns and outcomes of spinal injuries over five years of time. The mortality rate and cases of patients leaving against medical advice highlight areas for improvement in patient care and follow-upPublication Clinical and Radiological Outcome of Anterior only Stabilization for AO Type B And C Subaxial Cervical Spine Injury: An Observational Study(Nepal Medical Association, 2025) Subedi, Ram Sharma; Hamal, Bhadra; Baral, Kabita Devi; Rijal, Badri; Karmacharya, Mahesh; Sah, Prem Kumar; Dhakal, Gaurav RajAbstract Introduction: AO type B and C subaxial cervical spine injuries are highly unstable and require surgical fixation for the stabilization. This study aims to determine their outcome after anterior stabilization clinically and radiologically. Methods: This was an observational longitudinal study conducted at tertiary level trauma center, from March 2021 to April 2022 after ethical approval from Institutional Review Board (Reference Number: 665/2077/78). Based on inclusion criteria total sampling was done. Cervical spine injuries AO type B and C operated with anterior cervical stabilization were included. Descriptive statistics were used to analyze data. Results: Among 21 total cases, 14 (66.67%) were male and 7 (33.33%) were female with the median age of 40 (IQR 32-51) years. Eleven (52.38%) patients sustained AO type B injury and 10 (47.61%) patients sustained AO type C injury. The commonest mode of injury was fall from height 14 (66.66%) followed by RTA 6 (28.57%) and physical assault 1 (4.76%). Postoperatively there was 33% improvement in incomplete neurology by one grade on ASIA neurology. Pain was evaluated using Visual Analogue Score and disability was evaluated using Neck disability Index scoring with the median value of 2 (IQR 0.4-3) and 10 (IQR 3-13) respectively. Radiographic failure was present in 2 (9.52%) patients. Forteen (66.66%) patients showed Grade 1 fusion, six (28.57%) showed Grade 2 fusion, and one (4.76%) showed Grade 3 fusion.. Conclusions: Most of the patients experienced mild pain and disability, stable fusion and low rate of radiographic failure with no new neurological deterioration. Almost half of the injuries occurred at the level of C5-C6.Publication Clinico-demographic Profile of Patients Presenting with Road Traffic Accidents at National Trauma Center of Nepal: An Observational Study(Nepal Medical Association, 2024) Rijal, Badri; Kc, Bikash; Dahal, Amartya; Gautam, Nabaraj; Adhikari, Min ChandraAbstract Introduction: Road traffic accidents are a major global health concern, accounting for 1.35 million fatalities and countless impairments every year. The number of road traffic accidents in Nepal is rising, which has a significant effect on the country's economy and healthcare system. Over a period of five years, the study aimed to analyze the clinico-demographic characteristics of patients admitted for injuries due to road traffic accidents in the National Trauma Center of Nepal. Methods: This is an observational study conducted by reviewing a five-year admission data from 2018 to 2023 A.D. of a tertiary care trauma center. The study was conducted following approval from the Ethical Review Board of Nepal Health Research Council (Reference number: 969). All patients admitted to the trauma centre following injuries due to road traffic accidents were included in the study. The results were summarised using descriptive statistics. Results: Out of 20,843 admissions, 3,810 (18.28%) were due to RTAs. The male-to-female ratio was 4.44:1, with a median age of 31.00 (24.00 to 43.00) years. Age distribution was as follows: <18 years (6.75%), 18-39 years (62.13%), 40-59 years (23.62%), and ≥60 years (7.50%). The median hospital stay was 8.00 (3 to 16) days. The most common injuries were lower limb 2386 (62.62%), upper limb 958 (25.14%), and head injuries 890 (23.36%). The mortality rate was 72 (1.89%). Conclusions: Injuries due to road traffic accidents constitute a significant portion of admissions at the National Trauma Center in Nepal, predominantly affecting young males. Lower limb injuries were most common.Publication Functional Outcome Estimation of Bimalleolar Ankle Fractures Treated by Open Reduction and Internal Fixation at a Tertiary Care Center: A Descriptive Cross-sectional Study(Nepal Medical Association, 2020) Dwivedi, Rajeev; Karki, Ankit; Bhattarai, Roshan; Rijal, BadriAbstract: Introduction: Ankle fractures account for about 9% of all fractures in adults. Open reduction and internal fixation is the preferred treatment for such injuries. However, surgery is not free of complications, and outcomes following surgery are not always satisfactory. Therefore, this study aimed to estimate the functional outcomes of bimalleolar ankle fractures treated by open reduction and internal fixation. Methods: This descriptive, cross-sectional study was carried out at a tertiary care center in the western region of Nepal among the patients with bimalleolar ankle fractures from March 2017 to August 2020 after approval from the Institutional review committee. Convenience sampling was done to reach the sample size. Twenty-nine cases were included in the study. Data were recorded in proforma and data analysis was done in the statistical package for social sciences (SPSS 16.0). The American Orthopedic Foot and Ankle Society (AOFAS) ankle-handfoot score was used to assess the final outcome. Results: At the final evaluation mean AOFAS ankle-handfoot score score was 89.86 (±7.95). According to the AOFAS ankle-hindfoot score, there were 19 excellent (65.51%), six good (20.68%), and four fair (13.79%) results. Complications in the form of superficial infection were seen in four (13.79%) cases. Conclusions: Functional outcomes following surgical treatment of bimalleolar ankle fractures are mostly excellent to good and complications following surgery are few, therefore, surgery is a better option of treatment in bimalleolar ankle fractures.Publication LIMP Score and Anterior Cruciate Ligament Injury in Patient Undergoing Arthoscopy for Acute Knee Injury: An Observational Study(Nepal Medical Association, 2025) Karmacharya, Mahesh; Sherchan, Binod; KC, Bikash; Subedi, Ram Sharma; Rijal, Badri; Koju, Saphalata DeviAbstract Introduction: Globally, anterior cruciate ligament injury is common but difficult clinical diagnosis in acute setting because of pain during examination and difficult availability of investigations and diagnostic arthroscopy. Legs giving way, Inability to continue the task, Massive effusion and pop sound heard at the time of injury or LIMP score is a history based scoring which can be aid to diagnose anterior cruciate ligament injury. This study is designed to find out the proportion of patient with LIMP score of >2 having anterior cruciate ligament injury. Methods: An observational cross-section study was done among the patients visiting emergencies and out patient department of respective hospitals after approval from Institutional review Committee (Reference number: 23/2078/79). The LIMP score was assessed during the presentation and patients were followed up at arthoscopy for the final diagnosis. Results: There were 126 patients enrolled in the study among which 68 (54%) had LIMP score of >2. Out of the total, 74 (59%) had anterior cruciate ligament inury among which 67 (90.5%) had LIMP score >2. Among the patient who did not have anterior cruciate ligament injury, 51 (98%) had LIMP score <2. Conclusions: The proportion of patients having anterior cruciate ligament injury were higher in the category with LIMP score >2.Publication Management and Leadership Development in Healthcare Professionals(Nepal Medical Association, 2023) Karki, Lochan; Rijal, Badri; Hamal, Pawan Kumar; Khanal, Milan Chandra; Bhusal, SuzitAbstract In the healthcare system, leadership has never been more crucial. Initiatives to improve health care in underdeveloped nations frequently fail, not for lack of clinical and public health understanding, but rather for lack of management ability. However, there are currently few possibilities for thorough leadership development at any level of career. This short communication highlights the success of the International Public Health Management Development Program by the Nepal Medical Association in conjunction with the Indian Embassy in Nepal, financed by the Ministry of External Affairs under the Indian Technical Education Corporation.Publication Patient Satisfaction in Doctor Patient Communication in a Tertiary Care Hospital of Kathmandu: A Descriptive Cross-Sectional Study(Nepal Medical Association, 2021) Khanal, Milan Chandra; Karki, Lochan; Rijal, Badri; Joshi, Pramod; Bista, Navindra Raj; Nepal, Bikash; Rana, Krishna; Lamichhane, PrabeshAbstract: Introduction: Communication is an important aspect of the medical profession. Doctor-patient communication plays a significant role in health care delivery. This study aims to find outpatient department patient satisfaction in doctor-patient communication in a tertiary care hospital in Kathmandu, Nepal. Methods: A descriptive cross-sectional study was conducted in the outpatient department of a tertiary care hospital in Kathmandu, Nepal in the month of August 2019. Validated questionnaire of Patient Satisfaction Questionnaire, consisting of 80 items, originally developed by Willis H. Ware and his colleagues were used and distributed to the patient in the outpatient department of the hospital. Their satisfaction level for doctor-patient communication was assessed on a five-point scale. The questionnaire was distributed randomly to the patient attending the hospital outpatient department during one month period. Results: Out of the total participants, 420 (96%) at 95% CI (95.07–96.93) respondents reported that they were satisfied regarding communication with their doctors. Among the patients, 109 (24.0%) visited the department of medicine followed by obstetrics and gynaecology 85 (19.4%). Conclusions: The majority of participants were found to be satisfied with the doctor-patient communication. While this study has shown that the communication in the doctor-patient relationship was seen to be satisfactory, this might not show the generalized picture of the country. We should also think of ways to further improve the communication in our hospitals.Publication Post-operative Unilateral Visual Loss and Ophthalmoplegia following Cervical Spine Surgery in Prone Position: A Case Report(Nepal Medical Association, 2024) Gautam, Samaj; Bhusal, Suzit; Chaudhary, Ashlesha; Shrestha, Reshika; Rijal, Badri; Darjee, Prakash; Lama, Surya BajraAbstract Visual loss following a spine surgery in a prone position is a disastrous and irreversible complication. Moreover, the recommended treatment for such visual loss is lacking and the outcome is not so satisfactory. A 38-year-old gentleman developed profound right sided visual loss after an uneventful cervical spine surgery in a prone position that lasted approximately two and half hours. Immediate ophthalmic consultation was done and the case was diagnosed as right-sided central retinal artery occlusion. Despite the initiation of vasodilatation, anticoagulation, and adequate fluid infusion, satisfactory improvement was not achieved. Extensive review of pertinent literature highlighted limited efficacy of treatments for postoperative visual loss after prone spinal surgery, further emphasizing the importance of preventive measures as the cornerstone in such procedures.Publication Prevalence of Type 2 Diabetes among Patients Visiting Nepal Police Hospital in Kathmandu: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Rajbhandari, Bibek; Hyoju, Sundar Prasad; Poudel, Lisasha; Adhikari, Anurag; Rijal, Badri; Joshi, PramodAbstract: Introduction: The growing prevalence of diabetes mellitus (DM) is a critical threat for global health, including in Nepal, especially in Kathmandu District, where diabetic patients are increasing in hospitals catastrophically. This study tends to assess the prevalence rate of type 2 diabetes among admitted patients visiting a hospital in Kathmandu. Methods: An electronic chart review was done to assess the prevalence of type 2 diabetes in Nepal Police hospital, Kathmandu, Nepal. Ethical approval was taken from the Nepal Health Research Council. Considering eligibility criteria, 8631 cases from 4 May 2018 to 31 August 2020 were observed. The calculated sample size was 500. However, all diabetic cases, i.e., 576, were processed and analyzed using Python and later visualized using MS Excel. Results: The overall prevalence rate of type 2 diabetes was 6.67%. The prevalence rate was seen higher among males (7.5%). Similarly, a high prevalence rate was seen among 64-73 years, i.e., 15.10%. Conclusions: The findings showed a high prevalence rate of type 2 diabetes. Older age groups are at high risk. Urgent public health interventions including lifestyle modification measures are required to reduce the extra burden of type 2 diabetes.Publication Study on Clinico-Demographic Characteristics of Orthopaedic Cases in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2020) Rijal, Badri; Rana, Krishna; KC, Srijana; Lamsa, lJamunaAbstract: Introduction: Orthopedic conditions include a range of condition varying from traumatic injuries, congenital anomalies, chronic back-pain, arthritis, rheumatologic conditions, and other. In Nepal, approximately 2.35 million people are living with musculoskeletal conditions in which 175,000 people are suffering with MSD from non-traumatic causes. The aim of the study is to observe the clinical and demographic pattern of orthopedic problems presenting in the hospital. Methods: A descriptive cross-sectional study was done in All Nepal Hospital Private Limited in the month of November. The data from the medical record section was retrospectively collected. Sample size of 384 was included and convenience sampling technique was used. The descriptive statistical analysis was done. Results: Eight hundred forty four cases were included in the study. Implant removal was the main condition for admission in the hospital 105 (12.44%) followed by Forearm Bone Fracture 84 (9.95%) and Cut Injury 64 (7.58%). Most cases presented during the time 6 PM to 12 AM 312 (36.96%). Conclusions: Most of the orthopedic cases presented in the evening and night time. Implant removal, forearm bone fracture and cut injury form the major bulk of the cases.Publication Traumatic Spinal Cord Injury among Patients Admitted to the Spine Unit in a Tertiary Care Centre(Nepal Medical Association, 2023) Gautam, Samaj; Rijal, Badri; Sharma, Laxmi KantaAbstract Introduction: Spinal cord injury usually results in disabling conditions. The incidence of spinal trauma is region-specific due to unique geography and demography. The epidemiology of spinal trauma changes with economic and social factors even in different periods. The aim of this study was to find out the prevalence of traumatic spinal cord injury among patients admitted to the Spine Unit in a tertiary care centre. Methods: A descriptive cross-sectional study was done in a tertiary care centre among patients admitted to the Spine Unit from 1 January 2022 to 31 December 2022 after receiving ethical approval from the Institutional Review Committee. Demographic details, mode of injury, level of injuries, neurological grading at the time of admission using American Spinal Injury Association grading, management methods, and complication if any were recorded. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of 465 patients, the prevalence of traumatic spinal cord injury was 316 (67.95%) (63.72-72.20, 95% Confidence Interval). A total of 243 (76.89%) cases were due to falls. The mean age of patients was 43.13±16.55 years. Conclusions: The prevalence of traumatic spinal cord injury patients was lower than the other studies done in similar settings.