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 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.