Browsing by Author "Rijal, S"
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Publication Clinical, MRI and Arthroscopic Correlation in Internal Derangement of Knee(Kathmandu University, 2011) Sharma, UK; Shrestha, BK; Rijal, S; Bijukachhe, B; Barakoti, R; Banskota, B; Pradhan, I; Banskota, AKABSTRACT Background The traumatic or degenerative internal derangement of the knee requires certain investigations for the establishment of diagnosis, in addition to clinical history and a thorough physical examination. The use of arthrography and arthroscopy improves the accuracy of the diagnosis. MRI scanning of the knee joint has often been regarded as the noninvasive alternative to diagnostic arthroscopy. Objective The purpose of the study was to correlate clinical and low field MRI findings with arthroscopy in internal derangement of the knee. Methods Forty one patients with suspected internal derangement of the knee were subjected to MR examination followed by arthroscopy. Clinical criteria used were history, mode of injury, Mc Murray’s, Apley’s grinding, Thessaly’s test for meniscal injury. Drawer test was considered to be essential for clinical diagnosis of cruciate ligament injury. MRI of the knee was performed in low field open magnet (0.35T, Magnetom C, Seimens). Arthroscopy was done within two months of MR examination and was considered gold standard for the internal derangement of the knee. Results The sensitivity, specificity, diagnostic accuracy of clinical examination were 96.1%, 33.3% and 73.1% respectively for medial meniscal tear; 38.4%, 96.4% and 78.1% respectively for lateral meniscal tear. The sensitivity, specificity, diagnostic accuracy of MRI were 92.3%,100% and 95.1% for medial meniscal tear; 84.6%96.4% and 92.6% respectively for lateral meniscal tear. Conclusion Clinical examination showed higher sensitivity for medial meniscal tear compared to MRI, however with low specificity and diagnostic accuracy. Low field MRI showed high sensitivity, specificity, diagnostic accuracy for meniscal and cruciate ligament injury, in addition to associated derangement like articular cartilage damage, synovial thickening. KEY WORDS arthroscospy, knee, MRI.Publication Comparison of preoperative and postoperative corneal astigmatism after phacoemulsification through a 2.8mm clear corneal temporal incision(Institute of Medicine, 2016) Joshi, SN; Pant, M; Rijal, S; Bhattarai, DAbstract Introduction: Phacoemulsification with foldable intraocular lens implantation through clear corneal incision has become common surgical approach for cataract surgery because it produces minimal surgically induced astigmatism and provides best postoperative visual acuity. This study thus aims to compare the preoperative and postoperative corneal astigmatism and to compare the postoperative change in keratometric astigmatism between right and left eyes after temporal 2.8 mm clear corneal incision phacoemulsification cataract surgery and implantation of foldable intraocular lenses. Methods: A prospective study included 31 patients with bilateral senile cataract who had undergone sutureless, 2.8mm clear corneal incision phacoemulsification cataract surgery with foldable intraocular lens implantation. Keratometry was recorded preoperatively and weeks postoperatively using Nidek automated keratometry. A paired sample t-test was performed to compare the preoperative and postoperative corneal astigmatism. Results: Mean age of the population was 63.39 plus/minus 9.705 years (range: 49 to 83 years). Before surgery, mean corneal astigmatism in right and left eye was 0.92 plus/minus 0.58 * D and 0.85 plus/minus 0.61 * D respectively. After the surgery, mean astigmatism in right eye was 0.97 plus/minus 0.51 * D and in left eye was 0.97 plus/minus 0.48 * D There was no statistically significant difference in preoperative and postoperative keratometric astigmatism of both eyes. (RE: p-valve 0.427; LE: p-valve 0.188) Conclusion: Temporal clear corneal incision is quite stable and has minimal effect to corneal astigmatism. Keywords: Cataract, Clear Corneal Incision, Corneal Astigmatism, PhacoemulsificationPublication Neurocysticercosis- a review(Kathmandu University, 2003) Ansari, JA; Karki, P; Dwivedi, S; Ghotekar, LH; Rauniyar, RK; Rijal, SNA.