NepMed Repository :: Browsing by Author "Rokaya, Poojan Kumar"

Browsing by Author "Rokaya, Poojan Kumar"

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Bear Maul Injury among Patients Presenting to the Department of Surgery in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Menyangbo, Suryaman; Bhatta, Gakul; Rokaya, Poojan Kumar; Basnet, Rabin
Abstract Introduction: Bears are robust and agile wild creatures that can potentially inflict injuries. Black bears (Ursus thibetanus) are an inhabitant of the mountainous part of Nepal. Encounters between humans and bears generally occur in the bear-prevalent areas of Nepal and the world inflicting complex categorical injuries. The aim of the study was to find the prevalence of bear maul injury among patients presenting to the Department of Surgery in a tertiary care centre. Methods: A descriptive cross-sectional study was done in the Department of Surgery in a tertiary care centre from 1 August 2017 to 1 September 2022. Data was collected from the records of the Department of Surgery after receiving ethical approval from the Institutional Review Committee (Reference number: 078/79/38). The collected data included time of arrival in the hospital, type of bear, types of laceration, wound type, and demographic of patients. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 2980 patients presenting to the Department of Surgery, the prevalence of bear maul injury was 15 (0.50%) (0.25-0.75, 95% Confidence Interval). Of which, all had laceration injury, with the face and scalp 9 (60%) being the highest injured site. Autumn was the season attacked most in daytime. Conclusions: The prevalence of bear maul injury was lower than in other studies done in similar settings.
Burst Fracture of C5 with Traumatic Anterior Spondyloptosis of C6 and Posterior Spondylolisthesis of C4 Vertebra: A Case Report
(Nepal Medical Association, 2021) Rokaya, Poojan Kumar; Khadka, Nilam Kumar; Giri, Praveen Kumar; Khapung, Robin; Mahaseth, Nirajan
Abstract: Burst fracture of C5 with traumatic anterior spondyloptosis of C6 and posterior spondylolisthesis of C4 vertebra is an exceedingly rare high energy injury. Treatment includes decompression, reduction, stabilization, and fusion via anterior or posterior or combined anterior-posterior approach with or without prior traction. We report this rare subaxial cervical spine injury associated with quadriplegia managed with combined anterior and posterior instrumented fusion. A multidisciplinary approach with preoperative assessment and planning is crucial in managing cervical spine injury. Immediate postoperative critical care support, rehabilitation, and dedicated nursing care are required for a favorable outcome in traumatic quadriplegia.
Complication of Early Application of One and a Half Hip Spica for Femoral Shaft Fractures in Children below Six Years in a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Rokaya, Poojan Kumar; Rawal, Mangal; Kathayat, Tufan Singh; Thakur, Abhishek Kumar; Lama, Monika; Maharjan, Ramu
Abstract: Introduction: Hip spica with or without prior traction has become a standard treatment for closed isolated femoral shaft fracture in children below six years. The time of hip spica application is not uniform in the existing literature. The aim of this study is to find out the prevalence of complication of early application of one and a half hip spica for femoral shaft fractures in children below six years in a tertiary care hospital. Methods: A descriptive cross-sectional study was done among 42 children who were managed with early hip spica application (within 72 hours) for femoral shaft fracture from January 2015 to December 2020 after receiving ethical clearance from Institutional Review Committee. Convenient sampling technique was done. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Complication was seen in nine (21.4%) (95% Confidence Interval= 9.02-33.84) patients. Skin breakdown from local pressure had the highest prevalence in our study which was documented in three (7.14%) patients who resolved with conservative treatment. Conclusions: The prevalence of complication of early application of one and a half hip spica for femoral shaft fractures in children below six years was similar to other studies done in similar setting.
de Quervain’s Disease among Patients Visiting the Orthopaedic Outpatient Department of Tertiary Care Center: A Descriptive Cross- sectional Study
(Nepal Medical Association, 2023) Rokaya, Poojan Kumar; Karki,Dhan Bahadur; Kathayat, Tufan Singh; Rawal, Mangal; Sharma, Rachit; Ghimire, Anil
Abstract Introduction: de Quervain’s disease is one of the common causes of wrist pain. It can cause serious disability and absence from work due to impaired functioning of the wrist and hand. The aim of this study is to find out the prevalence of de Quervain’s disease among patients visiting the orthopaedic outpatient department of a tertiary care centre. Methods: This was a descriptive cross-sectional study conducted among patients visiting the orthopaedic outpatient department of a tertiary care centre after receiving ethical approval (IRC KAHS Reference: 078/079/56). This study was conducted from 1 January 2021 to 30 December 2021 from hospital medical records. A convenience sampling method was used. Patients with de Quervain’s disease from 16 to 60 years were included in this study. Clinically diagnosis of de Quervain’s disease was based on the tenderness of the radial styloid process, tenderness over the first extensor compartment on resisted thumb abduction or extension and positive Finkelstein test. Point estimate and 95% Confidence Interval were calculated. Results: Out of 9600 orthopaedic outpatients, de Quervain’s disease was seen in 128 (1.33%) (2.68-4.52, 95% Confidence Interval). Conclusions: The prevalence of de Quervain’s disease was similar when compared to other studies conducted in similar settings.
Epidemiology of Spinal Trauma and Related Complication
(Nepal Health Research Council, 2023) Kathayat, Tufan Singh; Rokaya, Poojan Kumar; Rawal, Mangal; Marasini, Pawan; Karki, Prashanna Dip; Nath, Mohan
Abstract Background: Traumatic spinal injury is leading cause of mortality and morbidity among the people of productive age group. This study aim to find the cause of spinal injury, site ,and mode of injury, treatment option given so that a preventive measures and create awareness among people of this region. Methods: This is a prospective observation study done in Karnali Academy of Health Sciences from December 2021 to January 2023. Performa was filled to collect data. Data were entered in excel sheet and transported to SPSS 16.0 and statistical analysis was done . Results: Out of 117 patients male population had higher incidence of spinal trauma (69.2%) with average age 43.9 years . Fall injury was the commonest mode of injury. 65.8% had injury at the thoracolumbar junction followed by lumbar, thoracic and cervical respectively. Cervical injury patients had higher incidence of neurological deficit. The average duration of trauma to hospital presentation was 10.9±11.2 hours. 19.7 % were operated and 6.8 % of patients were referred to other center. Conclusions: Fall injury being the commonest mode of injury in this art of world, prevention and awareness should be raised about the spinal trauma and its consequences. Adequate equipment with health facilities to the distant hospital may reduce the referral rate and duration of presentation to the hospital which ultimately prevent the further damage to the cord. Keywords : Fall Injury; spinal trauma; western Nepal.
Orthopaedics Practice in a Rural Hospital During the COVID-19 Pandemic: A Descriptive Cross-Sectional Study
(Nepal Medical Association, 2020) Rawal, Mangal; Kathayat, Tufan Singh; Rokaya, Poojan Kumar; Thakur, Abhishek Kumar; Mahat, Smritee; Acharya, Bishnu Dutta; Karki, Dhan Bahadur; Ojha, Sujata
Abstract: Introduction: The coronavirus disease 2019 pandemic is one of the biggest public health challenges that we have faced, and has had a significant impact on the delivery of essential healthcare worldwide. Trauma and orthopaedic surgery was one of the most severely affected specialties as all non-emergency surgical cases were cancelled. With the possibility of future peak of corona virus, knowing the impact of Covid on orthopaedics would enable us to manage trauma patient in an effective manner and will help us to resume normal schedule of the trauma care. Methods: This is a descriptive cross-sectional study. We studied the details of total number of patient at Orthopaedic and trauma outpatient, inpatient and operation theatre of Karnali Academy of Health Sciences from 14th March 2020 to 16 September 2020 as compared with the patient data from the same time period in 2019. Results: There were 2288 patients during the non-Covid period who visited to the orthopaedic outpatient in comparison to 1618 during Covid period. Only 5 implant removals were performed in comparison to 50 removals (90% reduction) in elective cases. But the number of surgical cases was almost similar (204 vs 207 respectively). Total number of hospital stay had significantly reduced in the non-COVID period (average 4 days vs 6 days). Conclusions: There is reduction in number of orthopaedic and trauma cases during COVID 19 with marked reduction in number of elective cases. Alternative methods of treatment like telemedicine and small scale health camps at peripheral districts should be conducted to treat non-urgent orthopaedic conditions during lockdown.
Prevalence of Spinal Injuries among Autopsied Cases of Traumatic Deaths
(Nepal Health Research Council, 2024) Acharya, Apurba; Bhattarai, Kushal; Rokaya, Poojan Kumar; Aryal, Umesh Raj; Kaphle, Sushma; Bista, Binamra; Khatiwada, Amit
Background: Traumatic deaths, resulting from spinal injuries are significant issue in Nepal. The study aims to assess the prevalence of spinal injuries amongst the traumatic death cases brought in for autopsy in Jumla and to provide their socio-demographic profile. Methods: This is a descriptive cross-sectional study done in Karnali Academy of Health Sciences (KAHS) from 16th July 2021 to 16th July 2023 incorporating all the traumatic deaths brought for autopsy. The data was collected using a proforma which included the modality of trauma, spinal involvement, seasons associated with trauma and demographic variables of the deceased. The data was analyzed using both Microsoft excel and SPSS 23.0. Results: A total of 55 cases were brought for autopsy following traumatic death with road traffic accident (45.45%) and fall injuries (29.1%) being the most common mode of trauma. Among all traumatic deaths, 29.1% cases presented with spinal injuries. The cervical spine (68.8%) was the most commonly affected spine followed by thoracic (12%), lumbar spine (6.3%) and two cases with multiple spinal involvement. Of all the spinal injury cases in traumatic deaths, the highest and the lowest number of cases occurred during spring and summer season respectively. Conclusions: Traumatic deaths caused by spinal injuries after fall and road traffic accidents is a common phenomenon in Jumla. Thus, timely preventive measures associated with these deaths needs to be addressed to reduce them. Keywords: Autopsy; deaths; Jumla; spinal injuries; trauma.
Spectrum of Diseases among Neurosurgical Patients in a Tertiary Care Hospital of Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Devkota, Harihar; Khadka, Nilam Kumar; Rokaya, Poojan Kumar; Giri, Pravin Kumar
Abstract: Introduction: The number of neurosurgical cases, especially traumatic injuries, are increasing in remote settings. This study aims to determine neurosurgical cases in a tertiary care center teaching hospital situated in a remote area of Nepal. Methods: It was a descriptive cross-sectional study among 138 neurosurgical patients at Karnali Academy of Health Sciences from 2019 August to 2020 July. A convenient sampling technique was used. The demographic data, the diagnosis, and management offered were recorded, reviewed, and analyzed using Statistical Package for Social Sciences version 16 and Microsoft Excel. Results: Out of 138 cases, trauma was the main finding in 102 (73.91%) cases, and fall injury was the most frequent mechanism of injury in 64 (46.38%) cases. Traumatic brain injury was the most common disease in 85 (61.6%) cases followed by prolapsed intervertebral disc in 11 (8%), Spine fracture/dislocation in 11 (8%), stroke in 7 (5.1%), spondylosis in 6 (4.3%) and so on. Among the Traumatic Brain Injuries, normal findings were noted in 28 (20.3%) cases, extra dural hemorrhage in 12 (8.7%), contusion 11 (8%), and skull base fracture in 7 (5.1%). With a mean age of 29.8 years, a maximum number of the cases were 30 (21.74%) from the age group 31-40. Conclusions: Trauma was seen in a majority of neurosurgical cases. Hematoma, depressed skull fracture, and spinal fractures were the main findings of neurosurgical cases. The burden of neurosurgical cases in this part of the world is quite high, so necessary step should be taken to increase such services.

Browsing by Author "Rokaya, Poojan Kumar"

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