Browsing by Author "Shrestha, Sandesh"
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Publication Relationship between Facet Joint Tropism with Lumbar Disc Herniation at A Particular Motion Segment(Nepal Health Research Council, 2023) Shrestha, Sandesh; Lakhey, Rajesh Bahadur; Paudel, Sharma; Paudel, SushilAbstract Background: Lumbar disc herniation is one of the important and common causes of low back pain. There are various modifiable and non-modifiable risk factors for the development of lumbar disc herniation. Any change in the orientation or asymmetry of the facet joint i.e. facet tropism may lead to abnormal shearing stress on the intervertebral disc and may lead to development of disc herniation. Methods: This is a cross-sectional observational study of 46 patients aged 18-40 years with clinical features of Prolapsed Intervertebral Disc and Magnetic Resonance Imaging evidence of single level prolapsed disc who presented to Tribhuvan University Teaching Hospital from December 2019 to June 2021. MRI measurement of facet tropism of normal level (L4-L5 or L5-S1) adjacent to herniated level was used for comparison. The p - value ? 0.05 was considered statistically significant. Overall association of tropism with lumbar disc herniation in affected and normal level combined and at each individual level was studied using McNemar Test. Results: We found a highly significant association of facet tropism with lumbar disc herniation (p-value <0.001). Considering the individual levels, at L4-L5 level, the association between facet tropism and lumbar disc herniation was highly significant (p-value <0.001). However, at L5-S1 level the association was not significant (p-value <0.388). Conclusions: The results of our study show strong association between FT and lumbar disc herniation at a particular motion segment. Keywords: Facet tropism; inter-vertebral disc prolapse; lumbar disc herniation; magnetic resonance imagingPublication Relationship between Facet Joint Tropism with Lumbar Disc Herniation at A Particular Motion Segment(Nepal Health Research Council, 2023) Shrestha, Sandesh; Lakhey, Rajesh Bahadur; Paudel, Sharma; Paudel, SushilAbstract Background: Lumbar disc herniation is one of the important and common causes of low back pain. There are various modifiable and non-modifiable risk factors for the development of lumbar disc herniation. Any change in the orientation or asymmetry of the facet joint i.e. facet tropism may lead to abnormal shearing stress on the intervertebral disc and may lead to development of disc herniation. Methods: This is a cross-sectional observational study of 46 patients aged 18-40 years with clinical features of Prolapsed Intervertebral Disc and Magnetic Resonance Imaging evidence of single level prolapsed disc who presented to Tribhuvan University Teaching Hospital from December 2019 to June 2021. MRI measurement of facet tropism of normal level (L4-L5 or L5-S1) adjacent to herniated level was used for comparison. The p - value ? 0.05 was considered statistically significant. Overall association of tropism with lumbar disc herniation in affected and normal level combined and at each individual level was studied using McNemar Test. Results: We found a highly significant association of facet tropism with lumbar disc herniation (p-value <0.001). Considering the individual levels, at L4-L5 level, the association between facet tropism and lumbar disc herniation was highly significant (p-value <0.001). However, at L5-S1 level the association was not significant (p-value <0.388). Conclusions: The results of our study show strong association between FT and lumbar disc herniation at a particular motion segment. Keywords: Facet tropism; inter-vertebral disc prolapse; lumbar disc herniation; magnetic resonance imagingPublication The Intersection of Neuroscience and Criminology: Role of Brain Mapping in Addressing Criminal Behavior by Nepal Police(Nepal Medical Association, 2024) Rajbhandari, Bibek; Regmi, Sushant; Dahal, Kanchan; Shrestha, SandeshAbstract Neuroscience is being integrated into criminal investigations, offering new opportunities for understanding, predicting, and potentially preventing criminal behavior. In Nepal, brain-mapping techniques like P300 wave tests and Brain Electrical Oscillation Signature profiling were used in a murder investigation in 2024. However, ethical concerns include privacy concerns, false positives, and the potential for false positives. Consent regarding neurobiological evidence in criminal cases is crucial, as intrusive procedures may require individuals to be informed. The legal implications of using neurobiological evidence could be severe if it serves to wrongfully accuse or convict an individual. Therefore, the use of neuroscience in criminology must be carefully balanced to ensure ethical considerations. This viewpoint interprets the potential of neuroscience in criminal investigations, addressing ethical, privacy, consent, and legal issues within the Nepal Police and criminal justice system.