Browsing by Author "Thapa, Sangharsha"
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Publication Anterior Cruciate Ligament Tear Using Magnetic Resonance Imaging among Patients Undergoing Arthroscopy in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Shrestha, Rohit; Khadka, Sushant Kumar; Chaudhary, Aashutosh; Acharya, Shreedhar Prasad; Malla, Manasil; Gautam, Prabesh; Maharjan, Sagar; Basi, Ashkal; Thapa, Sangharsha; Karki, SubindraAbstract Introduction: Magnetic Resonance Imaging is the preferred imaging modality in patients having anterior cruciate ligament tears. The aim of this study was to find out the prevalence of anterior cruciate ligament tears using magnetic resonance imaging among patients undergoing arthroscopy in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Orthopaedics and Traumatology of a tertiary care centre. Data from 17 November 2017 to 17 October 2022 were collected between 26 December 2022 and 30 December 2022 from the hospital records. Ethical approval was obtained from Institutinal Review Committee of the same institute (Reference number: 233/22). All patients with a knee injury who received arthroscopy were included in the study. Magnetic resonance imaging reports, arthroscopic findings and relevant data of each case were retrieved from the medical case records of patients. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among patients with arthroscopy confirmed anterior cruciate ligament tear, 138 (91.39%) (86.92 to 95.86, 95% Confidence Interval) had anterior cruciate ligament tear diagnosed with magnetic resonance imaging. The mean age of the patients who had anterior cruciate ligament tear in the magnetic resonance imaging was 32.35±11.31 years. Out of them, 87 (63%) were males and 51 (37%) were females. The mean duration of the injury was 11.60±18.47 months. Conclusions: The prevalence of anterior cruciate ligament tear using magnetic resonance imaging among patients undergoing arthroscopy in tertiary care centres was similar when compared to other similar studies when conducted in similar settings.Publication Anxiety among COVID-19 Patients during Their Stay in Isolation Ward in a Tertiary Care Center: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Rawal, Prabhat; Neupane, Rasik; Singh, Aastha; Basnet, Prabina; Chapagain, Sudeep; Chapagain, Sunder; Paudel, Rabi; Thapa, Sangharsha; Pokhrel, Rojan; Pokhrel, NirdeshAbstract: Introduction: Once a patient is diagnosed with COVID-19 infection, they are required to stay in isolation for some period of time without any social interaction whether be at home or in a hospital setting. The fear of contagion, stigmatization of COVID-19, the social isolation and fear of disease complication has undeniably brought lots of stress and other mental health problems among the infected patients. The main aim of this study is to find the prevalence of anxiety among patients staying in the isolation ward of a tertiary care center. Methods: This was a descriptive cross-sectional study conducted among 147 COVID-19 patients admitted in the isolation ward of a tertiary care center in Nepal from 20 June to 25 July 2021. Ethical approval was taken from Nepal Health Research Council (Reference number 3546). Convenient sampling method was used. Analysis of the data was done using Microsoft Excel and Software Statistical Package for Social Sciences version 26.0. Point estimate at 95% Confidence Interval was done and frequency and percentage were calculated. Results: Out of 147 participants, 29 (19.74.%) (95% Confidence Interval= 13.31-26.17) experienced some form of anxiety symptoms during their stay in isolation. Conclusions: Anxiety among COVID-19 patients in this study is similar to other studies done in similar settings. Anxiety among COVID-19 patients is quite high as compared to non COVID-19 patients, therefore assessment of mental health conditions like anxiety, insomnia, depression in patients admitted with COVID-19 should be performed along with the management of physical symptoms.Publication Benign Recurrent Aseptic Meningitis (Mollaret’s Meningitis) in an Elderly Male: A Case Report(Nepal Medical Association, 2021) Chand, Swati; Thapa, Sangharsha; Gautam, Khusal; Twayana, Anu Radha; Laguio-Vila, Maryrose R.; Elshourbagy, TarekAbstract: Mollaret’s meningitis is an aseptic recurrent benign lymphocytic meningitis lasting 2-5 days and occurs over years with spontaneous complete resolution of symptoms between episodes. An 88 years-old-male presented with acute onset headache, lethargy and altered sensorium after a recent ear infection. He had multiple similar episodes in the past, each preceded by ear or sinus infection with cerebrospinal fluid finding consistent with aseptic meningitis. However, no specific causative agent was ever identified. He was confused, disoriented and lethargic with normal vitals and systemic examination. Blood tests showed leukocytosis with neutrophilia. Cerebrospinal fluid analysis revealed increased cell count with lymphocyte predominance, elevated protein and negative polymerase chain reaction. Magnetic resonance imaging of brain showed chronic small vessel ischemic changes. He fulfilled the Bruyn’s criteria for clinical diagnosis. He was empirically administered acyclovir during hospitalization and was discharged without prophylactic antiviral due to negative cerebrospinal fluid analysis, culture, and multiplex polymerase chain reaction.Publication Mini-thoracotomy Approach for Heart Surgery in Tertiary Care Hospital of Nepal(Nepal Health Research Council, 2024) Bhattarai, Anil; Shah, Sangam; Ranabhat, Kamal; Chand, Swati; Thapa, Sangharsha; Khakural, PrabhatBackground: The usual surgical technique for heart surgery has been median sternotomy, which provides excellent exposure of all cardiac structures and facilitates the establishment of cardiopulmonary bypass with central cannulation. A number of alternative surgical techniques, including the right anterolateral thoracotomy, posterolateral thoracotomy, and partial sternotomy, have been suggested. We want to share our experience with right anterior mini-thoracotomy versus right axillary mini-thoracotomy for closing an atrial septal defect. Methods: The study was a retrospective cross-sectional study conducted in a hospital. The study comprised patients with atrial septal defect admitted to Green City Hospital in Kathmandu, Nepal. From May 2016 until September 2021. Data was extracted to MS excel sheet, and then transported to the STATA version 17 for analysis. First, we computed descriptive analysis which included calculation of frequency, percentage, mean and median for presentation of socio-demographic variables. Continuous data were tested for normality using Shapiro-Wilk test. Results: A total of 25 patient were included in the study with median age 26 years (20-32). The median aortic cross clamp time was 25 minutes ranging 20-35 min. The median duration of cardiopulmonary bypass time ranging from 31to 161 minutes. The median time of Ax was 25 minutes and 26 minutes for right anterior mini-thoracotomy and right axillary mini-thoracotomy respectively. The median duration of hospital stay was 4 days ranging from 3-4 days. Nearly 36% study participants were associated with abnormal body mass index. (Either under nutrition or over nutritional status). Conclusions: There were no significant differences between the duration of intensive care unit and hospital stays, aortic cross clamp time, and complications between the two groups. However, the possibility of less blood loss during surgery and of cosmetic appearance in axillary incision is of special importance. Keywords: Heart surgery; mini-thoracotomy; Nepal; right anterior; right axillary.Publication Successful Outcome of Anterior Cruciate Ligament (ACL) Reconstruction by Hamstring Tendon for Anterior Cruciate Ligament Deficit Knee at a University Hospital: A Descriptive Cross-sectional Study Authors(Nepal Medical Association, 2021) Shrestha, Rohit; Khadka, Sushant Kumar; Thapa, Sangharsha; Malla, Manasil; Basi, Ashkal; Bhandari, Prabha; Aryal, Laxman; Kandel, Binay; Adhikari, UmeshAbstract: Introduction: Anterior cruciate ligament is a commonly injured and reconstructed ligament in the knee. Unlike in urban areas where sports activities and road accidents are common mechanisms of injuries, the semi-urban and rural population has a different mode of injuries, needs, and expectations. This study explores the prevalence of successful outcome of anterior cruciate ligament reconstruction in by hamstring tendon for anterior cruciate ligament deficit knee at a university hospital. Methods: A descriptive cross-sectional study was conducted at Dhulikhel Hospital, Kathmandu University Hospital from 2018 February to 2020 January among patients having anterior cruciate ligament injuries after ethical approval. Whole sampling technique was used. Functional outcome was assessed with Lysholm scale at the end of at least one year. Data was analysed using Statistical Package for Social Sciences version 11. Point estimate at 95% Confidence Interval was calculated, with frequency and percentage. Results: Out of 66 anterior cruciate ligament reconstruction, 35 (59%) cases had successful outcomes. Excellent outcomes were seen in 9 (15%) cases and 26 (44%) had good outcomes. The mean Lysholm score was 84. Conclusions: Anterior cruciate ligament injuries were seen in heterogeneous populations during their activities of daily living or recreational sports activities. Anatomic anterior cruciate ligamentreconstruction with hamstring grafts provided good functional outcomes, especially among the young population. Our findings are similar to current studies on anterior cruciate ligament-reconstruction.Publication Undiagnosed Case of Klippel-Trenaunnay Syndrome Presenting as Extensive Heterotrophic Ossification and Flexion Deformity of Right Lower Limb Requiring Amputation : A Case Report(Nepal Medical Association, 2021) Gautam, Kushal; Thapa, Sangharsha; Twayana, Anu Radha; Chhantyal, Lokendra; Poudel, Puskar; KC, Avinash; Chand, SwatiAbstract: Klippel-Trenaunnay Syndrome is a rare disease characterized by a clinical triad of capillary malformation, soft tissue and bony hypertrophy, and atypical varicosity. This syndrome ranges from asymptomatic disease to life-threatening bleeding, embolism, and deformities. Management includes early diagnosis, prevention, and treatment of complications. We present a case of a 43-year-old male presenting with pain, swelling and deformity of the right leg for 30 years. On examination, diffusely enlarged tender right limb with several dark patchy discolorations, multiple tortuous vessels were found. Right leg X-ray showed heterotrophic ossification and distortion of ankle joint. Due to chronic severe pain, recurrent infection, contracture and flexion deformity of right leg, the patient underwent above knee amputation. This case focuses on the variable presentation and multiple problems faced by patients with Klippel-Trenaununay Syndrome as they get diagnosed late and shows the importance of high index of suspicion for early diagnosis and prevention of complications.