Browsing by Author "Yadav, Rupesh Kumar"
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Publication Clinical Outcome for Lumbar Disc Herniation Treatment with Intradiscal Oxygen-ozone Therapy(Nepal Health Research Council, 2023) Yadav, Rupesh Kumar; Sherpa, Tshering; Hamal, Pawan Kumar; Pokhrel, Nabin; Thakur, Jay Prakash; Amatya, Shirish Prasad; Piya, RoshanAbstract Background: Low back pain due to disc herniation is a common problem causing frequent hospital visits and loss of working days with major socio-economic impact. Conservative treatments like analgesics, physiotherapy do not work in all patients. Surgical treatment has been main stay of treatment when indicated but is associated with anesthetic and surgical complications. Intradiscal oxygen-ozone chemonucleolysis is minimum invasive procedure done under local anesthesia and has promissing role in shrinking the bulged disc and reducing nerve root compression and related symptoms. This retrospective study was done to see how intradiscal oxygen-ozone chemonucleolysis reduces the pain severity in patient with discogenic low back pain. Methods: Retrospective data were retrieved of those patients who underwent fluoroscopy guided intradiscal oxygen-ozone chemonucleolysis with 5-6 ml of an O2-O3 mixture (concentration of 30 microgram/ml) during the period of two years in Nepal pain care and research center. Numerical pain scale (NRS) at various follow ups were compared to preprocedural NRS. Results: Preprocedural NRS was 8± 1. NRS at three hours, one week, one month, three months and six months were 2± 0.3 (73.44 percent reduction), 2.5± 2 (68.85 percent reduction), 2.3± 2 (72.13 percent reduction), 1.8± 1.7 (77.87 percent reduction) and 1.67± 1.4 (79.51 percent reduction) respectively. Conclusions: Intradiscal oxygen-ozone chemonucleolysis can be useful modality of treatment for discogenic low back pain when failed to respond to the conservative management and in whom surgery is not indicated. Keywords: Chemonucleolysis; disc prolapse; fluoroscopy; low back pain; ozone.Publication Respiratory Morbidity and Mortality of Traumatic Cervical Spinal Injury(Nepal Health Research Council, 2023) Pokhrel, Nabin; Neupane, Aastha; Thapa, Nabin; Yadav, Rupesh Kumar; Hamal, Pawan Kumar; Malla, PragyaAbstract Background: Traumatic cervical spinal injuries can severely affect respiratory function and cause significant morbidity and mortality. The typical respiratory morbidity in cervical spine injury is Atelectasis, Ventilator-associated pneumonia, acute respiratory distress syndrome and delayed weaning, etc. The study aims to see the prevalence of respiratory morbidity as well as mortality associated with cervical spine injury. Methods: Cross sectional study based on retrospective data was conducted on the X Sciences with the existing hospital record during the period of 3 years to find out the prevalence respiratory morbidity like Ventilatory Associated Pneumonia, delayed weaning, ARDS, atelectasis of traumatic cervical spine injury, determine the prevalence, type, and impact of respiratory morbidity and mortality in this population. Results: Total no 76 patients data meeting the inclusion criteria included in study. Male patients were more prone to develop traumatic cervical spinal injuries (SCI). The prevalence of respiratory morbidity in term of VAP(57.89), delayed weaning(46.05) and Atelectasis(22.36) was high. Patients with Asia A Neurology has higher association for VAP and delayed weaning, while Asia E Neurology patients had no respiratory morbidity. The study found a significant positive association between respiratory morbidity with hospital stay, and ventilator days (p-value: 0.019 and 0.048). A total of 15 patients died, 28.95% were discharged on request and 40.8% leaving the hospital against medical advice. Conclusions: The prevalence of respiratory morbidity higher in cervical spine injury. Furthermore, it has associated with prolonged ICU and ventilator days and increase in mortality. Keywords: ARDS; atelectasis; delayed weaning; respiratory morbidity; traumatic SCI.