Introduction:Computers and other visual display terminals are now an essential part of our daily life. In the present era, use of computer has increased many folds, and its use has been associated with increased health risks, especially eyes. Materials and Methods:This hospital-based prospective, observational, descriptive study. "Specific Computer Users Questionnaire''regarding the visual symptoms was put used. Schirmer's test -I, and Tear film break up time were evaluated in all students.Results: Among 100 medical students 74% of the medical students sampled who used to spend 2 hours or more on their digital screens on a daily basis were complaining of one or more of CVS manifestation. Eye strain, burning eyes, neck, shoulder, or back pain, dryness, irritation and redness of eyes, headaches during or after working on computer and overall body fatigue were recorded in 89%,87%,78%,77%,71%and 68% respectively. Dry eye was associated with CVS in 58 % in right eye and 55% in left eye according to-Tear film break up time measurement whereas 59 % students have dry eye in right eye and 57% students have dry eye in left eye according to Schirmer's test -I measurement.Conclusions: Symptoms of CVS increase with increased duration of working on digital screens for 2 hours or more. The factors associated with the severity of CVS were hours of digital screens use per day and dry eye.

Introduction:  Osteoporosis is a common metabolic bone disease characterized by increased bone fragility, yet underdiagnosed and undertreated. With the increase in longevity of the populace, it is becoming an urgent and serious global epidemic. This being a preventable disease, has no clinical manifestations until there is a fracture. Early diagnosis and treatment are of dire necessity. Hence the aim of our study is to find the prevalence of osteoporosis among adults attending a tertiary care hospital-based on calcaneal quantitative ultrasound. Methods: This descriptive cross-sectional study was done in a tertiary care hospital, from 15th July 2019 to 15th October 2019 after receiving ethical approval from the Institutional Review Committee (Registration number: 2075 / 76 / 119). Convenient sampling was done. Data collection and entry was done in Microsoft excel, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.    Results: Out of 464 participants the overall prevalence of osteoporosis was 38 (8.2%) at a 95% confidence interval (5.7-10.7). Among the participants, 141 (30.4%) were male and 323 (69.6%) were female. The mean age of the participant was 41.02±14.96 years. Osteoporosis was more common in the older age group 11.66 (30.7%) in 60 years above Women were found to be more osteoporotic than men, 3.42 (9.0%) and 2.43 (6.4%) respectively. Bone mineral density and osteoporosis had a bimodal distribution, underweight 5.01 (13.2%) and obese group 5.32 (14.0%) were the two peaks. Conclusions: The prevalence of osteoporosis in our study is high and is consistent with other South Asian studies. Early detection of osteoporosis using calcaneal quantitative ultrasound can be a good screening tool.

INTRODUCTION: This retrospective review was performed to identify the incidence, causes, and details of hand injuries in patients presenting to a tertiary hospital of Kathmandu.  MATERIAL & METHODS: Records of all patients who had sustained hand injuries for last 5 years were collected from the Medical Record section. 832 injuries of the hand in 484 patients were reported in this review. These patients were reviewed for a geat the time of injury, gender, location of the incident, mechanism of injury, and fracture specifics.RESULTS: Majority (85.5%) of patients were males with a mean age of 28.79±12.81years and the rest were females with a mean age- of 30.43 ±17.13 yrs. Machinery injuries (25.2%) were the most common cause of injuries followed by road traffic accidents (14.5%). Metacarpal bone fractures (34.6%) were the common estinjuries of the hand. Most of the patients were treated with open reduction and fixation with Kwires.CONCLUSION: The study revealed the aetio-epidemiological and clinical profile of hand injuries, and its burden in eastern Nepal.Journal of Universal College of Medical Sciences, Vol. 5, No. 2, 2017, Page: 35-39

Background: Colles’ fracture is a common injury in the elderly population. Although it can be easily reduced, it is difficult to maintain the reduction in the conventional position of the wrist in palmar flexion with a poor functional outcome. Thus our study aimed to compare the radiological and functional outcome of such fractures with the wrist in two different posi­tions of dorsiflexion and palmar flexion. Methods: A prospective, observational study was conducted from April 2019 to March 2020 in the Orthopedics and Emergency department of KIST Medical College Teaching Hospital, Lalitpur, Ne­pal. Sixty-two patients, 31 in each group, all above 45 years with Colles’ fracture underwent close reduction and below elbow cast immobilization under hematoma block. Maintaining palmar flex­ion and ulnar deviation at the fracture site, the wrist was immobilized in dorsiflexion and palmar flexion attitude alternatively. During the respective follow-ups, the Demerit Scoring System of Saito was evaluated. Data collection and entry was done using the statistical package for social science version 16 and analyzed by using descriptive and inferential statistics. Results: All fractures were united. At the end of twelve weeks, Saito Scoring System of good to ex­cellent was markedly better in dorsiflexed group 29(93.5%) patients as compared to palmar flexed group 22(71.0%) patients, similarly grip power was also superior in dorsiflexed group 19(61.3%) patients than in palmar flexed group 11(35.5%) patients. Conclusions: Cast immobilization of Colles’ fracture with the wrist in dorsiflexion prevents re-dis­placement of the fragments resulting in significantly better radiological and functional outcomes.

Background: Colles’ fracture is a common injury in the elderly population. Although it can be easily reduced, it is difficult to maintain the reduction in the conventional position of the wrist in palmar flexion with a poor functional outcome. Thus our study aimed to compare the radiological and functional outcome of such fractures with the wrist in two different posi­tions of dorsiflexion and palmar flexion. Methods: A prospective, observational study was conducted from April 2019 to March 2020 in the Orthopedics and Emergency department of KIST Medical College Teaching Hospital, Lalitpur, Ne­pal. Sixty-two patients, 31 in each group, all above 45 years with Colles’ fracture underwent close reduction and below elbow cast immobilization under hematoma block. Maintaining palmar flex­ion and ulnar deviation at the fracture site, the wrist was immobilized in dorsiflexion and palmar flexion attitude alternatively. During the respective follow-ups, the Demerit Scoring System of Saito was evaluated. Data collection and entry was done using the statistical package for social science version 16 and analyzed by using descriptive and inferential statistics. Results: All fractures were united. At the end of twelve weeks, Saito Scoring System of good to ex­cellent was markedly better in dorsiflexed group 29(93.5%) patients as compared to palmar flexed group 22(71.0%) patients, similarly grip power was also superior in dorsiflexed group 19(61.3%) patients than in palmar flexed group 11(35.5%) patients. Conclusions: Cast immobilization of Colles’ fracture with the wrist in dorsiflexion prevents re-dis­placement of the fragments resulting in significantly better radiological and functional outcomes.

Background: Mid-clavicle fractures were traditionally managed by non-operative means which led to stiffness and painful shoulder. Surgical treatment on the other hand had the advantage of reducing malunion and allowing early shoulder movements, but also had incidences of infection. This study was carried out with the objectives of comparing functional outcome, fracture union rates, patient satisfaction rates and complications of both treatments. Methods: In this observational study done from October 2020 to September 2021 in the Orthopedics and Emergency department of KIST Medical College Teaching Hospital, Lalitpur, Nepal, 40 patients with mid-clavicle fractures were treated either conservatively or operatively according to their choice. 20 patients in each group were assessed functionally in each follow-up using the Constant and Murley score and union and complications were also assessed. Data collection and entry was done using the statistical package for social science version 22 and analyzed by using statistical tools like mean, frequency and Independent samples t-test. Results: At 6 months, there was no statistical difference in the Constant and Murley score between the two groups, but the scores were statistically better in the operative group at 6 weeks. Mean fracture union time in operative group (12.67 weeks) was statistically better than that in conservative group (14.89 weeks). Complications in operative group were mainly hardware related while stiffness was more common in conservative group. Conclusions: Operative treatment led to earlier fracture union, regain of shoulder function and return to work, but had the disadvantage of high cost and risk of infection as compared to conservative treatment.

Introduction: Distal radius fractures are one of the commonest fractures and more commonly involve children and elderly. Analgesia during reduction are determined by safety, simplicity, effectiveness and costs. The objective of this study is to evaluate the effectiveness of the Hematoma Block (HB) for reduction in distal forearm fractures in a developing country like Nepal. Methods: The study design was double blind randomized control trial performed at tertiary care hospital from July 2016 to August 2017. The patients having radiologically confirmed distal forearm fractures less than 96 hours old in 46 males and 54 females included after obtaining informed consent. 50 patients receiving Brachial Plexus Block (BPB group), and 50 patients receiving HB group during reduction of distal forearm fractures were initially allotted in two arms of randomized group. Pain measured by Visual Analogue Scale (VAS) was recorded before, during, and after reduction. Results: The study showed that HB with (mean ± SD) a VAS score of 2.08 ± 0.85 was as effective as BPB with a VAS of 1.7 ± 0.64 in terms of producing analgesia ( p=0.013), with the advantage of no motor paralysis and a significantly higher reduction rate, odds 3.45, 95% CI 1.52 – 7.85, p = 0.0013. 1/50 patients in brachial plexus block had bronchospasm needing intubation and ICU care where as 1/50 patient with hematoma block and infection which needed incision drainage and external fixation for complete healing. Conclusions: “The Hematoma Block” is to be encouraged in our set up for the reduction of the distal forearm fractures. The technique may be used in those fractures like isolated ulna fractures, minially displaced tibial fractures, fracture fibula where local anesthesia can be easily infiltrated percutaneously The study may be beneficial in managing such fractures and hence, it will help change in therapeutic policies comparing other modalities.

Introduction: The world has been threatened with the emergence of the Novel Corona Virus straining the health care system and creating a global pandemic. This is not the first pandemic, and it certainly will not be the last to affect humanity. As the medical community is exposed to these highly contagious new diseases with arrays of symptoms like fever, cough, shortness of breath, anosmia, insomnia, and myalgia. Back pain can also be considered as one of the symptoms of COVID-19 infection. Therefore, this study aimed to find out the prevalence of back pain among the Health care workers who were tested positive for COVID-19 by the end of their isolation period. Methods: This descriptive cross-sectional study was done from April 2021 to June 2021 in KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal, after receiving ethical approval from the Institutional Review Committee (Registration number: 2077/078/57). Convenience sampling was done. Data collection and entry were done in Microsoft excel, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 156 COVID-19 positive patients, the prevalence of back pain was seen among 64 (41%) patients (95% Confidence Interval= 42.23-57.75). Among them 21 (32.8%) were males and 43 (67.2%) were females. Likewise, the minimum age was 20 years and the maximum was 68 years with a mean of 33.5±10.28. Conclusions: This study demonstrated that a high proportion of healthcare workers were suffering from back pain and the findings are similar to the data from other international studies.