Med Phoenix最新文献_第8页

A Comparison of Incidence of Post Dural Puncture Headache Using 25G Quincke and 25G Whitacre Needle in Obstetric Patients Undergoing Caesarean Section under Spinal Anesthesia 腰麻下剖宫产术中25G Quincke与25G Whitacre针硬膜穿刺后头痛发生率的比较

Med Phoenix Pub Date : 2021-07-19 DOI: 10.3126/MEDPHOENIX.V6I1.36732

Chetan Bohara, R. Maharjan, Subi Regmi, Gunjan Regmi, Rajendra Kunwar, A. Shrestha

{"title":"A Comparison of Incidence of Post Dural Puncture Headache Using 25G Quincke and 25G Whitacre Needle in Obstetric Patients Undergoing Caesarean Section under Spinal Anesthesia","authors":"Chetan Bohara, R. Maharjan, Subi Regmi, Gunjan Regmi, Rajendra Kunwar, A. Shrestha","doi":"10.3126/MEDPHOENIX.V6I1.36732","DOIUrl":"https://doi.org/10.3126/MEDPHOENIX.V6I1.36732","url":null,"abstract":"Introduction: Spinal anesthesia has offered a new armamentarium for the anesthesiologists and has been widely used in the Cesarean section in the field of obstetrics, an alternative to general anesthesia. However, Post Dural Puncture Headache remains an inevitable complication of spinal anesthesia and can be minimized its incidence by reducing the size of the needle and changing the design of the needle tip. The objective of the study was to find the incidence of post-dural puncture headache undergoing subarachnoid block for CS using 25G Quincke and 25G Whitacre needles. \u0000Materials and methods: This study was conducted from August 2020 to January 2021 enrolling 72 parturients and were allocated in two groups of 36 each. Group A and B parturients received spinal anesthesia via. 25G Quincke and 25G Whitacre in sitting position respectively. All the patients were evaluated based on incidence, onset, duration, and severity of headache postoperatively for 72 hours after the subarachnoid block. \u0000Results: The incidence of post-dural puncture headache in the study was 7.2% in Group A and 3.15% in Group B which was statistically significant (P-value = 0.011), while there were no significant differences between these two groups in the onset, severity, and duration of post-dural puncture headache. \u0000Conclusion: Despite no significant differences were found for the onset, severity, and duration of post-dural puncture headache, the use of 25G Whitacre is associated with a reduced incidence of post-dural puncture headache compare to 25G Quincke.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122384921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Carotid Plaques Among Different Ethinic Patients with Ischemic Stroke 不同民族缺血性脑卒中患者颈动脉斑块的研究

Med Phoenix Pub Date : 2021-07-19 DOI: 10.3126/MEDPHOENIX.V6I1.36690

Bhakta Dev Shrestha, Sunny Bajracharya, Samrat Shrestha, Manen Prasad Gorkahly

{"title":"Carotid Plaques Among Different Ethinic Patients with Ischemic Stroke","authors":"Bhakta Dev Shrestha, Sunny Bajracharya, Samrat Shrestha, Manen Prasad Gorkahly","doi":"10.3126/MEDPHOENIX.V6I1.36690","DOIUrl":"https://doi.org/10.3126/MEDPHOENIX.V6I1.36690","url":null,"abstract":"Introduction: Sonographic evaluation of the carotid artery is commonly used for risk assessment in stroke. In Nepal, there are few studies regarding morphological changes in the carotid artery including the percentage of stenosis, types of plaque, sites of plaque. These changes quite vary in relation to age, sex, and ethnicity, and other risk factors. The primary objective of the study was to find the prevalence of carotid plaques in different ethnic groups with ischemic stroke. \u0000Materials and Methods: The study was an observational, cross-sectional descriptive study conducted in the Neuromedicine department of the National Academy of Medical Sciences. The study included a consecutive sampling of the patients diagnosed with ischemic stroke admitted in the neuro/medicine ward or those visiting neuro/medicine OPD of Bir hospital. \u0000Results: Out of the 80 study patients,26.3% patients were Brahmans/Chhetri,11.3% were Madhesi,10 % were Dalits,25% were Newars and 27.5% were Janajati. In descending order, the presence of carotid plaque in Janajati (20%) was followed by Newars (18.8), Brahmans (17.5%), Madhesi group (8.8%), and Dalit (7.5%). The mean number of plaque was higher in Brahman/Chhetri group 3.33 with S.D 3.28 and lowest in Janajati group 2.20 with S.D 3.16. It was found that around 24% of the cases had unilateral carotid plaques and 49% had bilateral carotid plaques. Janajati group had a maximum proportion of bilateral plaques while Dalit had the least proportion (15% vs 2.5%). However, the difference among the ethnic groups was not significant. \u0000Conclusion: The prevalence of carotid plaques, the maximum number of plaques, and the number of bilateral plaques, all were highest in the Janajati group. However, the mean number of the carotid plaque was highest among the Dalit group. Further larger studies are required to study the association of the Nepalese ethnicity with carotid morphological changes.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127971045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Knowledge, Attitude and Practices of Pharmacovigilance among Doctors at a Tertiary Care Teaching Hospital Birgunj, Nepal 尼泊尔Birgunj三级护理教学医院医生药物警戒的知识、态度和实践

Med Phoenix Pub Date : 2021-07-19 DOI: 10.3126/MEDPHOENIX.V6I1.36681

Smita Singh, D. Sarraf, P. Singh, Pragati Poudyel

{"title":"Knowledge, Attitude and Practices of Pharmacovigilance among Doctors at a Tertiary Care Teaching Hospital Birgunj, Nepal","authors":"Smita Singh, D. Sarraf, P. Singh, Pragati Poudyel","doi":"10.3126/MEDPHOENIX.V6I1.36681","DOIUrl":"https://doi.org/10.3126/MEDPHOENIX.V6I1.36681","url":null,"abstract":"Introduction: Pharmacovigilance helps in the detection and prevention of adverse effects of drugs. For the effectiveness of this program, health care professionals should report adverse drug reactions (ADRs) considering it as their moral and professional obligation. The objective of the study was to assess the knowledge, attitude, and practices (KAP) of the doctors towards ADRs and pharmacovigilance in National Medical College Teaching Hospital (NMCTH), a tertiary care teaching hospital situated in the Narayani zone. \u0000Materials and Methods: A cross-sectional study was carried out using a self-administered questionnaire consisting of four parts; first part included a demographic profile of participants, the second part consisted of ten questions for the assessment of the knowledge about pharmacovigilance, third part comprised of six questions on attitude and fourth part consisted of five questions on practice. The results were depicted in the form of percentages for each KAPs questionnaire. \u0000Results: The response rate of participants was 85.16%. Pharmacovigilance was correctly defined by 52%. Department of drug administration was responsible for monitoring ADRs in Nepal was correctly given by 80%. Only 8% had reported ADRs, although 62% had encountered an ADR in their clinical practice. \u0000Conclusion: The doctors at NMCTH had a poor KAP towards pharmacovigilance and educational intervention is needed for the proper functioning of this program.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122981927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Establishment and Management Of COVID-19 Testing Molecular Laboratory in Minimal Resource Setting, Challenges and Issues Reported From Birgunj, Nepal – An Experience of Pathologist 在最小资源环境下建立和管理COVID-19检测分子实验室，尼泊尔Birgunj报告的挑战和问题-病理学家的经验

Med Phoenix Pub Date : 2021-07-19 DOI: 10.3126/MEDPHOENIX.V6I1.37037

N. Pathak, Madan Kumar Upadhyay, Varsha Manandhar

{"title":"Establishment and Management Of COVID-19 Testing Molecular Laboratory in Minimal Resource Setting, Challenges and Issues Reported From Birgunj, Nepal – An Experience of Pathologist","authors":"N. Pathak, Madan Kumar Upadhyay, Varsha Manandhar","doi":"10.3126/MEDPHOENIX.V6I1.37037","DOIUrl":"https://doi.org/10.3126/MEDPHOENIX.V6I1.37037","url":null,"abstract":"The Coronavirus pandemic is recording numerous deaths worldwide. The temporal distribution and burden of the disease varies from setting to setting based on economic status, demography and geographic location. Nepal reported the first COVID-19 case on January 23, 2020. A rapid increase in the number of COVID-19 cases was being reported in Nepal as of June 2020. Limited molecular laboratory capacity in resource limited settings is a challenge in the diagnosis of the ever-increasing cases and the overall management of the disease. In this article, we share the experience, challenges and prospects in the rapid establishment of COVID-19 testing laboratory in Birgunj from available resources. We provide empirical evidence from Parsa district, as this is one of the SARS-CoV-2 transmission hotspots in Nepal and it is likely generalizable to other similar settings in the country. The first step in establishing the COVID-19 molecular testing laboratory were i) identifying a suitable space ii) renovating it and iii) mobilizing materials including consumables, mainly from the hospital store and administration. A chain of experimental design was set up with distinct laboratories to standardize the extraction of samples, preparation of the master mix and detection. At the commencement of sample reception and testing, laboratory contamination was among the primary challenges faced. The source of the contamination was identified in the master mix room and resolved. In summary, the established COVID-19 testing lab (Narayani PCR Lab) has tested more than 40,000 samples (January 2021) and is now the preferred setting for CoVID-19 testing. The lessons learnt may benefit the further establishment of testing laboratories for COVID-19 and/or other epidemic/pandemic diseases in resource-limited settings.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116887760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends of Hospital Care Services During COVID-19 Pandemic in a Tertiary Care Hospital at Province 5 第五省某三级医院2019冠状病毒病大流行期间医院护理服务趋势分析

Med Phoenix Pub Date : 2021-07-19 DOI: 10.3126/MEDPHOENIX.V6I1.36626

B. Lamichhane

{"title":"Trends of Hospital Care Services During COVID-19 Pandemic in a Tertiary Care Hospital at Province 5","authors":"B. Lamichhane","doi":"10.3126/MEDPHOENIX.V6I1.36626","DOIUrl":"https://doi.org/10.3126/MEDPHOENIX.V6I1.36626","url":null,"abstract":"Introduction: Health systems all around the globe have greatly been affected by the increasing demand for care of people with COVID-19. A well-prepared health system should have the capacity to maintain equitable essential health services in any pandemic or emergency. In this current scenario, this study aims to study the trends of hospital care services in one of the remote tertiary hospitals of province 5. The aim of the study was to assess the trends of various important health services along with the onset of the COVID-19 pandemic. \u0000Methods: A cross-sectional study was conducted in which data of the number of OPD cases, emergency cases, inpatients, deliveries, number of surgeries (major and minor), and the number of USG services were collected. Data of seven months prior to the onset of pandemic (August 15th, 2019 to March 15th, 2020) were compared with data of seven months following the onset of the pandemic (March 16th to October 16th, 2020) were recorded, compared, and plotted. \u0000Results: In regard to inpatients, there was an increment of 47.57%, the number of emergency cases increment by 41.90%, and the number of delivery increments by 94.70% was detected compared to seven months’ data prior to the onset of the pandemic. On the other hand, a reduction in total OPD, total number of surgeries, and USG by 32.7 %, 13.04%, 5.26 % respectively were detected. Looking through the trend, there was a decline in the number of OPD visits, inpatient cases, and emergency cases initially for three months (March-May) following the onset of the pandemic but along with an upsurge of the COVID pandemic, there was a marked increase in these services. \u0000Conclusions: The depiction of such trends of seeking and use of health services in resource-limited tertiary centers during this pandemic reflects the need of strengthening the overall health system. It also emphasizes the importance of the need of addressing non-COVID services during a pandemic, which was greatly affected by COVID-19.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133803805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of Tamsulosin and Alfuzosin in Management of Distal Ureteral Stones 坦索罗辛与阿氟唑嗪治疗输尿管远端结石的疗效观察

Med Phoenix Pub Date : 2021-07-19 DOI: 10.3126/MEDPHOENIX.V6I1.36352

B. Piya, A. Bhattarai

{"title":"Efficacy of Tamsulosin and Alfuzosin in Management of Distal Ureteral Stones","authors":"B. Piya, A. Bhattarai","doi":"10.3126/MEDPHOENIX.V6I1.36352","DOIUrl":"https://doi.org/10.3126/MEDPHOENIX.V6I1.36352","url":null,"abstract":"Introduction: Urinary tract calculi are the most frequent condition in urology clinics worldwide. The overall prevalence is about 5 % and lower urinary tract stones account for 70% among them. Medical expulsive therapy has been used to treat distal ureteric stone as it reduces symptoms and facilitates stone expulsion. The aim of this study is to evaluate and compare the efficacy of tamsulosin and alfuzosin as medical therapy in ureteric stones. \u0000Materials and Methods: A total of 87 patients with distal ureteral stones of size ≤10 mm were randomly divided into 3 groups. Group A patients (n-30) received 0.4 mg of tamsulosin daily, group B patients (n-29) received 10 mg of alfuzosin daily and group C patients (n-28) received 75 mg of diclofenac sodium. Patients in all groups received diclofenac sodium for one week and then as required. Follow-up was done on a weekly basis for 4 weeks. The stone expulsion rate, time for stone expulsion, and side-effects were recorded in each group. \u0000Results: The mean stone size (5.66, 5.79, 5.67) mm and age (29.1, 30.31, 29.4) were comparable in each group. The stone expulsion rate was 83.3%, 79.3%, and 50% in groups A, B, and C respectively. It showed that both the study groups (Group A and Group B) were effective than the control group (p-value 0.006 and 0.02 respectively) but there was no difference between tamsulosin and alfuzosin (p-value 0.69). The duration of stone expulsion was 11.5 days, 11.8 days, and 17.3 days for Group A, B, and C respectively. The drugs related side effects reported by patients were mild and transient. \u0000Conclusion: The use of tamsulosin and alfuzosin for the medical treatment of ureteric stones proved to be safe and effective and neither did have any significant benefits over the other.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124584973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Coexistence of Stump Appendicitis and Ovarian Fibro-Thecoma in a Young Women with Recurrent Right Iliac Fossa Pain During Pregnancy; A Rare Case Report 年轻女性妊娠期复发性右髂窝疼痛并发残端阑尾炎和卵巢纤维-鞘膜瘤一例一例罕见病例报告

Med Phoenix Pub Date : 2021-07-19 DOI: 10.3126/MEDPHOENIX.V6I1.36639

S. Ansari

{"title":"Coexistence of Stump Appendicitis and Ovarian Fibro-Thecoma in a Young Women with Recurrent Right Iliac Fossa Pain During Pregnancy; A Rare Case Report","authors":"S. Ansari","doi":"10.3126/MEDPHOENIX.V6I1.36639","DOIUrl":"https://doi.org/10.3126/MEDPHOENIX.V6I1.36639","url":null,"abstract":"Ovarian Fibro-thecoma is a rare, benign, sex cord-stromal neoplasm, with a typically unilateral location in the ovary, characterized by mixed features of both fibroma and thecoma. Ovarian Fibro-thecoma is Uncommon tumor of gonadal stromal cell origin accounting for 3-4% of all ovarian tumors. We describe a rare case of Fibro-thecoma in a 27- year women with a history of recurrent right iliac fossa pain during pregnancy associated with fever and vomiting with previous history of laparotomy for appendicular abscess 10 years back. She presented to us during pregnancy with this complain for which she was managed conservatively. She did not maintain her follow up regularly at our hospital and visited again after delivery of her baby with a still birth outcome with a newly diagnosed complex bilateral ovarian cyst demonstrated on ultrasound and computed tomography showed inflammatory Right sided tubo-ovarian mass along with inflammatory thickening of ileum in right lower quadrant adjacent to right ovarian mass lesion. The patient underwent laparotomy for this with the removal of mass along with the removal of appendicular stump for appendicular stump appendicitis which was diagnosed intraoperatively. The finding from histopathological examination of the mass was consistent with the diagnosis of Fibro-thecoma.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125664465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Success Rate of Insertion and Postoperative Sore Throat: I-Gel Versus Laryngeal Mask Airway Classic 插入和术后喉咙痛的成功率:I-Gel与喉罩气道经典

Med Phoenix Pub Date : 2021-07-19 DOI: 10.3126/MEDPHOENIX.V6I1.34548

Prakriti Pokhrel, Prastab Parajuli

{"title":"Success Rate of Insertion and Postoperative Sore Throat: I-Gel Versus Laryngeal Mask Airway Classic","authors":"Prakriti Pokhrel, Prastab Parajuli","doi":"10.3126/MEDPHOENIX.V6I1.34548","DOIUrl":"https://doi.org/10.3126/MEDPHOENIX.V6I1.34548","url":null,"abstract":"Introduction: Supraglottic devices are a useful advent in airway management filling a gap between the facemask and tracheal tube in terms of both anatomical position and degree of invasiveness. Laryngeal mask airway classic (LMA-C) being first of its kind and I-gel is second generation non-inflatable supraglottic device. The objective of our study was to compare the two supraglottic devices, Laryngeal mask airway classic (LMA-C) and I-gel for a success rate of insertion and postoperative sore throat. \u0000 Materials and Methods: A total of 80 patients scheduled for elective surgical procedures were studied in a prospective, randomly assigned, comparative and interventional manner. Patients were randomly allocated into two groups with forty patients in each group. I-gel and LMA-C were used in Groups 1 and 2 respectively. After achieving adequate depth of anesthesia the supraglottic device of appropriate size was inserted. The success rate of insertion of the device was represented by the number of insertion attempts. In the postoperative ward within 24 hours after surgery patient was asked whether a sore throat was present. \u0000 Results: There was a statistically significant difference between the two supraglottic devices in terms of successful attempts of insertion (p-value 0.02).In group 1(I-gel)34 out of 40 patients had first attempt insertion success,6 patients in the second attempt, and no patient had third insertion attempt. In group 2 (LMA-C) first-time insertion success was in 14 patients, 23 patients in the second attempt, and 3 patients in the third attempt. The incidence of postoperative sore throat was higher in the LMA-C group than the I-gel group(17.5% vs 5% respectively) with a p-value of 0.154. \u0000 Conclusion: Compared to the laryngeal mask airway classic, I-gel was inserted with less number of attempts and had a lower incidence of postoperative sore throat.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125653905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Weird Way to Sustain a Near Fatal Neck Injury, A Case Report 一种奇怪的方式来维持近乎致命的颈部损伤，一份病例报告

Med Phoenix Pub Date : 2021-07-19 DOI: 10.3126/MEDPHOENIX.V6I1.36581

Amit Jha, T. Limbu, Sovit Jung Baral, Donjon Bahadur Lamichhane, Bibek Regmi

引用次数: 0

Medical Education and Telemedicine in the COVID-19 Pandemic COVID-19大流行中的医学教育和远程医疗

Med Phoenix Pub Date : 2021-07-19 DOI: 10.3126/MEDPHOENIX.V6I1.38261

V. Paudel

引用次数: 1