Journal of the Institute of Medicine最新文献_第4页

Preoperative Anxiety Assessment in Adult Patients Undergoing Elective Surgeries: A Cross-Sectional Observational Study 择期手术成年患者术前焦虑评估的横断面观察研究

Journal of the Institute of Medicine Pub Date : 2020-12-31 DOI: 10.3126/JIOM.V42I3.37572

Santosh Acharya, Renu Gurung, B. Parajuli

{"title":"Preoperative Anxiety Assessment in Adult Patients Undergoing Elective Surgeries: A Cross-Sectional Observational Study","authors":"Santosh Acharya, Renu Gurung, B. Parajuli","doi":"10.3126/JIOM.V42I3.37572","DOIUrl":"https://doi.org/10.3126/JIOM.V42I3.37572","url":null,"abstract":"Introduction Anxiety is the subjective unpleasant feeling of dread over something unlikely to happen. The incidence of preoperative anxiety ranges from 32% to 76.7%. We aimed to measure the preoperative anxiety level using Amsterdam Preoperative Anxiety and Information Scale questionnaire and clinical rating scale given by attending anesthesiologist / anesthesia residents. Methods It was cross-sectional observational study conducted in wards. We enrolled 110 adult patients planned for elective gynecological and gastrointestinal surgeries. After taking informed written consent, principal investigator interviewed the patient, one day prior to surgery in wards using a structured questionnaire of Amsterdam Preoperative Anxiety and Information Scale. Demographics characters were recorded. The attending anesthesia residents (blinded to patient response) performed preanesthetic assessment, provided their subjective rating about patient anxiety and need for information using Clinical Rating Scale. Results Out of 110 patient, 57(51.81%) were found to have higher anxiety level. Comparing the APAIS score with various factors, we found younger age, female gender, unemployed status, higher level of education, adverse events in previous surgery and higher grade of surgery was associated with higher anxiety score. Comparing APAIS with Clinical Rating Score, there was poor correlation. Conclusion The incidence of preoperative anxiety is high (51.81%) in adult patients undergoing elective surgery. During the preoperative anesthetic checkup, APAIS can be used as a screening tool. It provides relevant information on the presence of preoperative anxiety and need for information, which helps to achieve patient satisfaction and better outcome.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"18-22"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44829409","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: 3

Ectopic Thyroid Tissue in Submandibular Region in Pediatric Patient: A Case Report 儿童下颌下区异位甲状腺组织1例报告

Journal of the Institute of Medicine Pub Date : 2020-12-31 DOI: 10.3126/JIOM.V42I3.37604

Rashmita Bajracharya, H. Dutta

引用次数: 0

Admission Profile and Outcome of Patients in a Level III Intensive Care Unit: A Two-Year Comparative Study 三级重症监护病房患者入院概况和预后:一项为期两年的比较研究

Journal of the Institute of Medicine Pub Date : 2020-12-31 DOI: 10.3126/JIOM.V42I3.37582

S. Pathak, S. Acharya, P. Acharya, B. Bhattarai

{"title":"Admission Profile and Outcome of Patients in a Level III Intensive Care Unit: A Two-Year Comparative Study","authors":"S. Pathak, S. Acharya, P. Acharya, B. Bhattarai","doi":"10.3126/JIOM.V42I3.37582","DOIUrl":"https://doi.org/10.3126/JIOM.V42I3.37582","url":null,"abstract":"Introduction An Intensive Care Unit (ICU) is an area where critically ill patients are admitted and the highest level of care is provided with close intensive monitoring and management. Clinical audit is a must to measure indicators of the quality of care in ICU and benchmarking outcome. The main aim of the study was to evaluate the profile of patients admitted to ICU and assess their outcome of two consecutive years. Methods A single-institutional, descriptive cross-sectional study was conducted on all adult patients admitted to the ICU of Tribhuvan University Teaching Hospital, Kathmandu, between April 2018 and April 2020 (Baisakh 2075 to Chaitra 2076). Results With an average of 1.98 admissions per day, a total of 1447 patients were admitted to TUTH ICU over the period of two years. A male preponderance was noted with a male to female ratio of 1.19:1. Most of the patients admitted were neurosurgical cases 429 (29.6%). A total of 884 (61%) were shifted out of ICU in stable condition while the overall mortality was 458 (31.6%). Conclusion This study shows that there is a higher severity of illness at admission as well as a comparatively high mortality rate. More number of patients were male, of age group of 15-65 years, with medical and neurosurgical conditions. This study of profile and outcome of patients admitted in ICU can serve as a quality indicator as well as evidence on which planning and policymaking can be based upon in the future.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"52-56"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44501618","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

Patterns and Causality Assessment of Adverse Drug Reactions in Inpatients of a Tertiary Care Hospital, Nepal 尼泊尔一家三级医院住院患者药物不良反应的模式和因果关系评估

Journal of the Institute of Medicine Pub Date : 2020-12-31 DOI: 10.3126/JIOM.V42I3.37601

A. Mudvari, D. Yadav, R. Ghimire, Pravin Prasad

{"title":"Patterns and Causality Assessment of Adverse Drug Reactions in Inpatients of a Tertiary Care Hospital, Nepal","authors":"A. Mudvari, D. Yadav, R. Ghimire, Pravin Prasad","doi":"10.3126/JIOM.V42I3.37601","DOIUrl":"https://doi.org/10.3126/JIOM.V42I3.37601","url":null,"abstract":"Introduction Adverse drug reaction (ADR) is a leading cause of morbidity and mortality around the world. Causality assessment is done to establish relation of drug exposure with undesired clinical events. This study conducted in tertiary care hospital was undertaken to evaluate the patterns of ADR and causality assessment using Naranjo causality algorithm. \u0000MethodsData on suspected ADR cases were collected retrospectively from Medicine and Dermatology wards of Tribhuvan University Teaching Hospital, Kathmandu from April 2018 to April 2019. Naranjo causality assessment was performed. Statistical analysis was done using SPSS version 18. \u0000ResultsOf 34 suspected ADR, occurrence of ADR was more in females (18) as compared to males (16). Skin and integumentary system was the most common organ affected (35.29%). Pyrazinamide induced hepatitis was found to be the most common suspected ADR. Causality assessment was performed and ADRs were categorized as possible 17 (50%), probable 16 (47.06%) and definite 1 (2.94%). \u0000ConclusionThe patients are commonly admitted at the hospital due to suspected ADRs. Pyrazinamide induced hepatitis was the most common suspected ADR.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"97-101"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45643700","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

Learning to Live with COVID-19 in Nepal: A Unique Experience 在尼泊尔学习与COVID-19共存:一次独特的经历

Journal of the Institute of Medicine Pub Date : 2020-08-31 DOI: 10.3126/JIOM.V42I2.37477

Yogendra Pratap Singh

引用次数: 0

Early Outcome of Surgery in Pediatric Head Injury: Experience From a Tertiary Care Center in Eastern Nepal 尼泊尔东部一家三级医疗中心的儿童颅脑损伤手术早期结果

Journal of the Institute of Medicine Pub Date : 2020-08-31 DOI: 10.3126/JIOM.V42I2.37529

B. Khanal, P. Kafle, S. Singh, S. Yadav, Bishomber Neupane, Ipsa Shakya, D. Yadav

{"title":"Early Outcome of Surgery in Pediatric Head Injury: Experience From a Tertiary Care Center in Eastern Nepal","authors":"B. Khanal, P. Kafle, S. Singh, S. Yadav, Bishomber Neupane, Ipsa Shakya, D. Yadav","doi":"10.3126/JIOM.V42I2.37529","DOIUrl":"https://doi.org/10.3126/JIOM.V42I2.37529","url":null,"abstract":"Introduction Head injuries among the pediatric age group remain an unwelcomed source of morbidity and mortality resulting from falls, motor vehicle accidents, assaults, and child abuse. Early identification and management of traumatic brain injury (TBI) are crucial in halting the progress of the primary insult and preventing or reducing secondary brain injury. The present study aims to investigate the major cause of pediatric TBI and analyze the early outcome and serve as a reference study from a tertiary care center in eastern Nepal. Methods This is a prospective cohort study conducted in the Department of Pediatric Medicine and Neurosurgery from February 2018 to January 2020. All the pediatric head injury cases that were managed surgically in the center were included in the study. Presenting Glasgow coma scale (GCS) was correlated with the Glasgow outcome scale (GOS). Results The study population comprised of 65 patients fulfilling the study inclusion criteria. The mean age of the study population was 10.86±4.72 years, fall was the commonest mode of injury (52.3%), 50.8% had mild TBI, 43.1% had moderate TBI and 6.2% had severe TBI. Depressed skull fracture with underlying extradural hematoma (EDH) or contusion was the commonest pathological diagnosis seen in 30.8 % (20) cases. The mean duration of hospital stay was 2.6 days. The presenting GCS correlated well with the outcome. Conclusion This study concluded that the timely management of pediatric TBI can prevent grave prognosis and the patients presenting GCS and the pupillary reaction has strong correlation with the outcome.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"16-20"},"PeriodicalIF":0.0,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42540765","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

Clinical Profile of Patients Undergoing Temporary Transvenous Pacing in a Tertiary Cardiac Care Centre in Nepal 尼泊尔三级心脏护理中心临时经静脉起搏患者的临床概况

Journal of the Institute of Medicine Pub Date : 2020-08-31 DOI: 10.3126/JIOM.V42I2.37534

Manju Sharma, S. Jha, A. Sayami, R. Gajurel, C. Poudel, R. Khanal, S. Pathak, S. Thapa, S. Adhikari, V. Yadav

引用次数: 1

Relationship Between Ossicular Chain Erosion and Facial Canal Dehiscence in Chronic Otitis Media Squamous 慢性鳞状中耳炎听骨链糜烂与面神经管开裂的关系

Journal of the Institute of Medicine Pub Date : 2020-08-31 DOI: 10.3126/JIOM.V42I2.37524

B. Kharel, A. Shreepaili, Prashant kumar Tripathi, Y. Neupane, U. Gurung, R. Pradhananga, P. Rayamajhi, H. Bhattarai

引用次数: 0

Outcome of Elastic Stable Intramedullary Nail in Length Unstable Diaphyseal Femur Fractures in Children: A Case Series 弹性稳定髓内钉治疗儿童长度不稳定股骨骨干骨折的疗效:一个病例系列

Journal of the Institute of Medicine Pub Date : 2020-08-31 DOI: 10.3126/JIOM.V42I2.37531

P. S. Bhandari, S. Uprety

引用次数: 0

Initial Experience with Simple Oncoplastic Breast Conserving Surgery in Nepal: A Case Report 尼泊尔乳腺癌单纯保乳手术的初步经验：一例报告

Journal of the Institute of Medicine Pub Date : 2020-08-31 DOI: 10.3126/JIOM.V42I2.37549

Y. Singh, S. Khanal

引用次数: 0