Kathmandu University medical journal (KUMJ)
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Kathmandu Univ Med J (KUMJ) · Oct 2012
Randomized Controlled TrialPreemptive use of small dose fentanyl suppresses fentanyl induced cough.
Fentanyl, a synthetic opioid, is a popular choice amongst anaesthesiologists in the operating room. Pre induction intravenous fentanyl bolus is associated with coughing in 28-65% of patients. Fentanyl induced cough is not always benign and can be remarkably troublesome at the most critical moment of anaesthesia when airway reflex is lost. ⋯ Pre-emptive use of minimal dose fentanyl 25 μg administered one minute before a larger bolus dose of fentanyl (125 or 150 μg) can effectively suppress cough.
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Kathmandu Univ Med J (KUMJ) · Oct 2012
Intrauterine foetal death and its probable causes: two years experience in Dhulikhel Hospital-Kathmandu University Hospital.
World health Organization definition of intrauterine foetal demise encompasses any abortion or fetal demise prior to expulsion from its mother, and recommends different protocols according to gestational age. However, conventionally and also in our institution, foetal demise prior to 28 weeks of gestation is managed as abortion in a manner different from foetal demise post 28 weeks of gestation. ⋯ While comparing the subject with the theme of the national conference of Nepal Society of Obstetricians and Gynaecologist, most of the cases were mother not receiving antenatal care or those receiving antenatal care in the periphery, There is no denying that there would be a massive improvement in women's health if the co-ordination between the peripheral health care center and tertiary care center was to be improved.
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On 2011, Cluster of cholera cases was reported in the Tilathi VDC of Saptari, Nepal. ⋯ Vibrio cholerae was the causative agent behind the outbreak and probable source of infection was the problematic pond water which they used for different purpose. Immediate chlorination of the pond was recommended to halt further spread of the epidemics.
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Poisoning is one of the leading causes of morbidity and mortality in Nepal and also a major public health problem worldwide. A thorough review of the risk factors helps to decrease the incidence and mortality. The study evaluates the cases admitted in Dhulikhel Hospital, Kavre, Various parameters like age, sex, marital status, time of ingestion, month of occurrence, agent responsible for incidence; type of poisoning, psychosocial problem, outcome and duration of treatment are analyzed. ⋯ Based on these findings preventive measures like precaution taken at various levels, restriction in free sale of the poisons and promoting Poison Information Centers along with public awareness and proper psychosocial management to decrease the incidence and mortality in poisoning cases can be suggested.