Kathmandu University medical journal (KUMJ)
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Kathmandu Univ Med J (KUMJ) · Jan 2015
Undertreated Hypertension and its Implications for Public Health in Nepal: Nationwide Population-Based Survey.
Hypertension (HTN), a major risk factor for cardiovascular diseases (CVDs), is a substantial global public health problem. Occasional studies indicate a high prevalence of HTN in the Nepalese population, but no nationwide population-based data exist so far. We opportunistically used a survey of major disorders of the brain in Nepal to measure blood pressure (BP) in participants selected randomly from the adult general population. ⋯ In the context of the survey we could not collect data on antihypertensive therapy being taken but, clearly, whatever this might have been, it was failing to meet treatment needs. Almost one in six adults met criteria for hypertension, carrying risk implications for CVDs and their substantial public-health consequences. Two remediable associated factors were identified, although in a cross-sectional survey we could not prove causation.
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Kathmandu Univ Med J (KUMJ) · Jan 2015
ReviewPoint-of-care Ultrasonography in Critically Ill Patients.
Point-of-care ultrasonography has been used frequently by the physicians involved in managing critically ill patients. It allows direct visualization of pathology or abnormal physiological state at the bed side. ⋯ It is helpful to guide the therapy in patients with undifferentiated shock and for bedside diagnosis of common pathological conditions in acute care setting. It can facilitate common bedside procedures and interventions.
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Kathmandu Univ Med J (KUMJ) · Jan 2015
Case ReportsAnesthetic Management of a Patient with Myasthenia Gravis for Meningioma Surgery - A Case Report.
Myasthenia gravis is a disease of great challenge to the anesthesiologist, because it affects the neuromuscular junction. Anesthetic management involves either muscle relaxant or non-muscle relaxant techniques. This case report documents the safe use of fentanyl, propofol and sevoflurane combination guided by bispectral index, without the use of muscle relaxants in a patient with myasthenia gravis who presented for meningioma surgery.
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Kathmandu Univ Med J (KUMJ) · Jan 2015
Case ReportsCommunity-Acquired Methicillin Resistant Staphylococcus aureus Bacteremia: Case Series.
Community-acquired methicillin resistant Staphylococcus aureus (MRSA) usually causes skin and soft tissue infections. However, community-acquired methicillin resistant S.aureus has been identified as a causative agent of many invasive infections like necrotizing fasciitis, pneumonia and bacteremia. Risk factors such as immunodeficiency and skin and soft tissue infections have been identified for acquiring bacteremia. We present four cases of bacteremia caused by community-acquired methicillin resistant S.aureus, risk factors and outcome.
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Kathmandu Univ Med J (KUMJ) · Jan 2015
Percutaneous Ilio-Sacral Screw Fixation in Supine Position under Fluoroscopy Guidance.
Pelvic ring disruption when treated conservatively can be associated with prolonged hospital stay and immobilization, mal-union, chronic pain, limb length discrepancy if they are treated conservatively. Open reduction and fixation in an already compromised soft tissue and hemodynamically unstable patient causes more soft tissue injury, heamatoma, infection and neurovascular injury. Percutaneous iliosacral joint fixation can be an alternative technique for sacro-iliac joint injury and sacral fracture. ⋯ Percutaneous ilio-sacral screw fixation for sacro-iliac joint injury and sacral fracture with C arm guidance is safe and minimally invasive technique. Clear images and accurate interpretation of X-rays, CT scans and per operative C arm images are important to avoid malpositioning of screws and iatrogenic neurovascular injuries.