Kathmandu University medical journal (KUMJ)
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When a woman in late pregnancy has cardiac arrest and resuscitation fails, should an attempt be made to deliver the baby by Caesarean section? Many obstetricians would hesitate to operate in these circumstances for fear of delivery a baby who survives but shows profound neurological handicap. Obstetricians need to have a clear view on whether and when to operate in such cases. Here we report two cases of PMCD.
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Kathmandu Univ Med J (KUMJ) · Jul 2007
Randomized Controlled Trial Comparative StudyBreathing comfort associated with different modes of ventilation: a comparative study in non-intubated healthy Nepalese volunteers.
To compare subjective experience of comfort associated with various commonly used supportive modes of mechanical ventilation for weaning in the intensive care unit (ICU). ⋯ Perception of breathing comfort can vary widely with various supportive modes of ventilation in the ICU. Hence, no single supportive mode should be used in all patients during weaning from mechanical ventilation. Key words: assisted spontaneous breathing; biphasic positive airway pressure; breathing comfort; continuous positive airway pressure; mechanical ventilation; supportive modes synchronized intermittent mandatory ventilation; weaning.
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Kathmandu Univ Med J (KUMJ) · Jul 2007
Randomized Controlled Trial Comparative StudyComparative study of esmolol and labetalol to attenuate haemodynamic responses after electroconvulsive therapy.
The study was designed to evaluate the hemodynamic effects of Esmolol and labetalol in patients undergoing electroconvulsive therapy. ⋯ It was concluded that Esmolol is effective in blunting the hemodynamic response after ECT stimulus in the first three minutes after application of the electrical current, whereas Labetalol is effective after five minutes onwards till ten minutes.
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Kathmandu Univ Med J (KUMJ) · Jul 2007
Case Reports Randomized Controlled TrialDo we have to hyperventilate during laparoscopic surgery?
The purpose of this study was to assess the effects of hyperventilation on patients undergoing laparoscopic surgeries on haemodynamics, partial pressure of carbon dioxide and acid base status. ⋯ 10-15% increment in Minute Volume is beneficial during C02 pneumoperitoneum to prevent adverse effects of hypercarbia and acidosis.
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Penetrating neck wounds are potentially dangerous and require emergency management because of the presence of vital structures in the neck. Organic foreign bodies further carries a risk of wound infection. We present a case of penetrating broken branch of a tree traversing from zone II to zone III without any neurovascular injury. Neck exploration was done with midline mandibulotomy approach and foreign body was removed without any complication.