Kathmandu University medical journal (KUMJ)
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Kathmandu Univ Med J (KUMJ) · Jul 2007
Evaluation of septic complications in patients undergoing biliary surgery for gall stones in a tertiary care teaching hospital of South India.
One of the etiologies of formation of gall stones is infection and bile is a good media for microorganisms to grow. Acute cholecystitis and spillage of bile intraoperatively can lead to sepsis and postoperative complications. An attempt to study the nature of organisms and their antibiotic sensitivity is important to take appropriate steps. ⋯ The overall rate of septic complications following biliary surgery was extremely low. Present study does not show any correlation between infected bile and septic complications that is in accordance with the published literature. Present study also highlights the fact that good surgical techniques and judicious use of prophylactic antibiotics are two major factors for lower incidence of septic complications, if any, after biliary tract surgery.
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Kathmandu Univ Med J (KUMJ) · Apr 2007
Case ReportsTopiramate induced bilateral angle-closure glaucoma.
Topiramate is a sulfamate-substituted monosaccharide and is used as an antiepileptic medication. It can also be used as a prophylactic agent for headache from migraine. ⋯ This is the first reported case of topiramate induced bilateral angle-closure glaucoma in Nepal. This case was managed successfully by discontinuing topiramate and by starting anti-glaucoma medication along with atropine eye drops which were tapered and eventually discontinued.
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Kathmandu Univ Med J (KUMJ) · Apr 2007
Comparative StudyComparative study between bupivacaine heavy vs pethidine intrathecally to study early haemodynamic changes and postoperative analgesia in patients undergoing caesarean section.
To study early hemodynamic changes and duration of postoperative analgesia between two study groups of intrathecal pethidine and bupivacaine heavy in patients undergoing caesarean section. ⋯ The hemodynamic parameters (HR & BP) were compared in different time intervals. The difference in heart rate and blood pressure at different time intervals in the two study groups were statistically insignificant as (p > 0.05). The total duration of postoperative analgesia in patients receiving sole intrathecal pethidine was 8 hours and 30 minutes. Where as, in Bupivacaine group the duration was 2 hrs and 36 minutes. This has been found statistically significant (p<0.05).
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Kathmandu Univ Med J (KUMJ) · Apr 2007
Case ReportsSitus inversus with dextrocardia with multiple cardiac lesions in adult.
Situs inversus with dextrocardia is the malposition most likely to occur with structurally normal heart; generally discovered on routine chest x-ray or physical examination performed for other reasons. These persons experience normal longevity of life and have similar risk of getting acquired disease as that of other person of same age and sex group. ⋯ Incidence of congenital cardiac anomalies in dextrocardia with situs inversus is very low globally but its figure in Nepal is not known. We report an adult of 43 years age having situs inversus with dextrocardia associated with multiple cardiac lesions i.e. ventricular septal defect, aortic regurgitation, mitral regurgitation and tricuspid regurgitation.
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The present study was undertaken to study the frequency of electrolyte imbalance in children with diarrhoea and the relationship between electrolyte abnormalities and mortality. ⋯ Hyponatremia, hypokalemia and metabolic acidosis are common electrolyte and acid-base abnormalities in children with diarrhoea and dehydration and often responsible for mortality.